[Pharmwaste] FW: Regarding flushing of pharmaceuticals in households...

Wed, 20 Jul 2005 21:52:14 -0400

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This process would ensure that no assessment of waste, patient compliance,
pharmacoeconomic policy projections, or sources of payment for potential for
identification of unidentified counterfeit medication would occur. Quite
successfully. No ability to determine whether one drug of a class has a
lower compliance or patient dissatisfaction rate than another, and no
ability to use non-compliance to address side effects or public health
educational campaigns. From Hush and Flush, the process will become Hush and
Hide. 

This will take the entire unused medication issue and hide it. What is
needed is a godd assessment of policies that ever urge greater access,
greater price control and work toward more profligate prescribing regardless
of use rates. With 60% of the population non-compliant with medications now,
we will hide that and continue the process. Smarter prescribing, less waste
at the front ned should be the goal and that will entail using numbers to
educate prescribers, insurance companies, and perhaps manufacturers.
Certainly policies as currently followed have led us to this situation where
the problem exists, but hiding it will not solve it and frankly will
contribute to the old policies continuing to churn out more and more waste.

Do I have an answer for all the problems, no, but setting in motion a public
education campaign that starts a process of sweeping the problem into the
landfill which may or may not leak today tomorrow or the next is not one I
would think has universal support. I continue to hear incineration as the
preferred method for pharmaceutical destruction, diversion control, or
simple inactivation of ingredients. 

If 60% of patient can't follow the instruction such as "Take one a day"
accurately, I also fear that the steps involved will simply not be met by
the majority of the public. Or that is how I read the evidence.

Once a public has the attached message in their "daily exposure" then when a
better system or systems, which I do believe is ahead of us, is found the
whole educational process will need to start up again and  redirect a public
starting down one path. It is not a process that engenders trust as the
medical community can vouch for given the history of say Thalidomide, or
more recently Vioxx.

Just some thoughts.

Stevan Gressitt, M.D.

  _____  

From: pharmwaste-admin@lists.dep.state.fl.us
[mailto:pharmwaste-admin@lists.dep.state.fl.us] On Behalf Of Tenace, Laurie
Sent: Monday, July 18, 2005 9:10 AM
To: pharmwaste@lists.dep.state.fl.us
Subject: [Pharmwaste] FW: Regarding flushing of pharmaceuticals in
households...

Minnesota is always on top of things - 

  _____  

From: pharmwaste-owner@lists.dep.state.fl.us
[mailto:pharmwaste-owner@lists.dep.state.fl.us] On Behalf Of Walter, Rebecca
Sent: Friday, July 15, 2005 4:48 PM
To: pharmwaste-owner@lists.dep.state.fl.us
Subject: Regarding flushing of pharmaceuticals in households...

Here is a flyer that the Office of Environmental Assistance (OEA) in
Minnesota developed to educate citizens how to dispose of their unwanted
pharmaceuticals.  The OEA is currently working on printing copies to
distribute state wide. 

http://www.moea.state.mn.us/hhw/pharmaceuticals.cfm 

Rebecca Walter, PCS 
Minnesota Pollution Control Agency 
(651) 296-3552 

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<div class=3DSection1>

This process would ensure that no
assessment of waste, patient compliance, pharmacoeconomic policy =
projections,
or sources of payment for potential for identification of unidentified
counterfeit medication would occur. Quite successfully. No ability to =
determine
whether one drug of a class has a lower compliance or patient =
dissatisfaction
rate than another, and no ability to use non-compliance to address side =
effects
or public health educational campaigns. From Hush and Flush, the process =
will
become Hush and Hide. <o:p></o:p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

This will take the entire unused
medication issue and hide it. What is needed is a godd assessment of =
policies
that ever urge greater access, greater price control and work toward =
more
profligate prescribing regardless of use rates. With 60% of the =
population
non-compliant with medications now, we will hide that and continue the =
process.
Smarter prescribing, less waste at the front ned should be the goal and =
that
will entail using numbers to educate prescribers, insurance companies, =
and
perhaps manufacturers. Certainly policies as currently followed have led =
us to
this situation where the problem exists, but hiding it will not solve it =
and
frankly will contribute to the old policies continuing to churn out more =
and
more waste.<o:p></o:p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

Do I have an answer for all the =
problems,
no, but setting in motion a public education campaign that starts a =
process of
sweeping the problem into the landfill which may or may not leak today =
tomorrow
or the next is not one I would think has universal support. I continue =
to hear
incineration as the preferred method for pharmaceutical destruction, =
diversion
control, or simple inactivation of ingredients. =
<o:p></o:p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

If 60% of patient can&#8217;t =
follow the instruction
such as &#8220;Take one a day&#8221; accurately, I also fear that the =
steps
involved will simply not be met by the majority of the public. Or that =
is how I
read the evidence.<o:p></o:p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

Once a public has the attached =
message in their
&#8220;daily exposure&#8221; then when a better system or systems, which =
I do
believe is ahead of us, is found the whole educational process will need =
to
start up again and &nbsp;redirect a public starting down one path. It is =
not a
process that engenders trust as the medical community can vouch for =
given the
history of say Thalidomide, or more recently =
Vioxx.<o:p></o:p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'>Just some =
thoughts.<o:p></o:p></span></font></p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'>Stevan Gressitt, =
M.D.<o:p></o:p></span></font></p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'>&nbsp;&nbsp;<o:p></o:p></span></font=
></p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'><o:p>&nbsp;</o:p></span></font></p>

<div>

<div class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><font =
size=3D3
face=3D"Times New Roman"><span style=3D'font-size:12.0pt'>

<hr size=3D2 width=3D"100%" align=3Dcenter tabindex=3D-1>

</span></font></div>

<p class=3DMsoNormal><b><font size=3D2 face=3DTahoma><span =
style=3D'font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font =
size=3D2
face=3DTahoma><span style=3D'font-size:10.0pt;font-family:Tahoma'> =
pharmwaste-admin@lists.dep.state.fl.us
[mailto:pharmwaste-admin@lists.dep.state.fl.us] <b><span =
style=3D'font-weight:
bold'>On Behalf Of </span></b>Tenace, Laurie<br>
<b><span style=3D'font-weight:bold'>Sent:</span></b> Monday, July 18, =
2005 9:10
AM<br>
<b><span style=3D'font-weight:bold'>To:</span></b>
pharmwaste@lists.dep.state.fl.us<br>
<b><span style=3D'font-weight:bold'>Subject:</span></b> [Pharmwaste] FW:
Regarding flushing of pharmaceuticals in =
households...</span></font><o:p></o:p></p>

</div>

<p class=3DMsoNormal><font size=3D3 face=3D"Times New Roman"><span =
style=3D'font-size:
12.0pt'><o:p>&nbsp;</o:p></span></font></p>

<p class=3DMsoNormal><font size=3D2 color=3Dnavy face=3DArial><span =
style=3D'font-size:
10.0pt;font-family:Arial;color:navy'>&nbsp;</span></font><o:p></o:p></p>

<div>

<p class=3DMsoNormal><st1:State w:st=3D"on"><st1:place w:st=3D"on"><font =
size=3D2
  color=3Dnavy face=3DArial><span =
style=3D'font-size:10.0pt;font-family:Arial;
  color:navy'>Minnesota</span></font></st1:place></st1:State><font =
size=3D2
color=3Dnavy face=3DArial><span =
style=3D'font-size:10.0pt;font-family:Arial;
color:navy'> is always on top of things -</span></font><font =
color=3Dnavy><span
style=3D'color:navy'>&nbsp;</span></font><o:p></o:p></p>

<p class=3DMsoNormal><font size=3D3 color=3Dnavy face=3D"Times New =
Roman"><span
style=3D'font-size:12.0pt;color:navy'>&nbsp;</span></font><o:p></o:p></p>=

</div>

<div>

<div class=3DMsoNormal align=3Dcenter style=3D'text-align:center'><font =
size=3D3
face=3D"Times New Roman"><span style=3D'font-size:12.0pt'>

<hr size=3D3 width=3D"100%" align=3Dcenter tabindex=3D-1>

</span></font></div>

<p class=3DMsoNormal><b><font size=3D2 face=3DTahoma><span =
style=3D'font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font =
size=3D2
face=3DTahoma><span style=3D'font-size:10.0pt;font-family:Tahoma'> =
pharmwaste-owner@lists.dep.state.fl.us
[mailto:pharmwaste-owner@lists.dep.state.fl.us] <b><span =
style=3D'font-weight:
bold'>On Behalf Of </span></b>Walter, Rebecca<br>
<b><span style=3D'font-weight:bold'>Sent:</span></b> Friday, July 15, =
2005 4:48
PM<br>
<b><span style=3D'font-weight:bold'>To:</span></b>
pharmwaste-owner@lists.dep.state.fl.us<br>
<b><span style=3D'font-weight:bold'>Subject:</span></b> Regarding =
flushing of
pharmaceuticals in households...</span></font><o:p></o:p></p>

</div>

<p class=3DMsoNormal><font size=3D3 face=3D"Times New Roman"><span =
style=3D'font-size:
12.0pt'>&nbsp;<o:p></o:p></span></font></p>

Here is a
flyer that the Office of Environmental Assistance (OEA) in <st1:State =
w:st=3D"on"><st1:place
 w:st=3D"on">Minnesota</st1:place></st1:State> developed to educate =
citizens how
to dispose of their unwanted pharmaceuticals.&nbsp; The OEA is currently
working on printing copies to distribute state wide. =
<o:p></o:p>

<p><font size=3D3 face=3D"Times New Roman"><span =
style=3D'font-size:12.0pt'><a
href=3D"http://www.moea.state.mn.us/hhw/pharmaceuticals.cfm">http://www.m=
oea.state.mn.us/hhw/pharmaceuticals.cfm</a>
<o:p></o:p></span></font></p>

<p><font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt;font-family:Arial'>Rebecca
Walter, PCS</span></font> <br>
<font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt;font-family:Arial'>Minnesota
Pollution Control Agency</span></font> <br>
<font size=3D2 face=3DArial><span =
style=3D'font-size:10.0pt;font-family:Arial'>(651)
296-3552 </span></font><o:p></o:p></p>

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