[Pharmwaste] pharmaceutical sources

[gressitt@uninets.net]

John, This is a question that I am sure many have looked
for the answer to and had the same grest success. Ther have
been some numbers I recall 3% from a rather remarkably poor
source that got some publicity at one point but it doesn't
hold up. New Drug Applications require an assessment of
metabolic process including excretion. These numbers can be
found in many Prescribing Information Sheets. Virtually
every drug has a different metabolic process, excretion
rate, and cascade of bio-active metabolites that also
complicates the picture.

Could I suggest that there may be another way to indirectly
approach this question? Pharmaceutical complince rates
amongst patients runs 30-60% depending on the study and
actually can be lower and higher given the setting.
Therefore 70-40% of prescriptions written are not used.
Rate of non-fill and non-refill cut into this and you are
left with what is filled but not taken. That number is what
will be available for "hush and flush." Of course there
remains the problem of what agents in what proportion are
to be then disposed. 

I'm curious about your thoughts on this approach.
Stevan Gressitt, M.D.  

On Wed, 1 Jun 2005 07:19:29 -0700
 John Solvie <JSolvie@LasVegasNevada.GOV> wrote:
> Does anyone know of any studies that have attempted to
> estimate the
> percentage of pharmaceuticals in aquatic environments
> caused by flushing
> unused medications down the toilet versus unmetabolized
> pharmaceuticals that
> pass through the body?  In other words, if the public no
> longer disposed of
> any unused medications in the sewer, what would be the
> estimated percentage
> reduction of pharmaceuticals in aquatic environments?
>  
> We have discussed this subject at length and cannot
> locate any empirical
> findings.  Any input you can provide would be greatly
> appreciated.
>  
> John Solvie
> City of Las Vegas
> Industrial Waste Section
> (702) 229-6547
> JSolvie@LasVegasNevada.gov
> <mailto:JSolvie@LasVegasNevada.gov> 
>