[Pharmwaste] pharmaceutical sources

grace.chen@deancare.com grace.chen@deancare.com
Wed, 1 Jun 2005 11:15:13 -0500


Good morning,

I too have not found any such studies.  However, I can say that county in
Indiana collected around 500 lbs. of meds in two days.  The population in
2004 was just under 200,000 in the county.  The latest estimate for the US
population is just under 300 million people.  Based on these numbers, there
would be roughly 750,000 lbs. of meds removed from the sewer annually.    I
believe that with each subsequent collection, they collected more meds too.

Grace Chen, Pharm.D.
Drug Information Pharmacist
Dean Business Office
1808 W. Beltline Highway
Madison, WI 53713
(608) 250-1198
grace.chen@deancare.com


                                                                                                                                 
                    <gressitt@uninets.net>                                                                                       
                    Sent by:                           To:     John Solvie <JSolvie@LasVegasNevada.GOV>,                         
                    pharmwaste-admin@lists.dep.s        "'pharmwaste@lists.dep.state.fl.us'" <pharmwaste@lists.dep.state.fl.us>  
                    tate.fl.us                         cc:                                                                       
                                                       Subject:     Re: [Pharmwaste] pharmaceutical sources                      
                                                                                                                                 
                    06/01/2005 10:04 AM                                                                                          
                                                                                                                                 
                                                                                                                                 




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>
>

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