[Pharmwaste] Drug collection information

[Bickford, Barbara J.]

> On 11/14, Wendi Shafir forwarded to this list serv a request from
> Donna Twickler, EPA Region 5, in the form of Donna's email to me.
> Here is what I sent to Donna with one small addition (Donna, that is
> EPA's website on pharmaceuticals and the environment).  If anyone else
> responded to Donna, I invite you to post your response here also.
> 
Barb Bickford, Medical Waste Coordinator
WI Dept. of Natural Resources, Bureau of Waste Management
101 S. Webster St.,  P.O. Box 7921,  Madison, WI   53707-7921
Phone:   608-267-3548                          FAX:  608-267-2768
barbara.bickford at dnr.state.wi.us OR medical.waste at dnr.state.wi.us
DNR medical waste information:  www.dnr.wi.gov/org/aw/wm/medinf/
Hospitals for a Healthy Environment:   www.h2e-online.org

> ______________________________________________ 
> From: 	Bickford, Barbara J.  
> Sent:	Thursday, November 10, 2005 4:33 PM
> To:	'Twickler.Donna at epamail.epa.gov'
> Subject:	Drug collection information
> 
> Donna, my answers are indented below.
> 
> Hi Barb,
> 
> USEPA Region 5 was approached by CDC to participate in a
> pharmaceutical collection program with them (and FDA) in Michigan.
> The focus of their collection is antibiotics, however they will accept
> other solid pharmaceuticals that are not considered controlled
> substances.
> Apparently this is the first time CDC has done this, so they are
> looking for information and support.  I mentioned Wisconsin has a
> pharmaceutical collection in Madison scheduled this Fall.  CDC has
> contacts in Madison, so they are very interested in the specifics of
> the Madison collection event.  I was wondering whether you could
> provide me with some specific information on the collection, which I
> can share with CDC?
> 
> 	The collection will be April 29, 2006, not this fall.  Contact: 
> 	Grace Welham, Pharm.D.
> 	Drug Information Pharmacist
> 	Dean Health System
> 	(608) 250-1198
> 	grace.welham at deancare.com
> 
> The proposed Michigan collections would involve secure drop off
> containers/totes located at Meijer stores throughout Michigan, for a 3
> month period.   It's unclear whether these containers would be
> situated in the customer area near the pharmacy or behind the counter.
> They will be somehow monitored by the pharmacy staff.
> 
> The first question CDC asked is whether USEPA has any containers for
> depositing the pharmaceutical bottles in the container, but would
> prevent access to the drugs after they had been deposited.  An example
> is a mailbox type container, either attached to a wall or free
> standing that is secured.   USEPA Region 5 does not have this type of
> container
> nor the ability to purchase them.  Along these lines I was wondering
> what type of containers Wisconsin used/will use for their one day
> collection.  Are you aware of containers that meet the above
> description in the healthcare setting that could possibly be borrowed
> for the duration of the project?  I saw a medical waste contaier in
> the Federal Occupational Health office today, when I received a flu
> shot.   It was designed like a mailbox, however it was smaller than
> would be needed for pharmaceutical collections.   The nurse thought
> there were larger containers of the same design available for
> purchase.
> 
> 	I don't know what containers Dean Health Systems intends to use.
> I suppose they will receive them, sort out the controlled substances,
> sharps, mercury thermometers, and aerosals and put the remainder
> directly into DOT compliant shipping containers.
> 
> 
> The question I have is whether theMichigan project group had
> coordinated with U.S. Drug Enforcement Agency to date.  I know you
> have received guidance from their DC HQ DEA office.  I am not sure
> that the only thing that the project team has to do is say "no
> controlled substances will be collected".  Do individuals always know
> whether their perscription is a controlled substance?  Does it matter
> whether or not the individual deposits the drug directly into the
> container or the pharmacy staff deposits it.  How are containers
> typically secured?   I know that the DEA issues drive most programs to
> have 1 day pharm collection events, due to the fact that a law
> enforcement official has to be present during the collection.
> 
> 	I don't know if prescriptions must be labelled as controlled
> substances.  Even if they are, you cannot guarantee that CSs won't be
> brought in.  Charlotte Smith told us last week that about 10% of
> prescriptions are CS's, which is a lot, and for painkillers (as are
> used after oral surgery) there are often unused Rx's out there in
> medicine cabinets.
> 
> 	I haven't heard anything to suggest that the person must deposit
> the drug vs the collector.  I have heard of that for sharps, if the
> collector touches the container, they must have bloodborne pathogen
> training and have been offered the shots.  This is really more of an
> OSHA issue, and maybe you should ask them.  
> 
> 	Again, I don't know much about the containers or how they are
> secured.
> 
> 
> Also, could you provide me with the name of the person at DEA you with
> whom you have been coordinating?   I would like to contact them
> directly, to ask them if they would like to or feel they need to
> participate on the work group.  I would also like to ask whether they
> have secure containers that could be borrowed for the 3 month duration
> of the project.  It is estimated that approximately 190 containers
> would be needed.
> 
> 	I'll try to forward the letter Grace got from DEA. [I did, and
> Grace had posted it to this listserve in mid-September] 
> 	Charlotte Smith was at a meeting sometime recently where a DEA
> person said DEA may have to change its rules to accommodate drug
> collections.  DEA is aware that their rules present a road block and
> force people to flush/landfill contrulled substances, and that that is
> not good for the environment.  
> 
> CDC decided to use Phamlink (sp) for disposal.  I don't know anything
> about this company, but according to CDC they meet all applicable
> disposal regulations (including EPAs).   What company are you using
> for
> disposal?
> 
> 	I am not sure but I think they are using Onyx.
> 
> The last question I have is whether Wisconsin has information on the
> environmental hazards associated with the improper disposal of
> pharmaceuticals.   We are checking with our headquarters office to
> determine if there is any EPA information on this available for
> distibution.
> 
> 	Nothing specific from us.  USGS has done some studies linking
> the presence of some compounds with problems in aquatic life.   EPA
> information on the environmental hazards associated with the improper
> disposal of pharmaceuticals is available at
> www.epa.gov/nerlesd1/chemistry/pharma/index.htm. 
> 
> Any information you could provide would be greatly appreciated.
> 
> Thanks!
> 
> Donna
> 
> 
-------------- next part --------------
An HTML attachment was scrubbed...
URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20051116/ae46e810/attachment-0001.html