[Pharmwaste] Percentage of waste drugs from unwanted consumer meds

Sun Jan 22 19:35:36 EST 2006

With the reorganization of the Maine Benzodiazepine Study Group there is now
an academic base in the US as well as the link to the Memorial University in
Newfoundland. Are there other colleges or students that might care to form a
collaborative here? I believe we can coordinate. Stevan Gressitt, M.D. 

  _____  

From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Tenace,
Laurie
Sent: Monday, November 14, 2005 9:41 AM
To: pharmwaste at lists.dep.state.fl.us
Subject: RE: [Pharmwaste] Percentage of waste drugs from unwanted consumer
meds

This sounds like a great project for a college student. In fact, it would be
great for students from various states - 

Laurie 

  _____  

From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Galvin, Dave
Sent: Friday, November 11, 2005 1:59 PM
To: 'Charlotte A. Smith'; pharmwaste at lists.dep.state.fl.us
Cc: Stevan Gressitt; Gilliam, Allen
Subject: RE: [Pharmwaste] Percentage of waste drugs from unwanted consumer
meds

Charlotte et al. --  This is one of the key unanswered questions of the
moment.  I am aware of only two published studies that try to assess what
people do with old/unused medications, both via surveys.  Neither directly
answers the question, but both at least give a glimmer of what avenue people
use for disposal, and the more recent study also attempts to proportion out
use vs. disposal avenues.

A ten-year-old study from Pittsburg (I have only seen references to it, have
not tracked down the original article), appears to be the only American data
published:  Kuspis, D.A., and E.P. Krenzelok.  1996.  "What happens to
expired medications?  A survey of community medication disposal."  Vet.
Human Toxicol.  38: 48-49.  The survey found that 54 percent of people
dispose of unused medications in the solid waste, 35 percent via the sink or
toilet, and only 1 percent by returning them to pharmacies (as summarized in
the following source).

In the December, 2005, issue of Environmental Health Perspectives (available
on-line earlier), a new British study gives us the most useful look at this
issue:  Bound, J.P., and N. Voulvoulis.  2005.  "Household disposal of
pharmaceuticals as a pathway for aquatic contamination in the United
Kingdom."  Environmental Health Perspectives 113 (12): 1705-1711
(accessible at: http://ehp.niehs.nih.gov/members/2005/8315/8315.pdf ).  This
survey of residents in southeast England found that, on average, half do not
finish prescription medications and thus end up with waste medications to
dispose.  While 80 percent of pain meds are typically used up, only 18
percent of antibiotics are used as prescribed, leaving 82 percent as waste.
Roughly half of beta-blockers and anti-depressants go unused.  Overall,
British residents dispose of 63 percent of used meds in the solid waste, 11
percent in the toilet, and bring 22 percent back to pharmacies.  The authors
present a very useful conceptual model for quantifying the pathways of
pharmaceuticals from domestic use into the environment.  They conclude,
"...disposal of unused pharmaceuticals either by household waste or via the
sink or toilet may be a prominent route that requires greater attention."

If we could get some up-to-date surveys of this kind here in the states,
they would be very useful to enlighten us all and help fill in the blanks in
the Bound and Voulvoulis model.  Maybe together with the non-compliance rate
information that Dr. Gressitt has referred to, we could begin to get our
arms around a rough quantification of waste pharmaceuticals in this country.

I hope this helps.

-- Dave Galvin

   Local Hazardous Waste Management Program in King County

   Seattle, Washington

   206-263-3085

   Dave.Galvin at metrokc.gov 

  _____  

From: Charlotte A. Smith [mailto:csmith at pharmecology.com] 
Sent: Friday, November 11, 2005 6:01 AM
To: Gilliam, Allen; pharmwaste at lists.dep.state.fl.us
Cc: Stevan Gressitt
Subject: RE: [Pharmwaste] Percentage of waste drugs from unwanted consumer
meds

Thanks, Allen, and much success at your seminar. Will you be discussing drug
waste with folks? The more often the better!  

Steve, if you have any hard data, that would be very helpful. I have given
your name to the Washington staffers, so they may be contacting you. Hope
you don't mind! 

Charlotte A. Smith, R. Ph., M.S., HEM

President

PharmEcology Associates, LLC

200 S. Executive Drive, Suite 101

Brookfield, WI 53005

262-814-2635

Fax: 414-479-9941

csmith at pharmecology.com

www.pharmecology.com

H2E Champion for Change Award 2004

  _____  

From: Gilliam, Allen [mailto:GILLIAM at adeq.state.ar.us] 
Sent: Friday, November 11, 2005 7:38 AM
To: Charlotte A. Smith; pharmwaste at lists.dep.state.fl.us
Cc: Stevan Gressitt
Subject: RE: [Pharmwaste] Percentage of waste drugs from unwanted consumer
meds

Charlotte (we're gonna miss ya at our next H2E seminar in n.w. arkansas in
january!),

i hope Stevan (cc'd above) will respond with more detailed info he had
provided (back in july?) regarding "non-compliance rates" (% of meds not
used by residential recipients).   i believe he referred to another person
and report (by a pharmaceutical company?) that indicated 40 to 60 % of drugs
prescribed are "tossed".  the med's final resting place (landfill or
toilet?) i don't believe was mentioned because of lack of data.  i believe
he even estimated the monetary losses to states' healthcare programs to be
about $1 million for a state the size of arkansas (~2.5 million population)
because of this waste.  considering today's economic woes and the rising
costs of healthcare, one would think state legislators' eyes would pop out
of their sockets if they had this type of info and try to mitigate.

Stevan?  think you can dig up that source again?

Thanx in advance,

allen gilliam

adeq state pretreatment coordinator

501.682.0725

-----Original Message-----
From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Charlotte A.
Smith
Sent: Thursday, November 10, 2005 4:16 PM
To: pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] Percentage of waste drugs from unwanted consumer meds

Hello,

I just received a call from a staffer at the US House of Representatives
Science Committee inquiring as to what percentage of drugs entering the
environment, primarily through drain/sewer disposal, can be attributed to
consumers flushing unwanted medications. I do not know of any studies on
this or available data. Do any of you have information you can share that I
can refer back to this gentleman? It appears the House of Representatives is
starting to become interested in this issue so I think we should do all we
can to make the case for enabling legislation, especially with respect to
DEA and funding of programs. Thanks much! 

Charlotte A. Smith, R. Ph., M.S., HEM

President

PharmEcology Associates, LLC

200 S. Executive Drive, Suite 101

Brookfield, WI 53005

262-814-2635

Fax: 414-479-9941

csmith at pharmecology.com

www.pharmecology.com

H2E Champion for Change Award 2004

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