[Pharmwaste] Non-adherence

gressitt at uninets.net gressitt at uninets.net
Mon Jan 29 09:27:12 EST 2007


Allen, the Registry site is at www.communityofcompetence.com  Howeveer it
will measure what is returned rather than actual compliance. That would be
a deriviative conclusion that Matthew Mirelles has attempted and with some
interesting results. What is necessary for his work to continnue howeveer
is more actual reporting from as broad an array of sites as possible. The
best information I have seen on actual compliance comes from within the
Pharmaceutical Industry but is "proprietary." Stevan Gressitt, M.D.
207-441-0291

> I was reminded that non-adherence also includes those scripts that are
> not refilled.  I've been using 50% kind of as a national overall average
> in my presentations since the numerous reports I've perused range from
> 20% to 80% (for psychotrophics).  Regardless of which study and what %,
> our nations' waters are in deep doo.  The boulder/denver study REALLY
> opened some eyes over here.
>
> Slap me if I'm wrong but, didn't Dr. Gressitt (or somebody "out there")
> start a national registry to try and get some handle on this
> non-adherence rate? If so, what's that website again please? The only
> questionnaire I've got doesn't address "not refilled".
>
> Allen Gilliam
> ADEQ state pretreatment coordinator
>
> -----Original Message-----
> From: pharmwaste-bounces at lists.dep.state.fl.us
> [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Matthew
> Mireles
> Sent: Saturday, January 27, 2007 8:30 AM
> To: 'Jackson, Jennifer'; pharmwaste at lists.dep.state.fl.us
> Subject: RE: [Pharmwaste] RE: question on wastewater
> characterizationofpharmaceuticals
>
>
> Jen, thanks so much for your thoughtful and informative reply.  I agree
> that prevention has to be the key.  Do you have an idea on what drugs
> are most frequently showing up at your site?  If we can address the
> issues of over-prescription, non-adherence of medications, and proper
> disposal (this is the most challenging), then everyone should be happy.
> Thanks for the reference.
>
> Matthew Mireles
>
> -----Original Message-----
> From: pharmwaste-bounces at lists.dep.state.fl.us
> [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Jackson,
> Jennifer
> Sent: Friday, January 26, 2007 5:01 PM
> To: pharmwaste at lists.dep.state.fl.us
> Subject: [Pharmwaste] RE: question on wastewater characterization
> ofpharmaceuticals
>
> Hi Matthew,
>
> Your observation is a good one and there is a plethora of studies done
> on what pharmaceuticals are entering waterways through wastewater
> effluent. Check out the USGS 2002 Reconnaissance on Pharmaceuticals and
> Personal Care Products. Boulder Creek, Potomac and San Francisco Bay
> have some studies as well. Google Scholar will give you lots of hits. To
> begin, look at: http://toxics.usgs.gov/highlights/DM_top100.html as well
> as the archives of this listserv.
>
> Lots of pharmaceuticals are coming to our treatment plants, and yes,
> many wastewater agencies are concerned. Some pharms are broken down,
> some adsorb to biosolids and some come out the end pipe. Every treatment
> plant is different, with various kinds of technology. Reverse osmosis,
> UV, ozonation, carbon filtration and now ultrasound are all possible
> treatments that may break down or remove the pharmaceuticals.
> Unfortunately, some pharms respond better to certain treatments than
> others, meaning that a mix of treatments would be necessary to get 'em
> all. Also unfortunately, the burden of bringing this technology to our
> plants falls on our ratepayers -- real people, rather than the true
> culprits: over-prescription, formulations that don't break down and a
> lack of EPA and FDA collaboration in ensuring pharmaceuticals are tested
> for their environmental impacts.
>
> So pollution prevention is key for the portion of pharmaceuticals that
> are unused by hospitals, hospice, or residents, because that's much less
> expensive than, say reverse osmosis. Some people on this list are
> working toward a solution for disposal that will comply with DEA
> regulations as well as state and other federal law. The red tape is
> unbelievable.
>
> For pharms that we take and pass through our bodies, I believe some
> folks are looking at whether reformulation may be possible.
>
> Best,
> Jen Jackson
> _______________________________________________
> Pharmwaste mailing list
> Pharmwaste at lists.dep.state.fl.us
> http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste
>
>
> _______________________________________________
> Pharmwaste mailing list
> Pharmwaste at lists.dep.state.fl.us
> http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste
> _______________________________________________
> Pharmwaste mailing list
> Pharmwaste at lists.dep.state.fl.us
> http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste
>




More information about the Pharmwaste mailing list