FW: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12

Tue Jun 23 07:48:05 EDT 2009

From: mcmireles at communityofcompetence.com
[mailto:mcmireles at communityofcompetence.com] 
Sent: Monday, June 22, 2009 4:22 PM
To: VeoraLittle at aol.com; MMccarro at dtsc.ca.gov; wamore at gw.dec.state.ny.us;
pharmwaste at lists.dep.state.fl.us
Subject: Re: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12

We conduct the Annual Survey of non-institutional drug take-back programs and
publish the National Directory of Drug Take-Back and Disposal Programs.  We
have been in contact with 80 such programs organized by community coalitions.
Our Survey has provided some valuable "baseline info" that we wish to measure
over time.  

We don't survey healthcare instititions because most are involved with
commerical reverse distributors for disposal of unused and expired meds
(UEMs).  You may be able to get some info from the companies.  However, I
don't believe you can obtain a total picture of all the institutions because
of the number of vendors involved.  No federal agency is collecting this
info.

However, we set up the National UEM Registry in 2004 and have been receiving,
coding, and analyzing a large volume of UEM data shared by several drug
take-back programs.  They mainly submit the data to us for evaluation.  We
enter all the info into the Registry for national comparison.  We are seeing
several best practices and are offering a handy Manual of Procedures to
assist any group in organizing a drug take-back program.  

If anyone wants a copy of these publications, please contact me directly.

Matthew C. Mireles, PhD, MPH
President and CEO
Community Medical Foundation for Patient Safety
6300 West Loop South, Suite 288
Bellaire, TX 78401
832-778-7777
www.communityofcompetence.com

  _____  

From: VeoraLittle at aol.com
Sent: Monday, June 22, 2009 11:53 AM
To: MMccarro at dtsc.ca.gov, wamore at gw.dec.state.ny.us,
pharmwaste at lists.dep.state.fl.us
Subject: Re: [Pharmwaste] Re: Pharmwaste Digest, Vol 44, Issue 12

Consider this program, Operation Medicine Cabinet, A pharmaceutical take-back
program.  This program utilizes many community partners including Waste
Management, Law enforcement and coalitions for drug free spaces.

is a community event that Collier County Sheriff's Office and Drugfreecollier
have been doing for many years.  We have worked with Collier County Solid
Waste Management (Danette Huff and Beth Ryan) for several years.  They have 

We know that it is illegal to collect controlled substances without Law
enforcement present.  We know that not only our environment but our youth and
seniors (overdose, errors, abuse, selling) are in danger.   Attached is a
wonderful program we can  start in all communities to bring education and the
beginnings of a solution.  

Veora Little,CRNA   239-649-4202  veoralittle at gmail.com   a volunteer with
www.drugfreecollier.org 

In a message dated 6/22/2009 11:32:16 A.M. Central Daylight Time,
MMccarro at dtsc.ca.gov writes:

	This would seem to call for a "baseline assessment" of the industry's
handling practices, so that we can look at "take back" efforts with more
informed vision.

	I would add that we would need the same assessment for:

	-long term care facilities

	-Skilled nursing/rehabilitation facilities

	-mental heath facilities

	-Medical Clinics 

	-retirement complexes with medial clinics

	-veterinary hospital/kennels

	-veterinary services for agricultural purposes -livestock/ feed
lot/dairy

	There may be others.

	Matt McCarron

	Pollution Prevention/Green Business

	CA Dept. of Toxic Substances Control

	700 Heinz Ave. Suite 300  MS R2 - 2-3

	Berkeley, CA 94710

	510-540-3828

	Sustaining our resources sustains our future generations

	>>> "William More" <wamore at gw.dec.state.ny.us> 6/22/2009 7:57 AM >>>

	So what is the present compliance rate with our Hospitals Pharmacies
with the RCRA - Hazardous waste regulations? 

	How are they achieving Hazardous Waste Determinations? How do they
segregate wastes, and when?

	How many have a program that know where the stuff that the reverse
distributors don't want to take go?  What happens to the waste - contaminated
packaging - that comes from dispensing drugs that can be a "P" waste?  Do the
reverse distributors(RDs) tell the hospitals about these materials? Do they,
the RDs, take these back?

	Does that make them a TSDF?  Are they manifested?  What mechanisms
are the Hospital Pharmacies using to recover these materials from the patient
floors?

	What are the RDs doing with those materials that are never credited?
The partials that can't be reused because that are not factory sealed?  Those
materials that are so far out of date?  The RDs know what they are. Do they
pick them up anyway. Does that make them a TSDF? Are they manifested?

	Have all of the Hospital Pharmacies had their Formulary,(likely
stocked Drugs), reviewed as to which ones can be a Hazardous Waste when
unusable ,unreturnable, un credited, when a waste. Have they looked for
characteristic Hazardous Waste? Mercury compounds that may be used as a
preservative? Metals in vitamins or dietary supplements? Alcohol or CFCs in
inhalers?

	What are we seeing when we look at these questions???????

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