[Pharmwaste] Sampling of med take back items

Sat Jan 23 11:23:18 EST 2010

Nicely worded.And also the data has already driven policy by leading to
reduced first prescription duration.

Stevan Gressitt, M.D., Medical Director

Office of Adult Mental Health Services

Department of Health and Human Services

Marquardt Building, 2nd Floor

11 State House Station

32 Blossom Lane

Augusta, ME  04333-0011

Ph: (207)287-4273

Fax: (207)287-1022

Cell Phone: (207) 441-0291

E-Mail : stevan.gressitt at maine.gov

http://www.maine.gov/dhhs/mh/

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________________________________

From: Rod Larson [mailto:larsonr at husson.edu] 
Sent: Friday, January 22, 2010 10:01 AM
To: Dennis Lucia; pharmwaste at lists.dep.state.fl.us; Gressitt, Stevan;
Jeanie Jaramillo
Cc: Allan Geisendorfer; Jennifer_Crittenden at umit.maine.edu; Len Kaye;
John Schloss
Subject: Re: [Pharmwaste] Sampling of med take back items

I don't believe anybody was mandating anything.  A problem was posed and
suggestions made to help solve it.   

A great deal has been learned from tracking the types and quantity of
drugs being returned to this point.  But we have just scratched the
surface.  A drug take-program has many potential benefits to the
environment and society, in general.  Four of these include:
    1.  The reduction of environmental contamination.
    2.  The reduction of recreational use of prescribed and OTC
medications.
    3.  The reduction of inappropriate medication sharing.
    4.  An increase in knowledge regarding the how medications are
prescribed and used.  

The  Maine project is fortunate to have the resources and expertise
available (e.g., law enforcement, government officials, pharmacists,
researchers, students) to be able to address all four of the issues
listed above.  While I disagree that all the variables mentioned below
are needed in order to extract useful and meaningful information out of
such projects, I see no harm in collecting what we can (without
violating privacy laws) for the sake of improving how medications are
used, stored, and safely disposed of.  On the contrary, I believe it
would be irresponsible to throw away information that could be used to
benefit society, if one has the means and resources to collect, analyze
and report it.  

If someone doesn't have the resources and/or expertise to do anything
beyond collecting and destroying the medications, this doesn't mean that
their projects are not helpful.  The projects obviously benefit society
and the environment tremendously in the first three ways listed above.  

Just my two cents.

Rod

**************************************** 
Rodney A. Larson, Ph.D., R.Ph. 
Founding Dean 
School of Pharmacy
Husson University
One College Circle 
Bangor, Maine 04401-2929 
Phone: 207-941-7163 
Email: LarsonR at Husson.edu
****************************************

On 1/22/10 8:51 AM, "Dennis Lucia" <djlucia at gw.dec.state.ny.us> wrote:

Before you attempt to mandate that you need drug statistics for all
collections.  What have you learned from the collections that have been
held, where data on the types of drugs and quantity has been recorded?

Doing an analysis of every 1/10 or 1/20 or 1/100 will not tell you much
and requires that at each collection you have a trained pharmacist.  By
the way, you do know that having anyone other than law enforcement
handle the unwanted controlled substances at a collection event is
illegal. 

Are you planning to collect additional information in violation of
privacy laws.
Like:
Diagnosis; length of treatment;  
Did the patient have health insurance, type of health insurance;
1st prescription or multiple times that it has been prescribed
Male/female, age.
Why did patient stop taking drug? Reaction, type of reaction? Got
better? Died?
You will also need info on the location where the collection takes place
and demographic on the patient, regarding their life style, and medical
history.

There are many variables that make the analysis complicated...

Are you trying to get unwanted drugs out of households and properly
disposed of or are you trying to do a research study to analyze why
patients don't take the medications prescribed to them and why drugs are
being over prescribed?

Let's simplify the drug collections and work on the other issues in
other ways!!!

Dennis J. Lucia, P.E.
Pollution Prevention Unit
Division of Environmental Permits
New York State Department of Environmental Conservation
625 Broadway  4th Fl.- SW
Albany, NY 12233-1750
(518) 402-9469
Fax (518) 402-9168

>>> "Gressitt, Stevan" <Stevan.Gressitt at maine.gov> 1/22/2010 7:37 AM >>>
Your internal consistency idea looks good. I am not the mathematician or
statistician, but I suspect there is enough horsepower on this list to
advise. It might also be interesting to see the difference in
consistency at 1/10 1/20 1/100 depending on sixze as we all who are
trying to sample will probably do best if we adopt a "best practice" 

Stevan Gressitt, M.D., Medical Director
Office of Adult Mental Health Services
Department of Health and Human Services
Marquardt Building, 2nd Floor
11 State House Station
32 Blossom Lane
Augusta, ME  04333-0011
Ph: (207)287-4273
Fax: (207)287-1022
Cell Phone: (207) 441-0291
E-Mail : stevan.gressitt at maine.gov
http://www.maine.gov/dhhs/mh/

Confidentiality Notice: This e-mail message, including any attachments,
is for the sole use of the intended recipient(s).  It may contain
confidential and privileged information.  Any unauthorized review, copy,
use, disclosure, or distribution is prohibited.  If you are not the
intended recipient, please note that any dissemination, distribution or
copying of this is strictly prohibited.  Please contact me by reply
e-mail or telephone and destroy all copies of this message.
The Department of Health and Human Services (DHHS) does not discriminate
on the basis of disability, race, color, creed, gender, sexual
orientation, age, or national origin, in admission to, access to, or
operations of its programs, services, or activities, or its hiring or
employment practices.  This notice is provided as required by Title II
of the Americans with Disabilities Act of 1990 and in accordance with
the Civil Rights Act of 1964 as amended, Section 504 of the
Rehabilitation Act of 1973, as amended, the Age Discrimination Act of
1975, Title IX of the Education Amendments of 1972 and the Maine Human
Rights Act and Executive Order Regarding State of Maine Contracts for
Services.  Questions, concerns, complaints or requests for additional
information regarding the ADA may be forwarded to DHHS' ADA
Compliance/EEO Coordinators, 11 SHS-221 State Street, Augusta, Maine
04333, 207-287-4289 (V), 207-287-3488 (V), 1-800-606-0215 (TTY).  

________________________________

From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of
Jaramillo, Jeanie
Sent: Wednesday, January 20, 2010 2:29 PM
To: pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] Sampling of med take back items

I had no luck with having our epidemiologist help with a sampling
protocol.  He's already being pulled in many different directions.  I
did want to mention that our next event (3/27) will likely be the last
one in which we conduct a full inventory.  We will be collating the
items collected by participant (i.e. these 20 items all came from car
#1), which will be a little more work this time around.  I believe this
will allow us to validate sampling techniques that we could use for
future events.  For instance, we could pull out the data from every Xth
participant, summarize it, and extrapolate it to the total number of
participants and then compare that to the full inventory.  I'm sure
there's some statistical method to do that.  

Jeanie Jaramillo, PharmD
Managing Director, Texas Panhandle Poison Center
Assistant Professor, Texas Tech UHSC School of Pharmacy
1501 S. Coulter St.                   
Amarillo, TX 79106
P: (806) 354-1611
C: (806) 672-0833
F: (806) 354-1667
Cisco IP: 30412

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