[Pharmwaste] Institute for Medicine Safety Statement on drug disposal programs.

Sun Sep 12 12:11:14 EDT 2010

September 12, 2010
Announcement from the Institute for Medicine Safety

On September 25th, 2010, the U.S. D.E.A. will be sponsoring a first in the
nation national drug drop-off day that meets all state and Federal
requirements. It may be that other organizations plan similar, or other
activities, on the same date that may not meet Federal requirements. It is
important that any individuals involved, from event organizers to any
assisting health care providers, recognize that they are responsible for
even the inadvertent possession of controlled drugs, which is forbidden by
law without prior written authorization received from the U.S. D.E.A.
Regional Office.

The Institute testified before a U.S. Senate Subcommittee this summer and is
pleased that the U.S. Senate has unanimously, and without any
partisanship, passed legislation enabling the U.S. D.E.A. to develop
regulations to reduce medication diversion. Maine continues to have the only
legal mail-back pilot in the country for all classes of drugs for all
residents.

An International Prescription Drug Conference, the oldest in Maine and the
oldest drug disposal conference in the world will be held in Portland
October 10-12, 2010. See www.benzos.une.edu   for more information.

Institute for Medicine Safety
A collaborative of the School of Pharmacy, Husson University, The Center on
Aging, University of Maine and The Colleges of Pharmacy and Osteopathic
Medicine of the University of New England

http://www.benzos.une.edu
http://safemeddisposal.com
http://www.husson.edu/pharmacy

Purpose of the Institute:

The Institute for Medicine Safety was formed to encourage best practices and
best policy regarding the safe use of medicines, to discourage their misuse,
and to provide assistance in preventing abuse of pharmaceuticals across
their life cycle. A major focus is addressing unused medication disposal
practices and policy development and regulatory development and sustainable
funding mechanisms.

History and background:

The Maine Benzodiazepine Study Group was formed in 2001 as an independent
group of clinicians, private sector, governmental, and non-governmental
organizations with a Steering Committee that emphasized geographic disparity
and multidisciplinary engagement. By 2005, its annual conference had become
a large undertaking, with national and international attendance.  Professor
Len Kaye of the University of Maine Center on Aging, who was engaged with
improving safety in medication for the elderly offered to provide logistical
support.

The Group successfully initiated legislation in 2005, in consultation with
the Director of Maine Drug Enforcement Agency Roy McKinney, which enabled a
mail-back program in the State of Maine that could accept Drug Enforcement
Administration controlled substances. A grant from the U.S. Environmental
Protection Agency was awarded in 2007, which permitted a test for proof of
concept within the State of Maine. The grant was successfully completed in
2010. To continue this valuable project, further funding was obtained with
the support and assistance of the Maine Health and Human Services Committee.
The funding allowed for expansion to a statewide collection program that
will operate until funding is exhausted or the program becomes sustainable
through the efforts of the Institute.  Data from the pilot was useful in
helping draw attention to the problems of adherence, compliance, and
concordance as well as the difficulties in addressing prescription drug
abuse. A State of Maine policy curtailing the number of days of medications
given for first prescriptions of certain drug classes covered by MaineCare
was instituted to curtail waste and improve adherence.

The drug return programs across the country remain the only programs that
actually remove unused pharmaceuticals and personal care products from
harm’s way. There is rapidly growing interest by state, local and federal
governments, pharmacists, physicians, and non-governmental organizations in
increasing the number of collection programs at the municipal, county,
state, and even national levels. Reasons include the increase in
unintentional poisonings, intentional abuse, adherence issues, and
recognition of the potential environmental impacts of pharmaceuticals. There
is considerable, unique and broad-based experience in Maine, which has been
publicly recognized by clinicians and policymakers on the state and federal
level.  The conference presented by the Maine Benzodiazepine Study Group has
become the oldest and most comprehensive prescription drug abuse conference
in the State and the oldest continuous, comprehensive drug disposal
conference in the United States. We are unaware of any older annual drug
disposal conference elsewhere in the world.  The Institute was formed in
June 2010 to coordinate various efforts and absorbed the Maine
Benzodiazepine Study Group and the Drug Disposal Group.

Alphabetical listing of Institute Founders

Stevan Gressitt, M.D.
Faculty Associate, University of Maine Center on Aging
Founding Director, Maine Institute for Safe Medicine
University of New England, College of Pharmacy
Department of Pharmaceutical Sciences
Associate Professor of Clinical Psychiatry
University of New England, College of Osteopathic Medicine
716 Stevens Avenue
Portland, Maine 04103
Cell: 207-441-0291
E-mail: gressitt at gmail.com

Marc B. Hahn, D.O.
College of Osteopathic Medicine
Dean and Senior Vice President for Health Affairs
Phone: 207-602-2340
E-mail: DeanUNECOM at une.edu

Lenard W. Kaye, D.S.W./Ph.D.
Director, University of Maine Center on Aging
Administrator, Maine Benzodiazepine Study Group
Camden Hall
25 Texas Avenue
Bangor, Maine 04401-4324
www.mainecenteronaging.org
phone: 207-262-7920
E-mail: len.kaye at umit.maine.edu

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

Roy E. McKinney, Director
Maine Drug Enforcement Agency
166 State House Station
45 Commerce Dr., Suite 1
Augusta, ME 04333-0166
Phone: 207-626-3852

John V. Schloss, Ph.D.
Professor and Chair, Pharmaceutical Sciences
University of New England
College of Pharmacy, Room 320
716 Stevens Avenue
Portland, Maine 04103-2670
Phone: 207-221-4151
E-mail jschloss at une.edu

Institute Policy:
1. Support legislation regarding collection, return, and disposal of
prescription drugs and evaluation that improves prescribing practices to
diminish waste and improve prescription concordance; increases compliance
and adherence rates; and reduces diversion and abuse.
2. Support development of a peer-reviewed publication for advancement of
improved drug disposal options, and support formation of a National Drug
Return and Disposal Institute, and an International Association of Drug
Return and Disposal Organizations. This is to encourage sharing of
information and a site for recognition of best practice, regulatory
adherence, and data collection.
3. Support best international practices to avoid unused medicine being
inappropriately donated to disaster areas.
4. Encourage dissemination of relevant news and information, specifically on
improving lifecycle management of pharmaceuticals.

Sustainability:
5. Seek funding to continue the Maine mailback program and the Institute in
order to foster national and international replication and to hold at least
one annual meeting in the State of Maine to address pharmaceutical
life-cycle issues.
6. Explore and assist developing models of expansion of drug disposal
(mailback, event driven, and other continuously available models) to
determine best and most cost effective data collection.

Educational Obligation:
7. Provide support to prescribers and organizations at local, state and
national levels, particularly those engaged in the federally-mandated
service of “medication management.”
8. Enrich current relationships with federal, state and local governments,
corporations and non-governmental organizations. Ensure responsiveness to
requests for data, evaluation, and comment within available resources.
9. Provide specific support for endorsement of the Athens Declaration of
2007, the Istanbul Statement of 2009, and the Maine Proclamation of 2009.

Research:
10. Encourage drug disposal organizations to collect data to improve public
and patient health care outcomes, and to determine the post market
surveillance potential of drug disposal systems for counterfeit
identification, adverse drug-drug event identification, and abuse
prevention.
11.  Identify current and emerging data sources for geographic or physical
technology library development, and participate in that process.
12. Collect, analyze/compile, and disseminate data from take-back programs
regarding patient compliance/adherence to prescribed therapy.
13. Conduct drug utilization review (DUR) studies on the data collected from
take-back programs.

Stevan Gressitt, M.D.
Faculty Associate, University of Maine Center on Aging
Academic Member, Athens Institute for Education and Research
Athens, Greece
Founding Director, Institute for Medicine Safety
University of New England, College of Pharmacy
Department of Pharmaceutical Sciences
Associate Professor of Clinical Psychiatry
University of New England, College of Osteopathic Medicine
716 Stevens Avenue Portland, Maine 04103
Cell: 207-441-0291
E-mail: gressitt at gmail.com
http://www.benzos.une.edu   www.safemeddisposal.com
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