[Pharmwaste] Well it was bound to occur somewhere...

Pamela Ortner portner at angelahospice.net
Mon Feb 14 11:04:38 EST 2011

  ----- Original Message ----- 
  From: Matthew C. Mireles 
  To: Buxbaum.Diane at epamail.epa.gov ; easmith at comofcom.com 
  Cc: pharmwaste-bounces at lists.dep.state.fl.us ; 'Stevan Gressitt' ; Elizabeth A. Smith PhD ; pharmwaste ; Gilliam,Allen 
  Sent: Monday, February 14, 2011 11:04 AM
  Subject: RE: [Pharmwaste] Well it was bound to occur somewhere...

  Thanks so much for this suggestion.  I'll try to track down this book by Ehrenfeld.  We are a nonprofit medical research group based in Houston.  Many of us are researchers who study high-hazard industries, including health care.  We most interested in the man-made systems that are designed, developed and operated to the limits of human performance and safety.  Some are characterized by low probability-high consequence events, such as a catastrophic failure.  Most are highly reliable and beat the odds of a disaster that affect people and environment.  I'm an epidemiologist and very interested in emerging diseases and outbreaks directly or indirectly related to safety risks and dangers of these systems.   Their failures are often categorized as technological disasters.  Our questions are how do certain organization learn about these risks and dangers and why some can operate reliably and safey and others can't.

  Recently in the news, an alarming statistic was announced "Americans consumer 70% of the world's opiates and pain killers".  If you know of the reference to this statistic, please let us know.

  Matthew Mireles


    -----Original Message----- 
    From: Buxbaum.Diane at epamail.epa.gov 
    Sent: Feb 1, 2011 9:57 AM 
    To: "Matthew C. Mireles" 
    Cc: "Elizabeth A. Smith PhD" , "Gilliam,Allen" , 'Stevan Gressitt' , pharmwaste , pharmwaste-bounces at lists.dep.state.fl.us 
    Subject: RE: [Pharmwaste] Well it was bound to occur somewhere... 

    One can go back further.  The former editor of the magazine, Conservation Biology and professor at Rutgers, David Ehrenfeld in 1978 wrote an excellent book, The Arrogance of Humanism.  It tell the story very early on about the potential for unexpected outcomes of human technological advances.  I think the concept of "First Do No Harm" and the Precautionary Principles are really valuable foundations upon which to make decisions.  We are a mature species, I believe, but maybe not. 

    Diane D.  Buxbaum, MPH 
    Environmental Scientist 
    U.S.Environmental Protection Agency, Region 2 
    Division of Enforcement and Compliance Assistance 
    290 Broadway 
     New York, NY 10007 
    Ph. 212-637-3919 
    Fx   212-637-4086 
    buxbaum.diane at epa.gov 

    From:        "Matthew C. Mireles" <mirelesmc at earthlink.net> 
    To:        "Gilliam,Allen" <GILLIAM at adeq.state.ar.us>, 'Stevan Gressitt' <gressitt at gmail.com>, pharmwaste <pharmwaste at lists.dep.state.fl.us> 
    Cc:        "Elizabeth A. Smith PhD" <easmith at comofcom.com> 
    Date:        01/28/2011 10:30 AM 
    Subject:        RE: [Pharmwaste] Well it was bound to occur somewhere... 
    Sent by:        pharmwaste-bounces at lists.dep.state.fl.us 


    In most human endeavors, one solution may create other problems or unpredicted, unintended consequences.  A good read is Tenner's "When Technology Bites Back" (Princeton Press).  Weren't we supposed to be a paperless society about 15 years ago with electronic mail and communication? 
    New stories like that coming from Jakarta will only demonstrate that some individuals and organizations look for any opportunities to satisfy their greed and corruption.  Not too long ago, the president of a well-known commerical reverse distributor was arrested for stealing controlled substances for personal use. 
    Drug take-back and return programs are still a nascent initiative across the nation.  There are still inadequate data to support evidence that these programs are even effective or "successful".  What would be the best measurements or indicators?  Recently, we have been encouraged by more groups collecting usable data from drug collection.  Some day, it may be possible by comparing and analysis good data to truly appreciate and understand the magnitude of this problem that has a significant impact on public health, patient safety, healthcare cost, environment, legal system and society (you can add to this list...).  at the same, there should be some level of oversight and monitoring.  Who should be tasked with this?  Who would have the authority to do so? 
    Moreover, it is very important to know who is involved in any drug collection in the US, probably around the world too.  In 2008 we started an annual survey and publish the National Directory of Drug Take-Back and Disposal Programs.  today, we have an official roster of more than 420 such programs with more interest from our international community to be included in this Directory.  some have already expressed concerns about our survey and the info we compile; some have refused to be participate in the survey.  Please know that we collect survey data only for research purposes to compare programs and to observe trends.  For example, of all the drug take-back programs and events, about 80% came into operations in 2009.  There is still no consensus on how define or categorize unused and expired meds.  about 50% of the programs directly involve law enforcement.  Very few programs participate in data collection with the National Registry. 
    With funding we want to put the info into public domain for other researchers and policy makers.  For now, an updated roster of programs will be available on websites soon after all the surveys are compiled sometime later this spring.  The roster is often requested by federal agencies and others for review, but we are not compelled to report or even share our data. 
    If you have good ideas and suggestions, let us know. 
    Matthew Mireles

    -----Original Message----- 
    From: "Gilliam, Allen" 
    Sent: Jan 28, 2011 8:42 AM 
    To: 'Stevan Gressitt' , pharmwaste 
    Subject: RE: [Pharmwaste] Well it was bound to occur somewhere... 

    Just now seeing the tip of the iceberg…. 
    From: pharmwaste-bounces at lists.dep.state.fl.us [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Stevan Gressitt
    Sent: Thursday, January 27, 2011 9:24 PM
    To: pharmwaste
    Subject: [Pharmwaste] Well it was bound to occur somewhere... 

    Stevan Gressitt, M.D.
    Faculty Associate, University of Maine Center on Aging
    Academic Member, Athens Institute for Education and Research 
    Athens, Greece 
    Founding Director, International Institute for Pharmaceutical 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
    gressitt at gmail.com  
    Cell: 207-441-0291 
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