[Pharmwaste] Green pharmacy and pharmEcovigilance: prescribing and the planet

[DeBiasi, Deborah (DEQ)]

http://unrbep.org/green-pharmacy-and-pharmecovigilance-prescribing-and-t
he-planet/

This article is completely downloadable:
Green pharmacy and pharmEcovigilance: prescribing and the planet
<http://unrbep.org/green-pharmacy-and-pharmecovigilance-prescribing-and-
the-planet/> 
Posted by admin in News <http://unrbep.org/category/news/>  on March 18,
2011 | no responses
<http://unrbep.org/green-pharmacy-and-pharmecovigilance-prescribing-and-
the-planet/> 
Just published is a comprehensive examination of sustainability and the
use of pharmaceuticals in health care.  Read the summary at Expert
Review of Clinical Pharmacology, 2011, 4(2):211-232; doi:
10.1586/ecp.11.6
<http://www.expert-reviews.com/doi/abs/10.1586/ecp.11.6> ; 
"Green Pharmacy & PharmEcovigilance: Prescribing and the Planet
<http://www.expert-reviews.com/doi/pdf/10.1586/ecp.11.6> ,"  by Daughton
CG and Ruhoy IS
The article is Open Access and can therefore be freely downloaded as an
Acrobat PDF or accessed in HTML from these URLs:
http://www.expert-reviews.com/doi/abs/10.1586/ecp.11.6 or
http://www.expert-reviews.com/doi/pdf/10.1586/ecp.11.6 
One of the overarching objectives in our work on pharmaceuticals as
environmental contaminants has been to forge clearer linkages between
environmental integrity and human health, and to foster awareness,
dialog, and debate within the healthcare communities regarding the
intimate connections between the environment and the practice of
medicine.
Our major message is that a more sustainable system of health care can
evolve simply by focusing on redesign of any of numerous aspects of the
delivery of health care that serve to reduce and optimize the overall
use of medications.
The paper posits that any of the numerous actions, behaviors, and
customs involved with the prescribing and dispensing of drugs can be
altered to: (1) reduce the incidence of leftover medications (and
thereby lessen the need for disposal - which is usually done by flushing
to sewers or discarding in trash) and (2) reduce the quantities of
unmetabolized residues excreted or washed into sewers.  The second point
is one that is almost always discounted as not feasible, but one that we
maintain offers the greatest potential for minimizing the environmental
burden of pharmaceutical ingredients.
Unfortunately, these are really not issues that have historically
concerned most healthcare practitioners. But by using a systems-level
approach, we believe a cogent and compelling argument can be advanced.
By taking actions to protect the environment, a broad spectrum of
extremely important collateral benefits for health care can naturally
emerge. These benefits involve systems-wide improvements in:
(i)                  the quality of health care (e.g., improved
therapeutic outcomes),
(ii)                reducing healthcare costs (from lessened usage of
medications), and
(iii)               reducing drug diversion and unintended poisonings
(because of fewer leftovers); the latter is a major problem in the US
and a great concern to the White House ONDCP.
In the final analysis, we believe that the prudent prescribing and
dispensing of drugs, coupled with an enlightened understanding between
consumers and physicians with respect to medication utility and use,
would minimize the incidence of leftover medications - thereby largely
solving the current problems surrounding drug disposal and diversion.
Also, by reduced and prudent usage (coupled with the selection of those
drugs with favorable pharmacokinetics), the entry of residues (via
excretion and bathing) from the intended use of medications could also
be reduced.
In essence, by attempting to protect the environment from exposure to
medication residues, we believe that a rare win-win can be achieved -
for consumers (patients), healthcare professionals, health insurers, and
the pharmaceutical industry.
Christian Daughton, Ph.D.
Chief, Environmental Chemistry Branch (on detail) Environmental Sciences
Division National Exposure Research Laboratory U.S. Environmental
Protection Agency
944 East Harmon
Las Vegas, NV 89119
702-798-2207
daughton.christian at epa.gov



Deborah L. DeBiasi
Email:   Deborah.DeBiasi at deq.virginia.gov (NEW!)
WEB site address:  www.deq.virginia.gov
Virginia Department of Environmental Quality
Office of Water Permit and Compliance Assistance Programs
Industrial Pretreatment/Whole Effluent Toxicity (WET) Program
PPCPs, EDCs, and Microconstituents 
www.deq.virginia.gov/vpdes/microconstituents.html
Mail:          P.O. Box 1105, Richmond, VA  23218
Location:  629 E. Main Street, Richmond, VA  23219
PH:         804-698-4028
FAX:      804-698-4032 


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