[Pharmwaste] Items Accepted at Permanent Collection

[Fredrick L. Miller]

Since you asked the question, Margaret, it's my opinion the best current
way to handle the problem is to use the HHW program with cooperation
from state Board of Pharmacy (or equivalent in other jurisdictions) to
provide supporting expertise and deal with custody of controlled
substances, and with funding from industry.

Here's why that makes sense to me.

Citizens in many if not most jurisdictions in America are already
accustomed to recycling and HHW management through their local programs.
They can identify where and when to take the dangerous things they no
longer want in their homes.

Many political subdivisions have adequate secure facilities for HHW
operations so it would be relatively inexpensive to add a small
pharmaceutical management unit to the facility.  Those with mobile
programs such as King County's "Wastemobile" would face a bit more of a
challenge but it should still be doable. 

Having healthcare folks instead of police visible at the collection
point would encourage a certain sector of the population which might not
otherwise participate.  Further, this provides staff with much greater
understanding of the (legitimate) materials being collected.  Something
would still have to be done for contraband and oddball items but the
vast majority of the materials would be appropriately handled.
Healthcare staff could be scheduled for specific days/events to maximize
their utility while minimizing cost.

Cost of operations (cost to funding entities) would be minimized due to
economies of scale and synergies captured by utilizing existing
facilities and staff who already have appropriate education, experience,
and training.

That's my pipe dream and I'm sticking with it until someone comes up
with a better answer.

Fred Miller

p.s. Fred Gabriel is correct to point out that rules re. HHW vary from
state to state.  This is yet another reason I believe the HHW folks are
best suited for dealing with the issue.


-----Original Message-----
From: pharmwaste-bounces at lists.dep.state.fl.us
[mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Shield,
Margaret
Sent: Monday, March 26, 2012 8:21 PM
To: ANGELA Deckers; pharmwaste at lists.dep.state.fl.us
Subject: RE: [Pharmwaste] Items Accepted at Permanent Collection

Lots of good comments in this email string, but here are some additional
thoughts about rationales for collecting all medicines that may resonate
with your local law enforcement partners.

1.  Public safety reasons for medicine take-back programs include
preventing accidental poisonings, especially among youth and seniors.
Accidental poisonings in the home from over-the-counter medicines is a
big problem, especially among children.  Check the statistics in your
area or your state for more detail. 
In WA state:  
32% of child poisoning deaths in Washington were caused by someone
else's prescription medication and 26% were caused by over-the-counter
medications.
Source: Sabel, J. (2004). Washington State Childhood Injury Report -
Poisoning Chapter. WA DOH. Available online at:
http://www.doh.wa.gov/hsqa/emstrauma/injury/pubs/wscir/WSCIR_Poisoning.p
df

2. Some over-the-counter medicines - notably, dextromethorphan cough
suppressants- are abused, especially by youth, and therefore are also
valuable to collect to prevent  misuse and entry into the spiral of drug
abuse.

3.   To be effective, use of medicine take-back programs to reduce
access to potentially dangerous medicines in our homes and communities
need to be straightforward for consumers.  i.e. Keep it simple.  Many
people are unsure of the difference between prescription drugs and
over-the-counter drugs, or have items in their medicine cabinets that
they can't identify as one or the other.  This is confirmed by the FDA's
education efforts trying to explain what is an over-the-counter drug
versus a prescription drug.  Better to accept all drugs than to put an
additional barrier on the consumer (or onto the collector) of having to
sort out drugs into categories.

As Angela already mentioned, the environmental considerations for proper
disposal of waste pharmaceuticals extend to all medicines, not just
prescription drugs.

It's true that accepting all medicines will bring in larger volumes, and
result in higher disposal costs.  And that puts a burden onto local law
enforcement at a time when their budgets are shrinking.  Which bring us
back to a key question in all this - who should be paying to provide
safe, secure medicine take-back programs for our communities?

Margaret Shield PhD, Policy Liaison
Local Hazardous Waste Management Program in King County
(c) 206-265-9732
Protect Our Kids, Families, and Environment - www.TakeBackYourMeds.org