[Pharmwaste] Re: Pharmwaste Digest, Vol 118, Issue 4

Joel Kreisberg drkreisberg at teleosis.org
Sun Aug 16 17:35:58 EDT 2015


Interesting conversation.  I hadn't thought about the Selenium
concentration argument. It does point to the "one product at at time"
nature of the disposal issues. Having said that.  Many if not most
supplements are essentially food based products and thus do not qualify for
incineration in medical or pharmacuetical level incineration.  Sure as
Lawrence says, water or landfill isn't a good place. However, the cost does
not justify this perspective.  Most supplements can actually go into the
compost though some might argue that fish oils are animal products and
small compost systems don't do well with animal products.  Still,
supplements are basically concentrated food and thus do not require a
disposal process beyond what food requires. Thus, where I live, the compost
bin is the best place and solid waste stream appropriate (if I can say that
without offending anyone).    As I mentioned, indeed, Ross has an
interesting point about chromium and selenium, however, in the grand scheme
of things--based on my knowledge of prescribing supplements- (I have a
private practice in nutritional medicine)- trace minerals make up a very
small--even trace amount of the overall volume of nutritional supplements
sold in the US-- Fish oils, Vit. B, C, D, E dominate.

So my perspective has been, focus on key elements of the problem.
Nutriceuticals and supplements overall are dwarfed by pharmaceutical
products in terms of the overall risks and consequences in the
environment.  I agree it's easier to tell people just to throw it all in
one place.  If the costs was such that we could do this for all medicinal
products, sure why not--best for the consumer.  But given that the argument
is that the pharmacuetical companies should pick up the tab, which when
scaled to the US will not be insignificant.  My position is to leave
supplements out of this waste stream.

For the record.  Our 2009 data found that 10% of what was collected in the
Bay Area samples were nutritional supplements and in 2013  5% of the San
Francisco inventory samples were nutritional supplements.

Joel

Dr. Joel Kreisberg, DC, CCH, ACC |t <http://goog_807379531>eleosis.org
<http://www.teleosis.org>|drkreisberg at t <drkreisberg at teleosis.org>
eleosis.org  |510-558-7285 Ext 102


On Fri, Aug 14, 2015 at 8:11 AM, Lawernce Kenemore Jr. <ldkjr100 at gmail.com>
wrote:

> Throwing them in the trash or flushing them only continues to contribute
> to the contamination of our water systems and effects the eco-system.  It
> would be a poor response to tell someone to flush or throw in the trash
> from a Pharmaceutical professional.
> Coming soon an in home destruction of pharmaceuticals-OTC-vitamins
> supplements.
> FillAboxrecycling.com Stat-Medicament-Disposal
> Larry Kenemore Jr.
>
>
> On Fri, Aug 14, 2015 at 9:54 AM, <pharmwaste-request at lists.dep.state.fl.us
> > wrote:
>
>> Send Pharmwaste mailing list submissions to
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>>
>> Today's Topics:
>>
>>    1. Vitamins and Supplements (Tiemeier, Amy)
>>    2. FW: Vitamins and Supplements (Bunnell, Ross)
>>
>>
>> ---------- Forwarded message ----------
>> From: "Tiemeier, Amy" <Amy.Tiemeier at stlcop.edu>
>> To: "pharmwaste at lists.dep.state.fl.us" <pharmwaste at lists.dep.state.fl.us>
>> Cc:
>> Date: Fri, 14 Aug 2015 09:27:49 -0500
>> Subject: [Pharmwaste] Vitamins and Supplements
>>
>> Good Friday Morning!
>>
>>
>>
>> I wanted to get the group’s thoughts on the necessity of incinerating
>> vitamins and supplements vs just throwing them in the trash or flushing
>> them.
>>
>>
>>
>> Our non-profit has noticed that a fair amount of what we get in our drop
>> boxes are large bottles of vitamins and supplements that are expired. As we
>> pay for incineration by weight and are reliant on donations to support our
>> incineration, we were wondering if we could remove vitamins and supplements
>> from the list of items we accept and rather advise people to throw them in
>> the trash or flush them. It doesn’t seem like these types of items are the
>> ones we are worried about especially as they come from naturally occurring
>> sources. That being said, I wanted to get the thoughts of the experts on
>> the list serve who understand the environmental impact of these things
>> better than I do.
>>
>>
>>
>> Thank you for any input or insight you have.
>>
>>
>>
>> Warm Regards,
>>
>> Amy Tiemeier
>>
>>
>>
>> Amy Tiemeier, Pharm.D., BCPS
>>
>> *Director, Community Partnerships*
>>
>> *Associate Director, Office of Experiential Education*
>>
>> *Associate Professor, Department of Pharmacy Practice*
>>
>>
>>
>> [image: cid:image001.png at 01CFC03C.37B3BA50]
>>
>> 4588 Parkview Place, St. Louis, MO 63110-1088
>>
>> Office: 314.446.8554 | Fax: 314.446.8386
>>
>> *amy.tiemeier at stlcop.edu <amy.tiemeier at stlcop.edu>*
>>
>> [image: cid:image002.png at 01CFC03C.37B3BA50]
>>
>> [image: cid:image003.png at 01CFC03C.37B3BA50]
>> <http://www.stlcop.edu/index.html>[image:
>> cid:image004.png at 01CFC03C.37B3BA50] <https://www.facebook.com/STLCOP>[image:
>> cid:image005.png at 01CFC03C.37B3BA50] <https://twitter.com/STLCOPedu>[image:
>> cid:image006.png at 01CFC03C.37B3BA50]
>> <https://www.flickr.com/photos/stlcop/sets>
>>
>>
>>
>>
>> ---------- Forwarded message ----------
>> From: "Bunnell, Ross" <Ross.Bunnell at ct.gov>
>> To: "'pharmwaste at lists.dep.state.fl.us'" <
>> pharmwaste at lists.dep.state.fl.us>
>> Cc:
>> Date: Fri, 14 Aug 2015 14:57:38 +0000
>> Subject: [Pharmwaste] FW: Vitamins and Supplements
>>
>> Amy:
>>
>> Although it doesn’t squarely address your question, I’d like to offer
>> some insight from Connecticut DEEP’s experience with retail pharmacies that
>> may inform this issue.
>>
>>
>> In our inspections of retail pharmacies in Connecticut, we have made some
>> surprising findings, including some relating to the management of vitamins
>> and nutritional supplements.  More specifically, we have found that many
>> vitamins contain sufficiently high concentrations of selenium or chromium
>> as to be regulated as “toxic” hazardous wastes when they  are disposed of.
>> (I should note that chromium is a rather unique issue for CT because the
>> federal HW regs and most states provide an exemption from HW requirements
>> for wastes that contain primarily trivalent chromium, which is the type of
>> chromium that is found in vitamins; however CT does not adopt this
>> exemption, meaning that many vitamins will be classified as HW for chromium
>> in CT, where they would not be in most other states).
>>
>>
>>
>> Obviously vitamins and other nutritional substances contain a “nutritive”
>> rather than a “toxic” amount of such metals when consumed in the
>> recommended dosage.  However, when large amounts of vitamins are disposed
>> of at the same time, the potential exists for this disposal to result in a
>> slug of contaminant being released into the environment all at once.  This
>> might argue in favor of managing the vitamins/nutritional supplements the
>> same as the other pharmaceuticals that are collected – namely, in a manner
>> that will ensure that any toxic constituents are properly managed and are
>> not released into the environment.
>>
>>
>>
>> On a similar note, believe it or not, we have also found that some
>> “energy” bars contain enough chromium to be classified as a “toxic”
>> hazardous waste in CT.  Apparently, chromium is believed to boost energy,
>> and some manufacturers add it to their energy bars to appeal to consumers
>> who think that it enhances the effectiveness of the product.
>>
>>
>>
>> --Ross Bunnell, CT DEEP
>>
>>
>>
>> *From:* pharmwaste-bounces at lists.dep.state.fl.us [mailto:
>> pharmwaste-bounces at lists.dep.state.fl.us] *On Behalf Of *Tiemeier, Amy
>> *Sent:* Friday, August 14, 2015 10:28 AM
>> *To:* pharmwaste at lists.dep.state.fl.us
>> *Subject:* [Pharmwaste] Vitamins and Supplements
>>
>>
>>
>> Good Friday Morning!
>>
>>
>>
>> I wanted to get the group’s thoughts on the necessity of incinerating
>> vitamins and supplements vs just throwing them in the trash or flushing
>> them.
>>
>>
>>
>> Our non-profit has noticed that a fair amount of what we get in our drop
>> boxes are large bottles of vitamins and supplements that are expired. As we
>> pay for incineration by weight and are reliant on donations to support our
>> incineration, we were wondering if we could remove vitamins and supplements
>> from the list of items we accept and rather advise people to throw them in
>> the trash or flush them. It doesn’t seem like these types of items are the
>> ones we are worried about especially as they come from naturally occurring
>> sources. That being said, I wanted to get the thoughts of the experts on
>> the list serve who understand the environmental impact of these things
>> better than I do.
>>
>>
>>
>> Thank you for any input or insight you have.
>>
>>
>>
>> Warm Regards,
>>
>> Amy Tiemeier
>>
>>
>>
>> Amy Tiemeier, Pharm.D., BCPS
>>
>> *Director, Community Partnerships*
>>
>> *Associate Director, Office of Experiential Education*
>>
>> *Associate Professor, Department of Pharmacy Practice*
>>
>>
>>
>> [image: cid:image001.png at 01CFC03C.37B3BA50]
>>
>> 4588 Parkview Place, St. Louis, MO 63110-1088
>>
>> Office: 314.446.8554 | Fax: 314.446.8386
>>
>> *amy.tiemeier at stlcop.edu <amy.tiemeier at stlcop.edu>*
>>
>> [image: cid:image002.png at 01CFC03C.37B3BA50]
>>
>> [image: cid:image003.png at 01CFC03C.37B3BA50]
>> <http://www.stlcop.edu/index.html>[image:
>> cid:image004.png at 01CFC03C.37B3BA50] <https://www.facebook.com/STLCOP>[image:
>> cid:image005.png at 01CFC03C.37B3BA50] <https://twitter.com/STLCOPedu>[image:
>> cid:image006.png at 01CFC03C.37B3BA50]
>> <https://www.flickr.com/photos/stlcop/sets>
>>
>>
>>
>> ---
>> Note: As a courtesy to other listserv subscribers, please post messages
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>
>
> ---
> Note: As a courtesy to other listserv subscribers, please post messages to
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> received by digest recipients.
> ---
> TO SUBSCRIBE, go to:
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