From Laurie.Tenace at dep.state.fl.us Mon Jan 5 08:27:25 2015 From: Laurie.Tenace at dep.state.fl.us (Tenace, Laurie) Date: Mon Jan 5 08:27:57 2015 Subject: [Pharmwaste] common diabetes medication among drugs found in lake Michigan Message-ID: http://www.jsonline.com/news/health/common-diabetes-medication-among-drugs-found-in-lake-michigan-b99417112z1-287238651.html There is more than one way to measure prescription drug use in modern society. The most direct method is just to count up prescriptions filled by America's pharmacies. That would show, for instance, that more than 180 million prescriptions for diabetes drugs were dispensed in 2013. Or you could test the treated water coming out of sewage facilities such as the South Shore plant in Oak Creek. That approach reveals that in the Lake Michigan waters outside the plant, the diabetes drug metformin was the most common personal care product found by researchers with the School of Freshwater Sciences at the University of Wisconsin-Milwaukee. More importantly, according to their latest research, the levels of metformin were so high that the drug could be disrupting the endocrine systems of fish. Last month, a Journal Sentinel/MedPage Today investigation found booming sales of diabetes drugs, which in 2013 had grown to more than $23 billion. Metformin is a first-line treatment for type 2 diabetes and is the most commonly prescribed medicine for the condition. In 2013, about 70 million prescriptions were dispensed, according to IMS Health, a drug market research firm. It is so ubiquitous it can easily be found in water samples taken two miles off the shore of Lake Michigan. "I was kind of a surprise," said Rebecca Klaper, a professor of freshwater science at UWM. "It was not even on our radar screen. I said, 'What is this drug?' " The drugs get into the sewage and eventually the lake because they are not broken down completely after they are consumed and then excreted. The metformin concentrations are low, compared with the amount taken by people. For instance, coming right out of the treatment plant the levels are about 40 parts per billion. About two miles away, they drop to 120 parts per trillion. Other commonly found substances include caffeine, sulfamethoxazole, an antibiotic, and triclosan, an antibacterial and antifungal found in soap and other consumer products. Klaper co-authored a 2013 science journal paper on the finding as well as another one this year. The more recent research suggests that metformin in lake water is not just a curious artifact of everyday life. The study looked at the effect of metformin on fathead minnows in the lab that were exposed to the drug at levels found in the lake for four weeks. It found gene expression suggesting disruption of the endocrine system of male fish, but not females. In essence, the males were producing biochemicals that are associated with female minnows. The biochemicals are precursors to the production of eggs. Klaper said that because the minnows are a stand-in for other fish, the changes also could be affecting other species such as perch, walleye and northern pike. The UWM research confirms what others have found regarding prescription drugs showing up in America's lakes, rivers and streams, said Melissa Lenczewski, an associate professor of geology and environmental geosciences at Northern Illinois University. For years, it was assumed that the volume of water in the Great Lakes was so enormous that any drugs that got through treatment facilities would be diluted to the point that they would not pose a problem, said Lenczewski, who was not a part of the UWM study. That theory itself now is being diluted. Even more concerning are the much higher levels of antibiotics that are being put into rivers and streams near pig farms where the drugs are used to produce larger animals, she said. In addition, strains of antibiotic-resistant bacteria also have been found in water near those farms, she said. "It is very alarming how much we are putting drugs out there in the environment," she said. Laurie Tenace Environmental Specialist Waste Reduction Section Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4555 Tallahassee, FL 32399-2400 850.245.8759 Laurie.Tenace@dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150105/c9493022/attachment.html From SHoertt at haleyaldrich.com Mon Jan 5 09:46:10 2015 From: SHoertt at haleyaldrich.com (Hoertt, Susan) Date: Mon Jan 5 09:46:23 2015 Subject: [Pharmwaste] Unsubscribe Message-ID: <90C246DB0CBD2E448C36FCDB40CF37DC1ABC719A@exch10mail1.haleyaldrich.com> Susan Hoertt, R.S., CPEA Senior Scientist | Client Leader Haley & Aldrich 8899 Gander Creek Drive Miamisburg, OH 45342-5432 +1 937.530.1408 Office +1 937.620.3799 Cellular +1 937.530.1458 Fax SHoertt@HaleyAldrich.com From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Tenace, Laurie Sent: Monday, January 05, 2015 8:27 AM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] common diabetes medication among drugs found in lake Michigan http://www.jsonline.com/news/health/common-diabetes-medication-among-drugs-found-in-lake-michigan-b99417112z1-287238651.html There is more than one way to measure prescription drug use in modern society. The most direct method is just to count up prescriptions filled by America's pharmacies. That would show, for instance, that more than 180 million prescriptions for diabetes drugs were dispensed in 2013. Or you could test the treated water coming out of sewage facilities such as the South Shore plant in Oak Creek. That approach reveals that in the Lake Michigan waters outside the plant, the diabetes drug metformin was the most common personal care product found by researchers with the School of Freshwater Sciences at the University of Wisconsin-Milwaukee. More importantly, according to their latest research, the levels of metformin were so high that the drug could be disrupting the endocrine systems of fish. Last month, a Journal Sentinel/MedPage Today investigation found booming sales of diabetes drugs, which in 2013 had grown to more than $23 billion. Metformin is a first-line treatment for type 2 diabetes and is the most commonly prescribed medicine for the condition. In 2013, about 70 million prescriptions were dispensed, according to IMS Health, a drug market research firm. It is so ubiquitous it can easily be found in water samples taken two miles off the shore of Lake Michigan. "I was kind of a surprise," said Rebecca Klaper, a professor of freshwater science at UWM. "It was not even on our radar screen. I said, 'What is this drug?' " The drugs get into the sewage and eventually the lake because they are not broken down completely after they are consumed and then excreted. The metformin concentrations are low, compared with the amount taken by people. For instance, coming right out of the treatment plant the levels are about 40 parts per billion. About two miles away, they drop to 120 parts per trillion. Other commonly found substances include caffeine, sulfamethoxazole, an antibiotic, and triclosan, an antibacterial and antifungal found in soap and other consumer products. Klaper co-authored a 2013 science journal paper on the finding as well as another one this year. The more recent research suggests that metformin in lake water is not just a curious artifact of everyday life. The study looked at the effect of metformin on fathead minnows in the lab that were exposed to the drug at levels found in the lake for four weeks. It found gene expression suggesting disruption of the endocrine system of male fish, but not females. In essence, the males were producing biochemicals that are associated with female minnows. The biochemicals are precursors to the production of eggs. Klaper said that because the minnows are a stand-in for other fish, the changes also could be affecting other species such as perch, walleye and northern pike. The UWM research confirms what others have found regarding prescription drugs showing up in America's lakes, rivers and streams, said Melissa Lenczewski, an associate professor of geology and environmental geosciences at Northern Illinois University. For years, it was assumed that the volume of water in the Great Lakes was so enormous that any drugs that got through treatment facilities would be diluted to the point that they would not pose a problem, said Lenczewski, who was not a part of the UWM study. That theory itself now is being diluted. Even more concerning are the much higher levels of antibiotics that are being put into rivers and streams near pig farms where the drugs are used to produce larger animals, she said. In addition, strains of antibiotic-resistant bacteria also have been found in water near those farms, she said. "It is very alarming how much we are putting drugs out there in the environment," she said. Laurie Tenace Environmental Specialist Waste Reduction Section Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4555 Tallahassee, FL 32399-2400 850.245.8759 Laurie.Tenace@dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150105/ea035d16/attachment.htm From GILLIAM at adeq.state.ar.us Mon Jan 5 10:48:36 2015 From: GILLIAM at adeq.state.ar.us (Gilliam, Allen) Date: Mon Jan 5 10:48:51 2015 Subject: [Pharmwaste] common diabetes medication among drugs found in lake Michigan In-Reply-To: References: Message-ID: Thanks Laurie, Hope everyone's back in the working mood for this new year (blech..., not me!), Just out of curiosity, I googled metformin and scanned its "FDA Approval History" from 3/95 up until 8/14. Although I didn't check every date and "Applicant" (pharmaceutical co.?), I'm estimating there are 50+/- different companies who are making this drug now, if I'm understanding the "Approval History" chart correctly. Exponentially compound that number by the thousands of other drugs being manufacturing by a multitude of "big/little pharmas" and it's no wonder why that humongous group can't re-formulate their drugs to completely metabolize while in the patient. Even if forced to (at the consumer's expense) which is highly unlikely in our lifetime, the generics are already eating up my paycheck the way it is. Food, electricity, etc. or high dollar BP, etc meds? I want to personally thank Ms. Tenace(ious) for giving us this platform to share stories, reports, etc to bring to the forefront this not-so-subtle environmental issue for the past...what?...almost a decade? Without this listserve and many of its very active members I don't believe pharmaceutical laden waters of the U.S. would be at the level it has gained at EPA, DEA and the FDA. Kudos goes out to you Ms. Tenace! Let's keep this wheel churning, Allen Gilliam ADEQ State Pretreatment Coordinator 501.682.0625 From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Tenace, Laurie Sent: Monday, January 05, 2015 7:27 AM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] common diabetes medication among drugs found in lake Michigan http://www.jsonline.com/news/health/common-diabetes-medication-among-drugs-found-in-lake-michigan-b99417112z1-287238651.html There is more than one way to measure prescription drug use in modern society. The most direct method is just to count up prescriptions filled by America's pharmacies. That would show, for instance, that more than 180 million prescriptions for diabetes drugs were dispensed in 2013. Or you could test the treated water coming out of sewage facilities such as the South Shore plant in Oak Creek. That approach reveals that in the Lake Michigan waters outside the plant, the diabetes drug metformin was the most common personal care product found by researchers with the School of Freshwater Sciences at the University of Wisconsin-Milwaukee. More importantly, according to their latest research, the levels of metformin were so high that the drug could be disrupting the endocrine systems of fish. Last month, a Journal Sentinel/MedPage Today investigation found booming sales of diabetes drugs, which in 2013 had grown to more than $23 billion. Metformin is a first-line treatment for type 2 diabetes and is the most commonly prescribed medicine for the condition. In 2013, about 70 million prescriptions were dispensed, according to IMS Health, a drug market research firm. It is so ubiquitous it can easily be found in water samples taken two miles off the shore of Lake Michigan. "I was kind of a surprise," said Rebecca Klaper, a professor of freshwater science at UWM. "It was not even on our radar screen. I said, 'What is this drug?' " The drugs get into the sewage and eventually the lake because they are not broken down completely after they are consumed and then excreted. The metformin concentrations are low, compared with the amount taken by people. For instance, coming right out of the treatment plant the levels are about 40 parts per billion. About two miles away, they drop to 120 parts per trillion. Other commonly found substances include caffeine, sulfamethoxazole, an antibiotic, and triclosan, an antibacterial and antifungal found in soap and other consumer products. Klaper co-authored a 2013 science journal paper on the finding as well as another one this year. The more recent research suggests that metformin in lake water is not just a curious artifact of everyday life. The study looked at the effect of metformin on fathead minnows in the lab that were exposed to the drug at levels found in the lake for four weeks. It found gene expression suggesting disruption of the endocrine system of male fish, but not females. In essence, the males were producing biochemicals that are associated with female minnows. The biochemicals are precursors to the production of eggs. Klaper said that because the minnows are a stand-in for other fish, the changes also could be affecting other species such as perch, walleye and northern pike. The UWM research confirms what others have found regarding prescription drugs showing up in America's lakes, rivers and streams, said Melissa Lenczewski, an associate professor of geology and environmental geosciences at Northern Illinois University. For years, it was assumed that the volume of water in the Great Lakes was so enormous that any drugs that got through treatment facilities would be diluted to the point that they would not pose a problem, said Lenczewski, who was not a part of the UWM study. That theory itself now is being diluted. Even more concerning are the much higher levels of antibiotics that are being put into rivers and streams near pig farms where the drugs are used to produce larger animals, she said. In addition, strains of antibiotic-resistant bacteria also have been found in water near those farms, she said. "It is very alarming how much we are putting drugs out there in the environment," she said. Laurie Tenace Environmental Specialist Waste Reduction Section Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4555 Tallahassee, FL 32399-2400 850.245.8759 Laurie.Tenace@dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150105/0eb859a1/attachment-0001.htm From Kathy.Winston at dep.state.fl.us Mon Jan 5 11:46:56 2015 From: Kathy.Winston at dep.state.fl.us (Winston, Kathy) Date: Mon Jan 5 11:47:07 2015 Subject: [Pharmwaste] common diabetes medication among drugs found in lake Michigan In-Reply-To: References: Message-ID: I couldn't agree more; Laurie deserves a pat on the back and then some! From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Monday, January 5, 2015 10:49 AM To: Tenace, Laurie; 'pharmwaste@lists.dep.state.fl.us' Subject: RE: [Pharmwaste] common diabetes medication among drugs found in lake Michigan Thanks Laurie, Hope everyone's back in the working mood for this new year (blech..., not me!), Just out of curiosity, I googled metformin and scanned its "FDA Approval History" from 3/95 up until 8/14. Although I didn't check every date and "Applicant" (pharmaceutical co.?), I'm estimating there are 50+/- different companies who are making this drug now, if I'm understanding the "Approval History" chart correctly. Exponentially compound that number by the thousands of other drugs being manufacturing by a multitude of "big/little pharmas" and it's no wonder why that humongous group can't re-formulate their drugs to completely metabolize while in the patient. Even if forced to (at the consumer's expense) which is highly unlikely in our lifetime, the generics are already eating up my paycheck the way it is. Food, electricity, etc. or high dollar BP, etc meds? I want to personally thank Ms. Tenace(ious) for giving us this platform to share stories, reports, etc to bring to the forefront this not-so-subtle environmental issue for the past...what?...almost a decade? Without this listserve and many of its very active members I don't believe pharmaceutical laden waters of the U.S. would be at the level it has gained at EPA, DEA and the FDA. Kudos goes out to you Ms. Tenace! Let's keep this wheel churning, Allen Gilliam ADEQ State Pretreatment Coordinator 501.682.0625 From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Tenace, Laurie Sent: Monday, January 05, 2015 7:27 AM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] common diabetes medication among drugs found in lake Michigan http://www.jsonline.com/news/health/common-diabetes-medication-among-drugs-found-in-lake-michigan-b99417112z1-287238651.html There is more than one way to measure prescription drug use in modern society. The most direct method is just to count up prescriptions filled by America's pharmacies. That would show, for instance, that more than 180 million prescriptions for diabetes drugs were dispensed in 2013. Or you could test the treated water coming out of sewage facilities such as the South Shore plant in Oak Creek. That approach reveals that in the Lake Michigan waters outside the plant, the diabetes drug metformin was the most common personal care product found by researchers with the School of Freshwater Sciences at the University of Wisconsin-Milwaukee. More importantly, according to their latest research, the levels of metformin were so high that the drug could be disrupting the endocrine systems of fish. Last month, a Journal Sentinel/MedPage Today investigation found booming sales of diabetes drugs, which in 2013 had grown to more than $23 billion. Metformin is a first-line treatment for type 2 diabetes and is the most commonly prescribed medicine for the condition. In 2013, about 70 million prescriptions were dispensed, according to IMS Health, a drug market research firm. It is so ubiquitous it can easily be found in water samples taken two miles off the shore of Lake Michigan. "I was kind of a surprise," said Rebecca Klaper, a professor of freshwater science at UWM. "It was not even on our radar screen. I said, 'What is this drug?' " The drugs get into the sewage and eventually the lake because they are not broken down completely after they are consumed and then excreted. The metformin concentrations are low, compared with the amount taken by people. For instance, coming right out of the treatment plant the levels are about 40 parts per billion. About two miles away, they drop to 120 parts per trillion. Other commonly found substances include caffeine, sulfamethoxazole, an antibiotic, and triclosan, an antibacterial and antifungal found in soap and other consumer products. Klaper co-authored a 2013 science journal paper on the finding as well as another one this year. The more recent research suggests that metformin in lake water is not just a curious artifact of everyday life. The study looked at the effect of metformin on fathead minnows in the lab that were exposed to the drug at levels found in the lake for four weeks. It found gene expression suggesting disruption of the endocrine system of male fish, but not females. In essence, the males were producing biochemicals that are associated with female minnows. The biochemicals are precursors to the production of eggs. Klaper said that because the minnows are a stand-in for other fish, the changes also could be affecting other species such as perch, walleye and northern pike. The UWM research confirms what others have found regarding prescription drugs showing up in America's lakes, rivers and streams, said Melissa Lenczewski, an associate professor of geology and environmental geosciences at Northern Illinois University. For years, it was assumed that the volume of water in the Great Lakes was so enormous that any drugs that got through treatment facilities would be diluted to the point that they would not pose a problem, said Lenczewski, who was not a part of the UWM study. That theory itself now is being diluted. Even more concerning are the much higher levels of antibiotics that are being put into rivers and streams near pig farms where the drugs are used to produce larger animals, she said. In addition, strains of antibiotic-resistant bacteria also have been found in water near those farms, she said. "It is very alarming how much we are putting drugs out there in the environment," she said. Laurie Tenace Environmental Specialist Waste Reduction Section Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4555 Tallahassee, FL 32399-2400 850.245.8759 Laurie.Tenace@dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150105/5cdd1344/attachment.htm From wcermail at gmail.com Tue Jan 6 20:15:22 2015 From: wcermail at gmail.com (Bill Speenburgh) Date: Tue Jan 6 20:16:12 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: <20150106085355.937EF11053F@lists.dep.state.fl.us> References: <20150106085355.937EF11053F@lists.dep.state.fl.us> Message-ID: <006701d02a17$692c9c10$3b85d430$@gmail.com> As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." From jmullowney at pharma-cycle.com Wed Jan 7 06:38:09 2015 From: jmullowney at pharma-cycle.com (jmullowney) Date: Wed Jan 7 06:39:21 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Message-ID: Bill You do not need to have your urine tested you can just read the drug insert,that pice ?of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects.? Not all drugs are hazardous to ?humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org ? Sent from my T-Mobile 4G LTE Device
-------- Original message --------
From: Bill Speenburgh
Date:01/06/2015 8:15 PM (GMT-05:00)
To: pharmwaste@lists.dep.state.fl.us
Cc:
Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1
As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/98b0c76c/attachment.html From GILLIAM at adeq.state.ar.us Wed Jan 7 09:12:51 2015 From: GILLIAM at adeq.state.ar.us (Gilliam, Allen) Date: Wed Jan 7 09:37:57 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/73c28e7c/attachment.htm From zenllc at usfamily.net Wed Jan 7 10:09:16 2015 From: zenllc at usfamily.net (Catherine Zimmer) Date: Wed Jan 7 10:12:00 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: <002a01d02a8b$e99cea20$bcd6be60$@usfamily.net> Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/c5420529/attachment.htm From jmullowney at pharma-cycle.com Wed Jan 7 10:22:40 2015 From: jmullowney at pharma-cycle.com (Jim Mullowney) Date: Wed Jan 7 10:23:13 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: <002a01d02a8b$e99cea20$bcd6be60$@usfamily.net> References: <002a01d02a8b$e99cea20$bcd6be60$@usfamily.net> Message-ID: <005d01d02a8d$c6b30240$541906c0$@pharma-cycle.com> Hi all We will be filing legislation in Rhode Island today to require the cost of collecting the human waste from the 27 bad actor chemotherapy treatments as part of the cost of the treatment. Average cancer treatment is almost $200,000 per year and the cost to collect transport and destroy the contaminated urine and feces is about 2 to 3 % of that. I have a list of the problem drugs attached with excretion times and amounts. I will be happy to share the language in the legislation to file in other states. Thank you for your help Jim From: Catherine Zimmer [mailto:zenllc@usfamily.net] Sent: Wednesday, January 07, 2015 10:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/c57d11d7/attachment-0001.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 33943 bytes Desc: not available Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/c57d11d7/attachment-0001.png From AHeil at lacsd.org Wed Jan 7 10:33:36 2015 From: AHeil at lacsd.org (Heil, Ann) Date: Wed Jan 7 10:33:52 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: <002a01d02a8b$e99cea20$bcd6be60$@usfamily.net> References: <002a01d02a8b$e99cea20$bcd6be60$@usfamily.net> Message-ID: Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/f71f9c9c/attachment.htm From GILLIAM at adeq.state.ar.us Wed Jan 7 11:07:48 2015 From: GILLIAM at adeq.state.ar.us (Gilliam, Allen) Date: Wed Jan 7 11:08:12 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Message-ID: Thanks for the reminder and edification to all that responded. Laurie said it in the most simplest terms this mechanical engineer could understand, ?That?s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.? I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment. Jim?s chart was quite surprising. Don?t think I?ve seen anything like it before. Jim? What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy ?leftovers?? Allen Gilliam (Pharmwaste not in my job description, just continually passing thru) ADEQ State Pretreatment Coordinator 501.682.0625 From: Heil, Ann [mailto:AHeil@lacsd.org] Sent: Wednesday, January 07, 2015 9:34 AM To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/da0e7f23/attachment-0001.htm From Karen.Tannert at dshs.state.tx.us Wed Jan 7 11:30:03 2015 From: Karen.Tannert at dshs.state.tx.us (Tannert,Karen (DSHS)) Date: Wed Jan 7 11:30:14 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: Even when I was in pharmacy school in the 80's we discussed the shotgun approach to dosing. The developers seek an average that will correctly treat the most people without killing them - bell curve. Consider that the first stage of human testing is usually healthy males around 25 years of age. Individualized dosing based on genetics, metabolism, etc. was pretty much a pipe-dream at that point, but I've seen research creeping in that direction. An example, when I first started practicing was low dose estrogen birth control pills. They just started appearing on the market in the 80's when it was shown that the existing estrogen/progesterone combo products were overkill. I think drug companies should continue to tweak their products as they see what works at the most efficient dose possible, but I doubt they will without legislature/FDA/public hanging over them. Karen Tannert, R.Ph., M.P.H. Drugs and Medical Devices Group (MC 1987) Texas Department of State Health Services P O Box 149347 Austin, TX 78714-9347 (512) 834-6755 ext. 2350 (512) 834-6759 (fax) From: Gilliam, Allen [mailto:GILLIAM@adeq.state.ar.us] Sent: Wednesday, January 07, 2015 10:08 AM To: Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Thanks for the reminder and edification to all that responded. Laurie said it in the most simplest terms this mechanical engineer could understand, ?That?s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.? I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment. Jim?s chart was quite surprising. Don?t think I?ve seen anything like it before. Jim? What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy ?leftovers?? Allen Gilliam (Pharmwaste not in my job description, just continually passing thru) ADEQ State Pretreatment Coordinator 501.682.0625 From: Heil, Ann [mailto:AHeil@lacsd.org] Sent: Wednesday, January 07, 2015 9:34 AM To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/9bdd6a41/attachment.htm From Daughton.Christian at epa.gov Wed Jan 7 11:34:27 2015 From: Daughton.Christian at epa.gov (Daughton, Christian) Date: Wed Jan 7 11:34:47 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: The topic of drug excretion efficiency is far more complex than generally recognized. And the rudimentary pharmacokinetic data on package inserts can be very misleading for the purposes of environmental risk assessment. There are numerous variables that dictate the extent to which an API is excreted unchanged. And even then, the portion of parent API that is excreted unchanged reveals only part of the story. Reversible metabolic conjugates of the parent API, for example, can be highly excreted and serve as sizeable hidden reservoirs that can later release additional API. Excretion is a function not just of the API but also the genetics and health of the individual. Large portions of some APIs are not even absorbed - passing directly through the gut (a reason for high doses of certain APIs). A wide range of excretion values often occurs across the general population for many APIs. The role of pharmacokinetics in dictating the entry of APIs to the environment is rarely discussed in the literature. Here is the most comprehensive examination of this topic that I'm aware of: Daughton CG "Eco-directed sustainable prescribing: feasibility for reducing water contamination by drugs." Science of the Total Environment 2014, 493:392-404; http://dx.doi.org/10.1016/j.scitotenv.2014.06.013 [OpenAccess]. This paper can be directly downloaded from the link. I have also attached a reprint that contains some extensive supplementary data. The paper is not pleasant reading, but that reinforces the fact that this is a tough subject that's not amenable to easy summary. There is also a prior paper that shows how dose can be reduced for certain drugs - thereby reducing quantities excreted via sewage: Daughton CG and Ruhoy IS "Lower-Dose Prescribing: Minimizing 'Side Effects' of Pharmaceuticals on Society and the Environment," Science of the Total Environment, 2013, 443:324-337; available: http://dx.doi.org/10.1016/j.scitotenv.2012.10.092 (including supplementary data) [OpenAccess]. My apologies if this just confuses things. christian daughton ==================== Christian Daughton, Ph.D. Environmental Chemistry Branch Environmental Sciences Division National Exposure Research Laboratory U.S. Environmental Protection Agency 944 East Harmon Las Vegas, NV 89119 702-798-2207 daughton.christian@epa.gov CV: http://www.epa.gov/esd/bios/daughton.htm#publications PPCPs Literature Database: http://epa.gov/ppcp/lit.html Drug Disposal: http://epa.gov/ppcp/projects/disposal.html From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:08 AM To: Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Thanks for the reminder and edification to all that responded. Laurie said it in the most simplest terms this mechanical engineer could understand, ?That?s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.? I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment. Jim?s chart was quite surprising. Don?t think I?ve seen anything like it before. Jim? What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy ?leftovers?? Allen Gilliam (Pharmwaste not in my job description, just continually passing thru) ADEQ State Pretreatment Coordinator 501.682.0625 From: Heil, Ann [mailto:AHeil@lacsd.org] Sent: Wednesday, January 07, 2015 9:34 AM To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/aa4adec5/attachment-0001.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: 2014 - EDSP STOTEN reprint plus Supplemental Tables.pdf Type: application/pdf Size: 906118 bytes Desc: 2014 - EDSP STOTEN reprint plus Supplemental Tables.pdf Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/aa4adec5/2014-EDSPSTOTENreprintplusSupplementalTables-0001.pdf From jmullowney at pharma-cycle.com Wed Jan 7 11:35:35 2015 From: jmullowney at pharma-cycle.com (Jim Mullowney) Date: Wed Jan 7 11:37:15 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: <00c301d02a97$f6d84020$e488c060$@pharma-cycle.com> Thank you Allen. We have been working in RI for many years and feel we have a very strong case. We are also talking to Medicare on federal reimbursement. The legislation is modeled after the World Health Organizations recommendations. From: Gilliam, Allen [mailto:GILLIAM@adeq.state.ar.us] Sent: Wednesday, January 07, 2015 11:08 AM To: Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Thanks for the reminder and edification to all that responded. Laurie said it in the most simplest terms this mechanical engineer could understand, ?That?s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.? I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment. Jim?s chart was quite surprising. Don?t think I?ve seen anything like it before. Jim? What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy ?leftovers?? Allen Gilliam (Pharmwaste not in my job description, just continually passing thru) ADEQ State Pretreatment Coordinator 501.682.0625 From: Heil, Ann [mailto:AHeil@lacsd.org] Sent: Wednesday, January 07, 2015 9:34 AM To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/edafa612/attachment.htm From Deborah.DeBiasi at deq.virginia.gov Wed Jan 7 13:21:47 2015 From: Deborah.DeBiasi at deq.virginia.gov (DeBiasi, Deborah (DEQ)) Date: Wed Jan 7 13:22:23 2015 Subject: [Pharmwaste] Common as Dirt: New Antibiotic May Conquer Superbugs Message-ID: <2FB366A29AAF0D47BD422C53F698353F22940DB0@COVMSGCES-MBX02> http://www.nbcnews.com/health/health-news/common-dirt-new-antibiotic-may-conquer-superbugs-n281011 Common as Dirt: New Antibiotic May Conquer Superbugs menu Sections * News * Investigations * Politics * Health * Tech * Science * Pop Culture * Business * Latino * Asian America TV * Nightly News * Meet the Press * Dateline * TODAY Top storylines *Iraq Turmoil *West Bank Kidnappings *Ukraine Crisis Featured *30 seconds to know *Art of the Startup *Show Me *Nerdwatch *First Read *Flashback Multimedia *Video *Photo Top Stories * Officials Say They Can't Confirm Who Is Responsible for Paris Attack * Kerry Says Paris Victims Are 'Martyrs for Liberty' * Gunmen At Large After Deadly Attack at Paris Magazine * Driver of Dirty Pickup Hunted After Blast Near NAACP More from NBC * Local News * Weather * Sports * CNBC * MSNBC.COM * NBC.COM * Breaking News * In Plain Sight * NBC Learn * RE/CODE * Peacock Productions * Next Step for Vets * Parent Toolkit * nbcnews * home * latest * search * * * * * * [http://media1.s-nbcnews.com/i/newscms/2015_02/837911/150107-the-dirt-jsw-1129a_fdaec5dbd10784c7547bb8c53cbd0f76.jpg]Slava Epstein / Northeastern University 1 hours Health This black iChip was developed by researchers at Northeastern University to grow bacteria that usually don't grow in the lab. They used it to get a potentially very powerful new antibiotic from bacteria living in this soil samples, from a field in Maine. Common as Dirt: New Antibiotic May Conquer Superbugs By Maggie Fox A handful of dirt from a field has yielded what may be the first of a new family of antibiotics. Early tests suggest this one has the potential to be especially powerful, providing a new weapon against the growing threat of drug-resistant superbugs. Scientists at Northeastern University in Boston and a small company called NovoBiotic Pharmaceuticals used a new method to find the compound, which appears to bypass the many different tricks that germs have for getting around the effects of antibiotics. Tests in mice suggest it works to kill a wide range of bacteria, from staphylococcus to drug-resistant tuberculosis. They've named it teixobactin. It comes from a soil-dwelling bacteria that usually doesn't thrive in the lab, so it hadn't been developed as a source of antibiotics. "The compound is highly potent against a broad range of Gram-positive microbes, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE)," the company said in a statement. "The compound is highly potent against a broad range of Gram-positive microbes." And it came from an ordinary field in Maine. The new device may offer a way for scientists to harvest all sorts of different products from soil bacteria too shy to grow in most labs. "What most excites me ... is the tantalizing prospect that this discovery is just the tip of the iceberg," said Mark Woolhouse, a professor of infectious disease epidemiology at the University of Edinburgh. Bacteria develop resistance to drugs quickly. Even before penicillin was introduced in 1943, staphylococcus germs had genes that would have made them resistant to its effects. Just nine years after tetracycline was introduced in 1950, a resistant strain of Shigella evolved. Methicillin-resistant Staphylococcus aureus (MRSA) evolved just two years after methicillin hit the market in 1960. The last new antibiotic to be introduced was ceftaroline, in 2010. It took just a year for the first staph germ to evolve that resisted its effects. "We desperately need new antibiotics," said Allan Coukell, senior director for health programs at the Pew Charitable Trusts. "We have increasing numbers of infections that cannot be treated with existing drugs." "[Patients] are having to stay in the hospital, undergo other procedures, and, unfortunately, they are dying because we don't have new, effective antibiotics," added Amanda Jezek, vice president of public policy and government relations at the Infectious Diseases Society of America. The Centers for Disease Control and Prevention says more than two million people are infected by drug-resistant germs each year, and 23,000 die of their infections. The biggest killer by far in the U.S. is diarrhea-causing C. difficile. Near-untreatable cases of diarrhea, sepsis, pneumonia and gonorrhea are infecting millions more globally, the World Health Organization says. Many new antibiotics are found in microbes and especially fungi and bacteria from dirt. They use them to fight off other microbes. The original antibiotic, penicillin, comes from Penicillium, a fungus found just about everywhere, including in soil. And while researchers know that any sample of dirt is likely to yield a wealth of bacteria, many just won't grow in the lab. That makes it hard to get a large enough sample to pull antibiotics from. Kim Lewis of Northeastern and a team of colleagues came up with a new way to grow bacteria. It's called an iChip and it allows the bacteria to grow in their natural environment. They screened 10,000 different types of bacteria and found an especially promising one called Eleftheria terrae. Lab tests showed it makes a compound that is great at killing other bacteria. It breaks down their protective cell walls and stops the rebuilding process. But it doesn't break down the type of cell envelopes that Gram-negative bacteria make, so it's unlikely to work against most strains of E. coli, for example, the vibrio bacteria that cause cholera or the Yersinia bacteria that cause plague. E. terrae is itself a Gram-negative bacteria. It also doesn't appear to damage the cells of mammals. Tests in mice showed it could cure infections without causing harm. And it seems impervious to the various mutations that bacteria can use to resist its deadly effects. The researchers tried several ways to get bacteria exposed to teixobactin to mutate but they did not. That probably won't last forever, but it could take decades for resistant mutants to evolve, Lewis and colleagues say. "It is likely that additional natural compounds with similarly low susceptibility to resistance are present in nature and are waiting to be discovered," they wrote in their report, published in the journal Nature. "We desperately need new antibiotics." It would be years before this compound could become a new drug. Many tests are needed, and there are many ways for an experimental drug to fail. Jezek says antibiotics are an especially problematic area because there's not much profit in making them. "We are seeing companies pulling back from doing antibiotic development in part because the science is very difficult and the development costs are high," she said. "At the same time, the profit margins are very low." People only take antibiotics for a few days, usually - unlike heart disease drugs or pain relievers that are taken for decades. "It just has created a really unique, really challenging business model," Jezek said. This study points to a new way to find new antibiotics literally lying around, waiting to be discovered. First published January 7 2015, 10:03 AM Deborah L. DeBiasi Email: Deborah.DeBiasi@deq.virginia.gov WEB site address: www.deq.virginia.gov Virginia Department of Environmental Quality Office of Water Permits Industrial Pretreatment/Whole Effluent Toxicity (WET) Program PPCPs, EDCs, and Microconstituents http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx Mail: P.O. Box 1105, Richmond, VA 23218 Location: 629 E. Main Street, Richmond, VA 23219 PH: 804-698-4028 FAX: 804-698-4032 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/895b308b/attachment-0001.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 775988 bytes Desc: image001.jpg Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/895b308b/image001-0001.jpg From GILLIAM at adeq.state.ar.us Wed Jan 7 16:27:26 2015 From: GILLIAM at adeq.state.ar.us (Gilliam, Allen) Date: Wed Jan 7 16:27:43 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: Dr. Daughton, Yep, you?re right, it isn?t ?pleasant? reading, but the abstract and introduction is informative. Just scanning thru your paper I did pick up a few of your points regarding pollution prevention in various modes of opportunity/capability. Do you think your (and others) work/quasi-solutions have been taken into consideration by the ONDCP and/or the FDA? I don?t see EPA trying to put their short legs into this deep issue although it?s my opinion it could fall under the CWA?s purview. I can identify (and cringe at the same time considering all the resources put into the national drug take-back days and permanent 24/7 LE drop boxes) with your quote, ?Significantly, current approaches directed at reducing API levels in the environment have focused solely on pollution control? particularly improved wastewater treatment and take-back collection of unused consumer medications. These are end-of-pipe approaches, which for decades have been the hallmarks for controlling chemical contamination of the environment. These are not, however, approaches that can be relied upon to facilitate the sustainable use of medications. To the contrary, an argument may exist that pollution control measures might work counter to sustainability by deflecting the ongoing dialog surrounding drug residues in the environment away from possibly more effective measures addressing pollution prevention.? Thanks for the research you and others are doing on this issue Christian. Our grandchildren?s grandchildren lives on earth may depend on big Pharma?s actions if global warming doesn?t wrap up the human race first. Allen Gilliam ADEQ State Pretreatment Coordinator 501.682.0625 From: Daughton, Christian [mailto:Daughton.Christian@epa.gov] Sent: Wednesday, January 07, 2015 10:34 AM To: Gilliam, Allen; Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 The topic of drug excretion efficiency is far more complex than generally recognized. And the rudimentary pharmacokinetic data on package inserts can be very misleading for the purposes of environmental risk assessment. There are numerous variables that dictate the extent to which an API is excreted unchanged. And even then, the portion of parent API that is excreted unchanged reveals only part of the story. Reversible metabolic conjugates of the parent API, for example, can be highly excreted and serve as sizeable hidden reservoirs that can later release additional API. Excretion is a function not just of the API but also the genetics and health of the individual. Large portions of some APIs are not even absorbed - passing directly through the gut (a reason for high doses of certain APIs). A wide range of excretion values often occurs across the general population for many APIs. The role of pharmacokinetics in dictating the entry of APIs to the environment is rarely discussed in the literature. Here is the most comprehensive examination of this topic that I'm aware of: Daughton CG "Eco-directed sustainable prescribing: feasibility for reducing water contamination by drugs." Science of the Total Environment 2014, 493:392-404; http://dx.doi.org/10.1016/j.scitotenv.2014.06.013 [OpenAccess]. This paper can be directly downloaded from the link. I have also attached a reprint that contains some extensive supplementary data. The paper is not pleasant reading, but that reinforces the fact that this is a tough subject that's not amenable to easy summary. There is also a prior paper that shows how dose can be reduced for certain drugs - thereby reducing quantities excreted via sewage: Daughton CG and Ruhoy IS "Lower-Dose Prescribing: Minimizing 'Side Effects' of Pharmaceuticals on Society and the Environment," Science of the Total Environment, 2013, 443:324-337; available: http://dx.doi.org/10.1016/j.scitotenv.2012.10.092 (including supplementary data) [OpenAccess]. My apologies if this just confuses things. christian daughton ==================== Christian Daughton, Ph.D. Environmental Chemistry Branch Environmental Sciences Division National Exposure Research Laboratory U.S. Environmental Protection Agency 944 East Harmon Las Vegas, NV 89119 702-798-2207 daughton.christian@epa.gov CV: http://www.epa.gov/esd/bios/daughton.htm#publications PPCPs Literature Database: http://epa.gov/ppcp/lit.html Drug Disposal: http://epa.gov/ppcp/projects/disposal.html From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:08 AM To: Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Thanks for the reminder and edification to all that responded. Laurie said it in the most simplest terms this mechanical engineer could understand, ?That?s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.? I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment. Jim?s chart was quite surprising. Don?t think I?ve seen anything like it before. Jim? What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy ?leftovers?? Allen Gilliam (Pharmwaste not in my job description, just continually passing thru) ADEQ State Pretreatment Coordinator 501.682.0625 From: Heil, Ann [mailto:AHeil@lacsd.org] Sent: Wednesday, January 07, 2015 9:34 AM To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/a4d35506/attachment.htm From Daughton.Christian at epa.gov Wed Jan 7 17:03:20 2015 From: Daughton.Christian at epa.gov (Daughton, Christian) Date: Wed Jan 7 17:03:43 2015 Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 In-Reply-To: References: Message-ID: Allen: There is no immediate user of this work within outside EPA. This paper resulted from an EPA innovation program: http://www2.epa.gov/innovation/pathfinder-innovation-projects-awardees-2012 A feature of all my work over the last 10 years or so has been a focus on the intersection between the environment and the administration of health care. There have been several overarching objectives for this work, including (i) capturing the interest of investigators outside of EPA to pursue new ideas or approaches, (ii) educate the medical communities regarding the intimate linkages between health care and the environment (to treat them as an integral whole), and (iii) catalyze collaboration between healthcare professionals and environmental scientists (which does not exist to any meaningful extent). The ultimate objective is find ways to simultaneously protect the environment and improve the system of health care, all while saving resources and improving therapeutic outcomes. A key aspect of this work is to shift focus from pollution control and mitigation toward pollution prevention. ==================== Christian Daughton, Ph.D. Environmental Chemistry Branch Environmental Sciences Division National Exposure Research Laboratory U.S. Environmental Protection Agency 944 East Harmon Las Vegas, NV 89119 702-798-2207 daughton.christian@epa.gov CV: http://www.epa.gov/esd/bios/daughton.htm#publications PPCPs Literature Database: http://epa.gov/ppcp/lit.html Drug Disposal: http://epa.gov/ppcp/projects/disposal.html From: Gilliam, Allen [mailto:GILLIAM@adeq.state.ar.us] Sent: Wednesday, January 07, 2015 1:27 PM To: Daughton, Christian; Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Dr. Daughton, Yep, you?re right, it isn?t ?pleasant? reading, but the abstract and introduction is informative. Just scanning thru your paper I did pick up a few of your points regarding pollution prevention in various modes of opportunity/capability. Do you think your (and others) work/quasi-solutions have been taken into consideration by the ONDCP and/or the FDA? I don?t see EPA trying to put their short legs into this deep issue although it?s my opinion it could fall under the CWA?s purview. I can identify (and cringe at the same time considering all the resources put into the national drug take-back days and permanent 24/7 LE drop boxes) with your quote, ?Significantly, current approaches directed at reducing API levels in the environment have focused solely on pollution control? particularly improved wastewater treatment and take-back collection of unused consumer medications. These are end-of-pipe approaches, which for decades have been the hallmarks for controlling chemical contamination of the environment. These are not, however, approaches that can be relied upon to facilitate the sustainable use of medications. To the contrary, an argument may exist that pollution control measures might work counter to sustainability by deflecting the ongoing dialog surrounding drug residues in the environment away from possibly more effective measures addressing pollution prevention.? Thanks for the research you and others are doing on this issue Christian. Our grandchildren?s grandchildren lives on earth may depend on big Pharma?s actions if global warming doesn?t wrap up the human race first. Allen Gilliam ADEQ State Pretreatment Coordinator 501.682.0625 From: Daughton, Christian [mailto:Daughton.Christian@epa.gov] Sent: Wednesday, January 07, 2015 10:34 AM To: Gilliam, Allen; Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 The topic of drug excretion efficiency is far more complex than generally recognized. And the rudimentary pharmacokinetic data on package inserts can be very misleading for the purposes of environmental risk assessment. There are numerous variables that dictate the extent to which an API is excreted unchanged. And even then, the portion of parent API that is excreted unchanged reveals only part of the story. Reversible metabolic conjugates of the parent API, for example, can be highly excreted and serve as sizeable hidden reservoirs that can later release additional API. Excretion is a function not just of the API but also the genetics and health of the individual. Large portions of some APIs are not even absorbed - passing directly through the gut (a reason for high doses of certain APIs). A wide range of excretion values often occurs across the general population for many APIs. The role of pharmacokinetics in dictating the entry of APIs to the environment is rarely discussed in the literature. Here is the most comprehensive examination of this topic that I'm aware of: Daughton CG "Eco-directed sustainable prescribing: feasibility for reducing water contamination by drugs." Science of the Total Environment 2014, 493:392-404; http://dx.doi.org/10.1016/j.scitotenv.2014.06.013 [OpenAccess]. This paper can be directly downloaded from the link. I have also attached a reprint that contains some extensive supplementary data. The paper is not pleasant reading, but that reinforces the fact that this is a tough subject that's not amenable to easy summary. There is also a prior paper that shows how dose can be reduced for certain drugs - thereby reducing quantities excreted via sewage: Daughton CG and Ruhoy IS "Lower-Dose Prescribing: Minimizing 'Side Effects' of Pharmaceuticals on Society and the Environment," Science of the Total Environment, 2013, 443:324-337; available: http://dx.doi.org/10.1016/j.scitotenv.2012.10.092 (including supplementary data) [OpenAccess]. My apologies if this just confuses things. christian daughton ==================== Christian Daughton, Ph.D. Environmental Chemistry Branch Environmental Sciences Division National Exposure Research Laboratory U.S. Environmental Protection Agency 944 East Harmon Las Vegas, NV 89119 702-798-2207 daughton.christian@epa.gov CV: http://www.epa.gov/esd/bios/daughton.htm#publications PPCPs Literature Database: http://epa.gov/ppcp/lit.html Drug Disposal: http://epa.gov/ppcp/projects/disposal.html From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:08 AM To: Heil, Ann; 'Catherine Zimmer'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Thanks for the reminder and edification to all that responded. Laurie said it in the most simplest terms this mechanical engineer could understand, ?That?s how systemic drugs work. You take the pill and it has to go all over your body before it reaches the intended body part. We have to take a large dose to ensure a therapeutic amount of it reaches its target.? I stand down to you experts out there and thank you for enlightening me (again?) on why there is so much un-metabolized meds leaving out body into the environment. Jim?s chart was quite surprising. Don?t think I?ve seen anything like it before. Jim? What do you think the chances are that RI will pass legislation for passing on the cost to big Pharma to collect and destroy cytotoxic chemotherapy ?leftovers?? Allen Gilliam (Pharmwaste not in my job description, just continually passing thru) ADEQ State Pretreatment Coordinator 501.682.0625 From: Heil, Ann [mailto:AHeil@lacsd.org] Sent: Wednesday, January 07, 2015 9:34 AM To: 'Catherine Zimmer'; Gilliam, Allen; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Just to chime in here, just because a pharmaceutical passes through your body doesn?t NOT mean you are being overdosed or given unnecessary medication. Some drugs work without being consumed. If you have any chemistry background, think of a catalyst ? it causes certain reactions to occur, but is not consumed in the process. And yes, those little inserts in the drug packages have all sorts of good information on them. Ann Heil LACSD From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Catherine Zimmer Sent: Wednesday, January 07, 2015 7:09 AM To: 'Gilliam, Allen'; 'jmullowney'; 'Bill Speenburgh'; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Hi Allen and all, Yes, if you remember some years back, Ann Heil from I think its LA?s wastewater district compiled a list of metabolism vs. pass through of a number of common rx. And a EPA, Region 3 scientist says, I paraphrase here, ?the drug companies overdose us?. Pharmaceutical metabolism is less than an exact science, and Pharma is apparently not too interested in making it more so. Now, maybe with Almeda Co.?s take back ordinance, or maybe if EPA demanded Pharma clean up the nation?s waters?that would be incentive to develop more site specific and directed drugs. Following up on Jim?s comments?I have done exactly that with my physician. When she prescribes a drug?for which there is no rx-free alternative treatment, we?ll get out the package insert to identify the amount that passes through. A good education for both you and your MD. Very truly yours, Catherine Zimmer, MS, BSMT Zimmer Environmental Improvement, LLC St. Paul, MN Ph: 651.645.7509 zenllc@usfamily.net From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Gilliam, Allen Sent: Wednesday, January 07, 2015 8:39 AM To: jmullowney; Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 So the general public would not realize they?re paying for perhaps 25% of the (almost prohibitively) expensive drug they?ve been prescribed; the rest being wasted to the environment? Sumpthin just doesn?t pass the smell test on this scenario. Allen g From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of jmullowney Sent: Wednesday, January 07, 2015 5:38 AM To: Bill Speenburgh; pharmwaste@lists.dep.state.fl.us Subject: RE: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 Bill You do not need to have your urine tested you can just read the drug insert,that pice of paper that comes with your prescription with all the fine print. It will tell you how much passes in the urine and feces and how quickly. This is all information from the FDA. A patient on a chemotherapy drug called cyclophosphamide will urinate 1000 ppm in 24 hours, enough to kill a child nevermind the fact it is a US Epa hazardous waste and a known carcinogen as well as known to cause birtdefects. Not all drugs are hazardous to humans in small quantities but the ones that are need to be controlled such as cytotoxic chemotherapy drugs. Pee in a cup for two days after treatment if you are on chemo as recommended by the World Health Organization. Check out www.cytotoxicsafety.org Sent from my T-Mobile 4G LTE Device -------- Original message -------- From: Bill Speenburgh > Date:01/06/2015 8:15 PM (GMT-05:00) To: pharmwaste@lists.dep.state.fl.us Cc: Subject: [Pharmwaste] RE: Pharmwaste Digest, Vol 111, Issue 1 As a person with Type II diabetes, I am prescribed by the VA with 2 x 1000 mg tablets of Metformin per day. Maybe I will get my urine tested to see what passes thru? William G. Speenburgh World Class Environmental Resources, LLC (973) 770-2275 (Phone) (973) 219-5720 (cell) -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Tuesday, January 6, 2015 3:54 AM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 1 Send Pharmwaste mailing list submissions to pharmwaste@lists.dep.state.fl.us To subscribe or unsubscribe via the World Wide Web, visit http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste or, via email, send a message with subject or body 'help' to pharmwaste-request@lists.dep.state.fl.us You can reach the person managing the list at pharmwaste-owner@lists.dep.state.fl.us When replying, please edit your Subject line so it is more specific than "Re: Contents of Pharmwaste digest..." --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150107/271b7680/attachment-0001.htm From rochows at gmail.com Thu Jan 8 14:57:44 2015 From: rochows at gmail.com (Stefanie Rochow) Date: Thu Jan 8 14:58:13 2015 Subject: [Pharmwaste] Hospice drug disposal Message-ID: Hello All, I'm on a Alzheimer's and Dementia support group page and the question came up regarding what to do with the leftover meds. Some want to donate them. Some said hospice flushed them in the toilet or watched the person mix it with coffee ground and kitty litter. Some were aware of the take back program with the police and one was aware their landfill had a disposal site. Just wanted you to know work still needs to be accomplished with hospice folks and the take back message IS getting out there. The group I'm a member of is 12K strong and worldwide. Keep up the great work of getting pharmaceuticals out of our waterways. A few understood the consequences of it going into the wayer; just not what it does to the environment except to say it polluted it. I've asked them to contact me with what state they are from if they want more information. I did suggest they call their local, county, or state environmental department to get more information. Regards, Stefanie Rochow -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150108/ea2b6437/attachment.html From Deborah.DeBiasi at deq.virginia.gov Thu Jan 8 17:47:03 2015 From: Deborah.DeBiasi at deq.virginia.gov (DeBiasi, Deborah (DEQ)) Date: Thu Jan 8 17:47:28 2015 Subject: [Pharmwaste] Harmful Chemicals Found In Swimming Pools, Including Flame Retardants And Insect Repellant Message-ID: <2FB366A29AAF0D47BD422C53F698353F22941715@COVMSGCES-MBX02> http://www.huffingtonpost.co.uk/2015/01/08/swimming-pool-chemicals-harmful-to-swimmers_n_6435464.html Harmful Chemicals Found In Swimming Pools, Including Flame Retardants And Insect Repellant The Huffington Post UK | By Natasha Hinde * Posted: 08/01/2015 12:49 GMT Updated: 08/01/2015 13:59 GMT o As disgusting as it is, we all know that when you go swimming there's a high chance that somebody's relieved themselves in the pool. Yack. Now a new study has found that urine could be the least of your worries, as more harmful chemicals could be floating around in your local swimming haunt including insect repellant, caffeine and flame retardants. All of these have the potential to be ingested by swimmers and pose a hazard to their health. [swimming pool] Previous research has shown that urine in pools can react with chlorine to create potentially hazardous chemicals. Now, a study by Purdue University has revealed that chlorine could be reacting with body care products to create a similar effect. Professor Ernest Blatchley from the Division of Environmental and Ecological Engineering said: "The motivation for examining pharmaceuticals and personal care products is that there is this unknown potential for them to bring about undesired or unexpected effects in an exposed population." "There are literally thousands of chemicals from pharmaceuticals and personal care products that could be getting into swimming pool water." Samples of water were taken from a variety of indoor swimming pools in the US. Using a technique, which was developed by professor Ching-Hua Huang, of Georgia Institute of Technology, they were able to identify and quantify 32 pharmaceuticals and personal care products in water. Out of the 32 chemicals investigated, researchers found that there were three which showed up more regularly. These included Deet (which is found in insect repellants), caffeine and tri(2-chloroethyl)-phosphate (TCEP) - a type of flame retardant. "Swimmers are exposed to chemicals through three different routes: You can inhale, you can ingest and it can go through your skin. So the exposure you receive in a swimming pool setting is potentially much more extensive than the exposure you would receive by just one route alone," Blatchley added: He noted that he's unsure of what the consequences of this are for the human body. The study is published in the journal Environmental Science and Technology Letters. Deborah L. DeBiasi Email: Deborah.DeBiasi@deq.virginia.gov WEB site address: www.deq.virginia.gov Virginia Department of Environmental Quality Office of Water Permits Industrial Pretreatment/Whole Effluent Toxicity (WET) Program PPCPs, EDCs, and Microconstituents http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx Mail: P.O. Box 1105, Richmond, VA 23218 Location: 629 E. Main Street, Richmond, VA 23219 PH: 804-698-4028 FAX: 804-698-4032 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150108/357bbee8/attachment.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 15416 bytes Desc: image001.jpg Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150108/357bbee8/image001.jpg From info at greatlakescleanwater.org Fri Jan 9 08:28:18 2015 From: info at greatlakescleanwater.org (Chris Angel, President) Date: Fri Jan 9 08:30:37 2015 Subject: [Pharmwaste] Hospice drug disposal In-Reply-To: References: Message-ID: Stephanie, I'm replying to you-that would be an important group to help educate about proper disposal. Our program in the Great Lakes was started as a result of some of us who had direct contact with Hospice organizations and Hospice patients. One of our founders was nurse with a Hospice organization. I will attach the link to the Yellow Jug Old Drugs Documentary where she talks about her experiences. The film will all provide some insight into the environmental issues relating to improper Rx waste disposal. Most hospice groups do still have protocols in place that require staff to flush all unused meds to get rid of and to reduce potential for diversion. Families may be able to take rx waste to drug collection programs in their states and with recent DEA regs enacted to allow pharmacies to no collect controlled substances for disposal (if they choose to do do) caregivers, and families have additional options available for proper Rx waste disposal. Hopefully these changes will also see Hospice organizations reviewing their policies re rx waste disposal. https://www.youtube.com/watch?v=oy4zgVtNPbo&index=3&list=FL0hI_MiIFrdXFMeU2Hb5aEA   Chris Angel ---------------------------- Original Message ---------------------------- Subject: [Pharmwaste] Hospice drug disposal From: "Stefanie Rochow" Date: Thu, January 8, 2015 2:57 pm To: pharmwaste@lists.dep.state.fl.us -------------------------------------------------------------------------- > Hello All, > > I'm on a Alzheimer's and Dementia support group page and the question came > up regarding what to do with the leftover meds. Some want to donate them. > Some said hospice flushed them in the toilet or watched the person mix it > with coffee ground and kitty litter. > > Some were aware of the take back program with the police and one was aware > their landfill had a disposal site. > > Just wanted you to know work still needs to be accomplished with hospice > folks and the take back message IS getting out there. > > The group I'm a member of is 12K strong and worldwide. Keep up the great > work of getting pharmaceuticals out of our waterways. A few understood the > consequences of it going into the wayer; just not what it does to the > environment except to say it polluted it. > > I've asked them to contact me with what state they are from if they want > more information. I did suggest they call their local, county, or state > environmental department to get more information. > > Regards, > Stefanie Rochow > --- > Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. > --- > TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste > TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. > If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste > FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us > SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us >       Chris Angel, President       www.GreatLakesCleanWater.org                     989.736.8179 Facebook https://www.facebook.com/pages/Great-Lakes-Clean-Water-Organization/250252498393081 Twitter https://twitter.com/CleanWater9 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/79d8782b/attachment.html From Laurie.Tenace at dep.state.fl.us Fri Jan 9 13:36:32 2015 From: Laurie.Tenace at dep.state.fl.us (Tenace, Laurie) Date: Fri Jan 9 13:37:38 2015 Subject: [Pharmwaste] Disposal product Message-ID: All, I am forwarding this for your information. I am not promoting this product and have not closely reviewed their literature, but I think it is important that we are aware of products promoted for drug disposal. Laurie From: rkellar@disposaltechnologies.com [mailto:rkellar@disposaltechnologies.com] Sent: Friday, January 09, 2015 10:42 AM To: pharmwaste@lists.dep.state.fl.us Subject: Drug Dispose All Ladies and Gentleman: We have an answer to this growing problem. Drug Dispose All was created by a world renowned Chemist from the University of Texas at Arlington. Currently meets all DEA, EPA and CDC standards for safe destruction of Controlled Substances along with other medications. We had independent tests done on the effectiveness of the Drug Dispose All and it passed with flying colors. Our environmental tests show that it meets EPA solid waste standards and can be disposed of in the regular trash with no harm to the environment. We are currently rolling this product out among all areas of the Healthcare industry Please visit our website at www.drugdisposeall.com or call us at 855-562-2819 for more information. Help protect your children, grandchildren and the environment! -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/3abfd42e/attachment.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: MKD_INSTsalessheets.docx Type: application/vnd.openxmlformats-officedocument.wordprocessingml.document Size: 375521 bytes Desc: MKD_INSTsalessheets.docx Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/3abfd42e/MKD_INSTsalessheets-0001.bin -------------- next part -------------- A non-text attachment was scrubbed... Name: MKD_RETAIL_salessheets.docx Type: application/vnd.openxmlformats-officedocument.wordprocessingml.document Size: 351526 bytes Desc: MKD_RETAIL_salessheets.docx Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/3abfd42e/MKD_RETAIL_salessheets-0001.bin From DLotzer at uwhealth.org Fri Jan 9 13:52:51 2015 From: DLotzer at uwhealth.org (Lotzer Donna M) Date: Fri Jan 9 13:53:00 2015 Subject: [Pharmwaste] RE: Drug DisposeALL Message-ID: <1CCDE0102050044C8DBB849D4C8489B1413385B5@UWHC-MBX15.uwhis.hosp.wisc.edu> Imagine that - I was detailed by the local rep for this product and have a bottle sitting here on my desk at this very moment (!). The one I have is an 8oz bottle...here is the catch...it has an ADSORPTIVE capacity of 3000mg (3GM) which means putting in 6 x 500mg acetaminophen maxes out the capacity of the bottle (!!!!!!!!!!!!!!) It contains an unknown amount of charcoal in an unidentified liquid (I will leave it to everyone to visualize the potential for a black mess). When I asked for specifics it was denied. There is an MSDS but it gives almost no information at all. The "test by a major university" they refer to is not a very useful study, and the version I got had a lot of the details redacted, making me more than skeptical (perhaps frustrated is a better word). Then there is the whole issue of tossing the container into the trash/landfill/environment when it is used. Label says it meets DEA, EPA, FDA standards but not sure what that means and again no documentation. I opted to stay away from it but they really wanted me to promote it...said no thanks. Donna Donna Lotzer, Senior Clinical Pharmacist Poison Education Coordinator University of WI Hospital & Clinics Poison Prevention Center 600 Highland Ave, MC# 9475, Madison, WI 53792 dlotzer@uwhealth.org Phone: 608-265-8160 Please encourage others to save 800-222-1222 in both cell and home phones. This number will connect callers anywhere in the U.S. to a poison center. Calls are free, confidential and answered 24/7/365. Please help me educate your community about poison prevention. Call or email me for materials or program opportunities. -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Friday, January 09, 2015 12:38 PM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 10 From EGottlieb at cityofithaca.org Fri Jan 9 15:38:04 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Fri Jan 9 15:33:36 2015 Subject: [Pharmwaste] RE: Disposal product In-Reply-To: References: Message-ID: <65AC0C9A3A6A474EAD8D56070FED669834962742@MAIL.cityofithaca.org> I look forward to reading the evidence, that they offer to provide, that the product, "Meets the standard for non-retrievable established by the DEA, EPA, CDC, and FDA guidelines" My second question, left on their answering machine, was, "How are the institutions, listed at the bottom of their webpage, "related". Two of the links provided (Wake Up & SMARxT Disposal) do not lead to anything having to do with pharmaceutical disposal. [Welcome to: wakeupnow.org This Web page is parked for FREE, courtesy of GoDaddy.com.] [http://smarxtdisposal.net/ : "Hard Time Choosing A Credit Card Company? Try These Tips!"] Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Tenace, Laurie [Laurie.Tenace@dep.state.fl.us] Sent: Friday, January 09, 2015 1:36 PM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] Disposal product All, I am forwarding this for your information. I am not promoting this product and have not closely reviewed their literature, but I think it is important that we are aware of products promoted for drug disposal. Laurie From: rkellar@disposaltechnologies.com [mailto:rkellar@disposaltechnologies.com] Sent: Friday, January 09, 2015 10:42 AM To: pharmwaste@lists.dep.state.fl.us Subject: Drug Dispose All Ladies and Gentleman: We have an answer to this growing problem. Drug Dispose All was created by a world renowned Chemist from the University of Texas at Arlington. Currently meets all DEA, EPA and CDC standards for safe destruction of Controlled Substances along with other medications. We had independent tests done on the effectiveness of the Drug Dispose All and it passed with flying colors. Our environmental tests show that it meets EPA solid waste standards and can be disposed of in the regular trash with no harm to the environment. We are currently rolling this product out among all areas of the Healthcare industry Please visit our website at www.drugdisposeall.com or call us at 855-562-2819 for more information. Help protect your children, grandchildren and the environment! -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/c8babe05/attachment.htm From twaters at seminolecountyfl.gov Fri Jan 9 16:11:16 2015 From: twaters at seminolecountyfl.gov (Waters, Tom) Date: Fri Jan 9 16:11:33 2015 Subject: [Pharmwaste] RE: Disposal product In-Reply-To: <65AC0C9A3A6A474EAD8D56070FED669834962742@MAIL.cityofithaca.org> References: <65AC0C9A3A6A474EAD8D56070FED669834962742@MAIL.cityofithaca.org> Message-ID: <514E1C3C15565947B31BB9888BD2634ED30FE13401@SEMCTYEXCH.SEMCTY.NET> We have seen several similar products over the years; not specifically for pharmaceuticals, but for medical sharps or x-ray waste containing silver. Some of them have claimed to be "Biodegradable" - my least favorite word in the environmental dictionary. Each individual waste generating facility must make a waste determination. Here in Central Florida, we often interpret that to mean the generator would have to have the treated waste tested (TCLP) to determine if it a hazardous waste. In addition, the landfill still may not accept the material unless it is well bell the haz waste limits. I don't remember coming across the terminology "...standard for non-retrievable established by...EPA..." before, either. Tom Waters Environmental Programs Manager Solid Waste Management Division Seminole County Government 1950 State Road 419 Longwood, FL 32750 Office 407-665-2261 Fax 407-324-5731 www.seminolecountyfl.gov twaters@seminolecountyfl.gov [cid:image001.png@01D02C24.9C09D800] From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Ed Gottlieb Sent: Friday, January 09, 2015 3:38 PM To: Tenace, Laurie; 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] RE: Disposal product I look forward to reading the evidence, that they offer to provide, that the product, "Meets the standard for non-retrievable established by the DEA, EPA, CDC, and FDA guidelines" My second question, left on their answering machine, was, "How are the institutions, listed at the bottom of their webpage, "related". Two of the links provided (Wake Up & SMARxT Disposal) do not lead to anything having to do with pharmaceutical disposal. [Welcome to: wakeupnow.org This Web page is parked for FREE, courtesy of GoDaddy.com.] [http://smarxtdisposal.net/ : "Hard Time Choosing A Credit Card Company? Try These Tips!"] Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Tenace, Laurie [Laurie.Tenace@dep.state.fl.us] Sent: Friday, January 09, 2015 1:36 PM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] Disposal product All, I am forwarding this for your information. I am not promoting this product and have not closely reviewed their literature, but I think it is important that we are aware of products promoted for drug disposal. Laurie From: rkellar@disposaltechnologies.com [mailto:rkellar@disposaltechnologies.com] Sent: Friday, January 09, 2015 10:42 AM To: pharmwaste@lists.dep.state.fl.us Subject: Drug Dispose All Ladies and Gentleman: We have an answer to this growing problem. Drug Dispose All was created by a world renowned Chemist from the University of Texas at Arlington. Currently meets all DEA, EPA and CDC standards for safe destruction of Controlled Substances along with other medications. We had independent tests done on the effectiveness of the Drug Dispose All and it passed with flying colors. Our environmental tests show that it meets EPA solid waste standards and can be disposed of in the regular trash with no harm to the environment. We are currently rolling this product out among all areas of the Healthcare industry Please visit our website at www.drugdisposeall.com or call us at 855-562-2819 for more information. Help protect your children, grandchildren and the environment! ________________________________ ****Florida has a very broad Public Records Law. Virtually all written communications to or from State and Local Officials and employees are public records available to the public and media upon request. Seminole County policy does not differentiate between personal and business emails. E-mail sent on the County system will be considered public and will only be withheld from disclosure if deemed confidential pursuant to State Law.**** -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/a4dca9aa/attachment-0001.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 12253 bytes Desc: image001.png Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150109/a4dca9aa/image001-0001.png From jennifer.volkman at state.mn.us Fri Jan 9 17:54:19 2015 From: jennifer.volkman at state.mn.us (Volkman, Jennifer (MPCA)) Date: Fri Jan 9 17:54:39 2015 Subject: [Pharmwaste] RE: Drug DisposeALL In-Reply-To: <1CCDE0102050044C8DBB849D4C8489B1413385B5@UWHC-MBX15.uwhis.hosp.wisc.edu> References: <1CCDE0102050044C8DBB849D4C8489B1413385B5@UWHC-MBX15.uwhis.hosp.wisc.edu> Message-ID: What! No one sent me a free bottle! Could be because we sort of went over this a couple of months ago and I expressed my displeasure at claims made. We don't accept manufacturer claims. If we did, there wouldn't be any HW generated by anyone, right? If it is a listed drug, it doesn't matter if you play shake and bake with it. These are not drug disposal systems, they are drug nastyizers which make it less likely that someone will consume or sell the drugs put in them. DEA isn't going to approve any of these methods. DEA probably won't disapprove of claims made either. If a clinic or hospital or hospice nurse uses these for a little extra insurance that it could reduce pilfering, then they do that job ok. But it is not a disposal method. I wonder if EPA would make a statement. Maybe they are less strict than MN. Have a great weekend everybody! ________________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Lotzer Donna M [DLotzer@uwhealth.org] Sent: Friday, January 09, 2015 12:52 PM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] RE: Drug DisposeALL Imagine that - I was detailed by the local rep for this product and have a bottle sitting here on my desk at this very moment (!). The one I have is an 8oz bottle...here is the catch...it has an ADSORPTIVE capacity of 3000mg (3GM) which means putting in 6 x 500mg acetaminophen maxes out the capacity of the bottle (!!!!!!!!!!!!!!) It contains an unknown amount of charcoal in an unidentified liquid (I will leave it to everyone to visualize the potential for a black mess). When I asked for specifics it was denied. There is an MSDS but it gives almost no information at all. The "test by a major university" they refer to is not a very useful study, and the version I got had a lot of the details redacted, making me more than skeptical (perhaps frustrated is a better word). Then there is the whole issue of tossing the container into the trash/landfill/environment when it is used. Label says it meets DEA, EPA, FDA standards but not sure what that means and again no documentation. I opted to stay away from it but they really wanted me to promote it...said no thanks. Donna Donna Lotzer, Senior Clinical Pharmacist Poison Education Coordinator University of WI Hospital & Clinics Poison Prevention Center 600 Highland Ave, MC# 9475, Madison, WI 53792 dlotzer@uwhealth.org Phone: 608-265-8160 Please encourage others to save 800-222-1222 in both cell and home phones. This number will connect callers anywhere in the U.S. to a poison center. Calls are free, confidential and answered 24/7/365. Please help me educate your community about poison prevention. Call or email me for materials or program opportunities. -----Original Message----- From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of pharmwaste-request@lists.dep.state.fl.us Sent: Friday, January 09, 2015 12:38 PM To: pharmwaste@lists.dep.state.fl.us Subject: Pharmwaste Digest, Vol 111, Issue 10 --- Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients. --- TO SUBSCRIBE, go to: http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank. If you believe you may be subscribed with a different email address, please visit the subscriber listing at http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us From Burke.Lucy at CalRecycle.ca.gov Fri Jan 9 19:01:59 2015 From: Burke.Lucy at CalRecycle.ca.gov (Lucy, Burke@CalRecycle) Date: Fri Jan 9 19:02:15 2015 Subject: [Pharmwaste] RE: Disposal product In-Reply-To: <65AC0C9A3A6A474EAD8D56070FED669834962742@MAIL.cityofithaca.org> References: <65AC0C9A3A6A474EAD8D56070FED669834962742@MAIL.cityofithaca.org> Message-ID: It looks they just need to remove their links since both URLs (interestingly, including the PhRMA-funded site) have been abandoned in the past year. See: https://web.archive.org/web/20140109151510/http://smarxtdisposal.net/. https://web.archive.org/web/20140210052516/http://www.wakeupnow.org/ Burke From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Ed Gottlieb Sent: Friday, January 09, 2015 12:38 PM To: Tenace, Laurie; 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] RE: Disposal product I look forward to reading the evidence, that they offer to provide, that the product, "Meets the standard for non-retrievable established by the DEA, EPA, CDC, and FDA guidelines" My second question, left on their answering machine, was, "How are the institutions, listed at the bottom of their webpage, "related". Two of the links provided (Wake Up & SMARxT Disposal) do not lead to anything having to do with pharmaceutical disposal. [Welcome to: wakeupnow.org This Web page is parked for FREE, courtesy of GoDaddy.com.] [http://smarxtdisposal.net/ : "Hard Time Choosing A Credit Card Company? Try These Tips!"] Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Tenace, Laurie [Laurie.Tenace@dep.state.fl.us] Sent: Friday, January 09, 2015 1:36 PM To: 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] Disposal product All, I am forwarding this for your information. I am not promoting this product and have not closely reviewed their literature, but I think it is important that we are aware of products promoted for drug disposal. Laurie From: rkellar@disposaltechnologies.com [mailto:rkellar@disposaltechnologies.com] Sent: Friday, January 09, 2015 10:42 AM To: pharmwaste@lists.dep.state.fl.us Subject: Drug Dispose All Ladies and Gentleman: We have an answer to this growing problem. Drug Dispose All was created by a world renowned Chemist from the University of Texas at Arlington. Currently meets all DEA, EPA and CDC standards for safe destruction of Controlled Substances along with other medications. We had independent tests done on the effectiveness of the Drug Dispose All and it passed with flying colors. Our environmental tests show that it meets EPA solid waste standards and can be disposed of in the regular trash with no harm to the environment. We are currently rolling this product out among all areas of the Healthcare industry Please visit our website at www.drugdisposeall.com or call us at 855-562-2819 for more information. Help protect your children, grandchildren and the environment! -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150110/fd29cabc/attachment.htm From jhollar at pwaste.com Sat Jan 10 10:50:46 2015 From: jhollar at pwaste.com (Jeff Hollar) Date: Sat Jan 10 10:52:05 2015 Subject: [Pharmwaste] Pharmaceutical Waste Theft/Fines News Message-ID: <000f01d02ced$33b2ede0$9b18c9a0$@pwaste.com> Here are some recent stories in the news regarding theft and improper disposal of pharmaceutical waste. As time passes, these types of activities and actions are increasingly less likely to fly below the regulatory radar. Drug Disposal Workers Charged in Drug Theft http://www.memphisdailynews.com/news/2014/dec/19/drug-disposal-workers-charg ed-in-drug-theft/ 99 Cents Only Stores To Pay $2.3M In Hazardous Waste Case http://www.kpbs.org/news/2015/jan/06/99-cents-only-stores-pay-23m-hazardous- waste-case/ Vons, Safeway to Pay $9.87M for Hazardous Waste Disposal http://www.nbcsandiego.com/news/local/Vons-Safeway-Fined-Regulated-Hazardous -Waste-287563821.html Jeff Hollar President PharmWaste Technologies, Inc. 4164 NW Urbandale Dr., Ste A Urbandale, IA 50322 515-276-5302 (general) 515-331-7310 (direct) 515-360-9785 (cell) www.pwaste.com -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150110/033f3b18/attachment.html From Heidi at calpsc.org Sat Jan 10 14:13:28 2015 From: Heidi at calpsc.org (Heidi Sanborn) Date: Sat Jan 10 14:11:44 2015 Subject: [Pharmwaste] Any laws to address medical samples proper disposal by sales reps? Message-ID: <24D2A3DBD4377240A1B613A8B5293DBD1F43FA28@MBX029-E1-VA-8.EXCH029.DOMAIN.LOCAL> Dear Pharma Listserv: I was in a meeting yesterday where the lobbyists for Norvo Nordisk and Bay Bio were stating that the DEA wasn't having any more med collections because 40% of what they were collecting was not targeted product and they were told it was medical samples. I asked for names or anything in writing and didn't get them. 1) Has anyone confirmed that 40% of what comes in DEA events was medical samples or could you disprove that statement? 2) Does anyone know of any local, state or federal law that requires management of medical samples outside of public medicine bin programs? Thanks for your help! Heidi ******************************************************************** Heidi Sanborn, Executive Director (916) 706-3420 office (916) 402-3911 cell Heidi@CalPSC.org [cpsc_logo_350_pix] [cid:image001.png@01CC57C5.8223CD60]Web [cid:image002.png@01CC57C5.8223CD60] YouTube [cid:image011.png@01CC47A7.7F3D5C20] Facebook [cid:image012.png@01CC47A7.7F3D5C20] Twitter [cid:image013.png@01CC47A7.7F3D5C20] Linked In ********************************************************************* -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150110/ee8cc952/attachment.htm -------------- next part -------------- A non-text attachment was scrubbed... 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Name: image007.jpg Type: image/jpeg Size: 778 bytes Desc: image007.jpg Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150110/ee8cc952/image007.jpg -------------- next part -------------- A non-text attachment was scrubbed... Name: image008.jpg Type: image/jpeg Size: 6660 bytes Desc: image008.jpg Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150110/ee8cc952/image008.jpg From EGottlieb at cityofithaca.org Mon Jan 12 11:37:59 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Mon Jan 12 11:38:59 2015 Subject: [Pharmwaste] Any laws to address medical samples proper disposal by sales reps? In-Reply-To: <24D2A3DBD4377240A1B613A8B5293DBD1F43FA28@MBX029-E1-VA-8.EXCH029.DOMAIN.LOCAL> References: <24D2A3DBD4377240A1B613A8B5293DBD1F43FA28@MBX029-E1-VA-8.EXCH029.DOMAIN.LOCAL> Message-ID: <65AC0C9A3A6A474EAD8D56070FED66983496284E@MAIL.cityofithaca.org> Dear Ms. Sanborn, Medical offices could not legally dispose of unwanted (most likely outdated) pharmaceutical samples through the DEA Take Back Initiative. These would normally be returned using a reverse distributor. Some of the samples given to patients certainly showed up (legally) at DEA take back events. The claim that this amounted to 40% of what was collected is outrageously false. The inventory data my program collected didn't distinguish between medications packaged as samples and those in retail packaging. Once the outer packaging is removed there is probably no way to tell one from the other. I and one of the pharmacists that worked on our inventory, don't remember receiving any significant number of samples. We did take in OTC, herbal medications, and vitamins. If all of these are considered "non-target" then the percent could easily have been as high as 40. Maybe these manufactures meant to say "non-target" rather than "samples"? Further, I would be shocked if the national DEA office has any sort of inventory data for the medications collected during their take back program. The national office doesn't even know the wight collected at each site! I was told by the DEA that the only information that field offices were asked for by state DEA offices was the weight collected, the number of collection locations, and the number of law enforcement agencies participating. The national DEA office only asked the state offices for the total weight collected, the number of collection locations, and the number of law enforcement agencies participating. I know this because National totals are what they sent in response to my FOIL request for the weight collected at each location. When I promptly appealed, stating they sent me the incorrect information, they first claimed I missed the appeal deadline. After proving that I did not miss the deadline, they said that they didn't have the information I requested in the national office. I didn't follow up with FOIL requests to each state office. Some inventory work was done. Someone from this listserv provided a one page chart summarizing Arkansas's Participation in DEA National Take Back Initative Results (seven events, through 10/26/13). Along with AR totals for weight collected, number of collection locations and law enforcement agencies participating, there was an estimate, by the AR State Crime Lab, of the total number of pills collected in AR by event. It is possible the crime lab actually looked at a random sample of what was collected to estimate the number of pills per pound. It is also possible that at the same time they looked at other things as well. If so, there are many things, such as what percent was controlled, that would have been looked at before samples were counted. I just left a phone message with someone at the AR crime lab who may be able to shed light on what they did. Other state crime labs, or other agencies, may have done some inventory work. If so, no word of it has reached this listserv. Finally, the DEA has publicly said the program was discontinued once the new rule, allowing pharmacies to take back controlled, was adopted, since the public now has other ways to dispose of their unwanted medications (despite the fact that it will take an unknown amount of time for this option to be widely available.) Unless those manufactures produce some, there is no evidence to believe there are any other reasons. Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Heidi Sanborn [Heidi@calpsc.org] Sent: Saturday, January 10, 2015 2:13 PM To: Tenace, Laurie; 'pharmwaste@lists.dep.state.fl.us' Subject: [Pharmwaste] Any laws to address medical samples proper disposal by sales reps? Dear Pharma Listserv: I was in a meeting yesterday where the lobbyists for Norvo Nordisk and Bay Bio were stating that the DEA wasn?t having any more med collections because 40% of what they were collecting was not targeted product and they were told it was medical samples. I asked for names or anything in writing and didn?t get them. 1) Has anyone confirmed that 40% of what comes in DEA events was medical samples or could you disprove that statement? 2) Does anyone know of any local, state or federal law that requires management of medical samples outside of public medicine bin programs? Thanks for your help! Heidi ******************************************************************** Heidi Sanborn, Executive Director (916) 706-3420 office (916) 402-3911 cell Heidi@CalPSC.org [cpsc_logo_350_pix] [cid:image001.png@01CC57C5.8223CD60]Web [cid:image002.png@01CC57C5.8223CD60] YouTube [cid:image011.png@01CC47A7.7F3D5C20] Facebook [cid:image012.png@01CC47A7.7F3D5C20] Twitter [cid:image013.png@01CC47A7.7F3D5C20] Linked In ********************************************************************* -------------- next part -------------- An HTML attachment was scrubbed... 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Name: image008.jpg Type: image/jpeg Size: 6660 bytes Desc: image008.jpg Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150112/559a029a/image008.jpg From Deborah.DeBiasi at deq.virginia.gov Mon Jan 12 16:36:05 2015 From: Deborah.DeBiasi at deq.virginia.gov (DeBiasi, Deborah (DEQ)) Date: Mon Jan 12 16:36:36 2015 Subject: [Pharmwaste] BPA alternative disrupts normal brain-cell growth, is tied to hyperactivity, study says Message-ID: <2FB366A29AAF0D47BD422C53F698353F22941E7A@COVMSGCES-MBX02> http://www.washingtonpost.com/national/health-science/bpa-alternative-disrupts-normal-brain-cell-growth-is-tied-to-hyperactivity-study-says/2015/01/12/a9ecc37e-9a7e-11e4-a7ee-526210d665b4_story.html?hpid=z4 [http://img.washingtonpost.com/rf/image_1484w/2010-2019/WashingtonPost/2015/01/12/Interactivity/Images/80717102.jpg?uuid=i4xkCJqbEeS8-wWex6k93A] Companies used BPS as a safe alternative to BPA. (David McNew/Getty Images) By Amy Ellis Nutt January 12 at 3:28 PM In a groundbreaking new study, researchers have shown why a chemical once thought to be a safe alternative to bisphenol-A, which was banned by the government for baby bottles and sippy cups, might itself be more harmful than BPA. University of Calgary scientists say they believe their research is the first to show that bisphenol-S, an ingredient in many products bearing "BPA-free" labels, causes abnormal growth surges of neurons in an animal embryo. This disruption of prenatal cellular activity in zebra fish, which share 80 percent of their genes with humans and are considered a good model for studying human brain development, has been directly linked to hyperactivity, according to the study published Monday in the Proceedings of the National Academy of Sciences. "Finding the mechanism linking low doses of BPA (or BPS) to adverse brain development and hyperactivity is almost like finding a smoking gun," Hamid Habibi, one of the authors of the study, said in a news release. BPA is an industrial chemical found in many polycarbonate plastics as well as epoxy resins, which are used to coat the inside of metal food cans. Over the past few years, dozens of studies have linked BPA, which mimics estrogen, with prostate cancer, infertility, asthma, heart disease and neurodevelopmental disorders. The Federal Food and Drug Administration banned the use of BPA in baby cups and bottles and infant formula packaging in 2012, but last month it reiterated its belief that BPA is safe to use in the lining of canned foods and beverages. Deborah L. DeBiasi Email: Deborah.DeBiasi@deq.virginia.gov WEB site address: www.deq.virginia.gov Virginia Department of Environmental Quality Office of Water Permits Industrial Pretreatment/Whole Effluent Toxicity (WET) Program PPCPs, EDCs, and Microconstituents http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx Mail: P.O. Box 1105, Richmond, VA 23218 Location: 629 E. Main Street, Richmond, VA 23219 PH: 804-698-4028 FAX: 804-698-4032 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150112/69a478de/attachment.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 8135 bytes Desc: image001.jpg Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150112/69a478de/image001.jpg From greg.fabisiak at state.co.us Tue Jan 13 10:22:52 2015 From: greg.fabisiak at state.co.us (Fabisiak - CDPHE, Greg) Date: Tue Jan 13 10:23:16 2015 Subject: [Pharmwaste] Looking for Collection Receptacle Inner Liners Message-ID: Good Morning, I'm wondering if anyone is aware of vendors that are selling drug collection receptacle inner liners. I'm looking for inner liners to be used by law enforcement agencies. Since, in some cases, they may be turned over to a reverse distributor for disposal, they would need to be constructed and labelled as described in Subsection 1317.60 of the DEA rule for disposal of controlled substances. My Google searches for vendors have come up empty. I'm only looking for the liners, not the entire receptacle. Any assistance would be appreciated! -- *Greg Fabisiak* *Environmental Integration Coordinator* Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South, DEHS-A2 Denver, CO 80246-1530 office: 303.692.2903 | fax: 303.782.4969 e-mail: greg.fabisiak@state.co.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150113/45c480a3/attachment.htm From EGottlieb at cityofithaca.org Tue Jan 13 10:59:20 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Tue Jan 13 10:59:58 2015 Subject: [Pharmwaste] Looking for Collection Receptacle Inner Liners In-Reply-To: References: Message-ID: <65AC0C9A3A6A474EAD8D56070FED6698349629E1@MAIL.cityofithaca.org> Greg, The inner liner can be an opaque plastic bag. My program uses heavy duty, black plastic garbage bags. The bag can be sealed with tamper-proof tape. The bag size, weight, and ID # can be written on the tape with indelible marker. To prevent officers from being stuck with a sharp, the bags should be handled with care. Immediately placing the bag in a cardboard box or plastic storage tote is a good idea. Alternately, the collection boxes plastic tote could be replaced with a cardboard box (if you can find one that is the same size) which would be lined with the plastic inner liner. That may be the most efficient way to handle collected medications, especially if they will go to a reverse distributor. Be sure to copy the required information (bag size, weight, and ID #) onto the box from the inner liner. Best of luck, Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Fabisiak - CDPHE, Greg [greg.fabisiak@state.co.us] Sent: Tuesday, January 13, 2015 10:22 AM To: pharmwaste@lists.dep.state.fl.us Subject: [Pharmwaste] Looking for Collection Receptacle Inner Liners Good Morning, I'm wondering if anyone is aware of vendors that are selling drug collection receptacle inner liners. I'm looking for inner liners to be used by law enforcement agencies. Since, in some cases, they may be turned over to a reverse distributor for disposal, they would need to be constructed and labelled as described in Subsection 1317.60 of the DEA rule for disposal of controlled substances. My Google searches for vendors have come up empty. I'm only looking for the liners, not the entire receptacle. Any assistance would be appreciated! -- Greg Fabisiak Environmental Integration Coordinator [https://6bc585c3ac975c15d2250e882c44ab669f6363cd.googledrive.com/host/0B8gdupL6hOgVNDVKVVJBcXhoaWs/images/co_cdphe_div_env_72_rgb_email.png] Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South, DEHS-A2 Denver, CO 80246-1530 office: 303.692.2903 | fax: 303.782.4969 e-mail: greg.fabisiak@state.co.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150113/30c4aa62/attachment.htm From Laurie.Tenace at dep.state.fl.us Wed Jan 14 07:16:54 2015 From: Laurie.Tenace at dep.state.fl.us (Tenace, Laurie) Date: Wed Jan 14 07:17:40 2015 Subject: [Pharmwaste] Study: Diabetes drug found in Lake Michigan impacts fish Message-ID: http://www.freep.com/story/news/local/michigan/2015/01/13/metformin-diabetes-drug-pollution-lake-michigan/21734507/ Researchers have found that pharmaceuticals and personal care byproducts persist at low levels even miles from sewage discharge pipes out in Lake Michigan. And a new study from the University of Wisconsin-Milwaukee finds the most prevalent drug in the lake - the Type 2 diabetes medication Metformin - causes changes in the hormonal system of fish exposed to it. But just what long-term affects it may be having on the fish and their ability to reproduce still is unknown. In the research group's latest study, fathead minnows were exposed to Metformin at the levels found in Lake Michigan for four weeks. Male minnows showed disruption of their endocrine systems, producing a chemical messenger usually associated with females' egg production, said Rebecca Klaper, a professor and research scientist at the University of Wisconsin - Milwaukee's School of Freshwater Sciences who co-authored a 2013 paper finding Metformin and other products persisting in Lake Michigan, such as the birth-control pill hormone progesterone and sulphamethoxazole, an antibiotic used to treat urinary tract and ear infections. The drugs are not completely broken down by people's bodies after ingestion, are excreted and then are not fully removed by wastewater treatment processes. The flushing of old pharmaceuticals down the toilet also contributes to the problem. "It's enough to raise an alarm bell that this might be something that causes changes in reproduction of fish," she said. "It's something that definitely warrants further study." The levels of the products are relatively minuscule -micrograms and nanograms per liter of water, Klaper said. A microgram is one-millionth of a gram; a nanogram one-billionth of a gram. What impacts they have, if any, aren't well understood - individually or mixed together in the lake, she said. Metformin is found at the highest Lake Michigan concentrations of all the drugs tested for by researchers at up to 40 parts per billion. More than 60 million Metformin prescriptions were dispensed in the U.S. in 2013, according to drug market research firm IMS Health. "It wasn't something we had really thought about before," Klaper said. "But there are a lot of people with Type 2 diabetes, and it's a very common medication to be prescribed." The Metformin enters wastewater treatment plants at 40 parts per billion and is found at between 100 and 200 parts per trillion two miles out in Lake Michigan, Klaper said. "The sewage treatment plant is taking out a significant amount of the medication, but it's just that it's coming in at such a high concentration, it doesn't remove it all," she said. "A sewage treatment plant wasn't designed to take these medications out." Doing something about it would be a monumental task. Metformin is the most-prescribed treatment for the millions of Americans with Type 2 diabetes. And providing sophisticated-enough filtration systems for wastewater treatment plants to remove the drug and other personal care products is impractical. "It's very difficult - wastewater treatment plants aren't designed to treat nanoparticles," said Timothy Lynch, manager of the Benton Harbor-St. Joseph Wastewater Treatment Plant on the shores of Lake Michigan. The plant serves about 60,000 homes and treats about 9 million gallons of waste per day. "To retrofit with that type of technology would be very expensive, and are the paybacks for what you are accomplishing worth the cost? For most facilities and most governmental units, just maintaining the existing infrastructure is a challenge." Klaper said future study will look at how fish are affected over a longer term of exposure. "We also need to explore other compounds," she said. "This was just one of many. What happens when these are in a mixture? Which ones are the ones to focus on and get rid of? Then we've got a starting point." Contact Keith Matheny: (313) 222-5021 or kmatheny@freepress.com Laurie Tenace Environmental Specialist Waste Reduction Section Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4555 Tallahassee, FL 32399-2400 850.245.8759 Laurie.Tenace@dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150114/e5220250/attachment.html From EGottlieb at cityofithaca.org Wed Jan 14 12:19:50 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Wed Jan 14 12:25:09 2015 Subject: [Pharmwaste] FW: Drug Dispose All Message-ID: <65AC0C9A3A6A474EAD8D56070FED669834963FE2@MAIL.cityofithaca.org> Passing on Mike's reply... From: mmiller@disposaltechnologies.com [mmiller@disposaltechnologies.com] Sent: Wednesday, January 14, 2015 12:08 PM To: Ed Gottlieb Subject: RE: Drug Dispose All Test Results Ed, The DEA became aware of us last fall. They were very uncomfortable then. They did an onsite visit and took our testing for evaluation. They did not ask us to do a peer review. We told them we were doing one and offered to send a copy for their file. They are smart enough to know we would not be doing one if we were trying to hide something. It was only when a major reverse distributor asked about using us for destruction versus incineration that someone in Washington asked to talk to our chemist. That discussion has taken place and he told us he would make a positive recommendation. So there is no reason not to be optimistic. We actually are starting to sell increasing amounts of product to hospitals and pharmacies across the country. In fact we talked to NY Presbyterian today from your state. Cardinal is putting us in due to customer demand. I really don't know if we will get anything in writing from the DEA. That would be awesome if they did but might appear tantamount to an endorsement. We are pleased they are aware of us in Washington. That means we are making progress. I see you are involved in water treatment. Some of the states are telling hospitals that they can't waste medications into the sink or toilet anymore after procedures. We of course applaud that stance. Prior to our product there were not allot of good alternatives. Mike -------- Original Message -------- Subject: Drug Dispose All Test Results From: Ed Gottlieb > Date: Tue, January 13, 2015 12:25 pm To: "mmiller@disposaltechnologies.com" > Cc: "pharmwaste-owner@lists.dep.state.fl.us" > Hi Mike, Thanks for the prompt reply. I understand the DEA can't endorse a product. Isn't that different than them saying a process or product destroys or sequesters medications rendering them non-recoverable? You sound confident that the DEA will decide that the Drug Dispose All meets their non-recoverable standard. When they do, I imagine your product will sell well. Please let me know if I understand you correctly... the DEA has seen the test results you sent me (3 attachments) and they want to see a peer review of Dr. Shug's study before deciding if the Drug Dispose All unit meets their non-recoverable standard. You mention being, "told that the only way the carbon will release the medications is extreme heat...like 5000 degrees." This information was not in Dr. Shug's study. Isn't it key to making a determination about recoverability? Is there another study documenting this that the DEA has seen? It seems that my understanding on extracting compounds from activated carbon is wrong. Or, maybe, medications bind to it differently, making the methods I mentioned ineffective. I assume that the high temperature release you mention can only happen in an oxygen free environment. The MSDS for activated carbon shows ignition being greater than 400 C (752 F). Some studies show that used activated carbon can ignite at temperatures significantly less that listed in the MSDS. Could you please send me (or the listserv, cc'ed here) a copy of the DEA's response after they receive the peer review? Is there a date you expect the peer review to be completed? Thank you very much! Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: mmiller@disposaltechnologies.com [mmiller@disposaltechnologies.com] Sent: Tuesday, January 13, 2015 1:14 PM To: Ed Gottlieb Subject: RE: Test Results Ed, You certainly may pass this along. You will be interested to know that the DEA in Washington is well aware of us. In fact Dr. Shug has talked to their chemist. We know they will never endorse a product. We just don't want them to get in the way. After some initial reservations they now seem comfortable with our technology. The testing and the peer review are key. I am told that the only way the carbon will release the medications is extreme heat...like 5000 degrees. So short of a nuclear holocaust the medications are sequestered. Of course I am not a chemist but that is the only way I am aware of. I'll leave those discussions to Dr. Shug and the DEA chemist. Mike -------- Original Message -------- Subject: RE: Test Results From: Ed Gottlieb > Date: Tue, January 13, 2015 8:18 am To: "mmiller@disposaltechnologies.com" > Hi Mike, Impressive removal numbers! May I pass them along to the FL pharm waste listserv? Kevin Suhug, the author of the Texas U. study, states, "It is worth mentioning that certain types of activated charcoal, in general, is [sic] extremely efficient in the uptake of chemical compounds; once adsorbed, it is very difficult to reverse the sequestration process." He doesn't actually say which type of activated carbon is used in the Drug Dispose All. More importantly, I don't think that "very difficult to reverse" meets the DEA's non-retrievable standard. Can you please provide additional information regarding the Drug Dispose All?s ability to meet the non-retrievable standard? It is my understanding that some combination of techniques, (including: heat, pressure, steam, solvents, and physical pulverization) can be used to extract many compounds absorbed by activated carbon. Other methods, such as precipitation and distillation, can then used to isolate specific extracted compounds. Thank you. Sincerely, Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 ________________________________ From: mmiller@disposaltechnologies.com [mmiller@disposaltechnologies.com] Sent: Tuesday, January 13, 2015 9:23 AM To: Ed Gottlieb Subject: [FWD: Test Results] I butchered Ithaca. Here you go -------- Original Message -------- Subject: Test Results From: > Date: Fri, January 09, 2015 3:28 pm To: egottlieb@cityofithica.org Ed, Here are the confidential test results done at the University of Texas at Arlington with the confidential info redacted out. As you can see we have tested a great variety of medications including some of the most abused. In addition to this testing the University is conducting a peer review of their results to further validate their conclusions. I can understand your being skeptical about the validity of our claims. There are several competitive products that have no such testing. This stuff actually works. I am also attaching third party environmental testing we had done on our end waste that shows it to be harmless to the environment. Thanks for the heads up on our webpage. I will have those checked out next week. We are a start up and just started shipping last March. Our website was done by a marketing group over in Dallas when we were just getting started. Frankly it needs some clean up. Please feel free to call me with any other questions or concerns. Thanks for your interest and I hope you have a great weekend. Mike Miller Disposal Technologies 817-980-5266 (c) -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150114/7370752a/attachment.htm From EGottlieb at cityofithaca.org Fri Jan 23 09:15:11 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Fri Jan 23 09:22:00 2015 Subject: [Pharmwaste] Will Supreme Court hear PhRMA appeal of Alameda or let law stand? Decision due Jan 28 Message-ID: <65AC0C9A3A6A474EAD8D56070FED66983C1E4F0B@MAIL.cityofithaca.org> According to a Life Sciences Legal Update, the Supreme Court case docket shows a response to the Pharma lobby Writ is due by January 28, 2015. The response will be either to hear the case or to let the lower court ruling (supporting the law) stand. http://www.lifescienceslegalupdate.com/2015/01/articles/legislative-developments/drug-disposal-ordinance-supreme-court-writ-filed/?utm_source=Mondaq&utm_medium=syndication&utm_campaign=View-Original Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150123/c7e7dbd7/attachment.html From Laurie.Tenace at dep.state.fl.us Fri Jan 23 14:02:11 2015 From: Laurie.Tenace at dep.state.fl.us (Tenace, Laurie) Date: Fri Jan 23 14:07:41 2015 Subject: [Pharmwaste] articles about BPA exposure Message-ID: A few similar articles came out today: http://www.environmentalhealthnews.org/ehs/news/2015/jan/bpa-exposure-linked-to-changes-in-stem-cells-lower-sperm-production http://www.huffingtonpost.com/2015/01/22/chemicals-infertility-endocrine-disruptors_n_6524536.html http://www.dailymail.co.uk/health/article-2921840/Why-sperm-counts-falling-Contraceptives-drinking-water-chemicals-plastics.html Laurie Tenace Environmental Specialist Waste Reduction Section Florida Department of Environmental Protection 2600 Blair Stone Road, MS 4555 Tallahassee, FL 32399-2400 850.245.8759 Laurie.Tenace@dep.state.fl.us -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150123/2d8d60fb/attachment.htm From Deborah.DeBiasi at deq.virginia.gov Mon Jan 26 11:29:38 2015 From: Deborah.DeBiasi at deq.virginia.gov (DeBiasi, Deborah (DEQ)) Date: Mon Jan 26 11:30:08 2015 Subject: [Pharmwaste] Fate of Pharmaceutical and Personal Care Products in Irrigated Wastewater Effluent Message-ID: <2FB366A29AAF0D47BD422C53F698353F2294F267@COVMSGCES-MBX02> TR- 052 Fate of Pharmaceutical and Personal Care Products in Irrigated Wastewater Effluent / Loftus, Lucy; Jin, Guang; Armstrong, Shalamar; Bierma, Thomas; Walker, Paul; Zheng, Wei; Kelly, Walt. - Champaign, IL : Illinois Sustainable Technology Center, 2015. Download at http://hdl.handle.net/2142/73116 or http://istc.illinois.edu/info/library_docs/TR/TR052.pdf. Abstract: The potential human and environmental health risks posed by pharmaceuticals and personal care products (PPCPs) have been identified as a research priority at both the federal and state level. It has been well documented that municipal wastewater treatment plants with surface discharge fail to remove many of these emerging contaminants; however, little research has been conducted to determine the capability of lagoon treatment systems to remove PPCPs or of organic-matter-rich clay loam soils to filter PPCPs and reduce surface water pollution. The objective of this study was to determine the fate and transport of selected pharmaceuticals in lagoon-treated wastewater effluent applied as cropland irrigation in Illinois. In this study, we were able to determine the presence of six of the seven priority PPCPs in lagoon-treated wastewater effluent; verify the absence of studied PPCPs in soil and well water prior to treatment; determine characteristics of cropland soil that may impact PPCP transport when wastewater irrigation begins; and conduct sorption isotherm studies to understand the sorption and desorption capabilities of field soils in Lexington, Illinois. Deborah L. DeBiasi Email: Deborah.DeBiasi@deq.virginia.gov WEB site address: www.deq.virginia.gov Virginia Department of Environmental Quality Office of Water Permits Industrial Pretreatment/Whole Effluent Toxicity (WET) Program PPCPs, EDCs, and Microconstituents http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx Mail: P.O. Box 1105, Richmond, VA 23218 Location: 629 E. Main Street, Richmond, VA 23219 PH: 804-698-4028 FAX: 804-698-4032 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150126/7e3bc0bf/attachment.html From scott.seery at acgov.org Wed Jan 28 12:03:52 2015 From: scott.seery at acgov.org (Seery, Scott, Env. Health) Date: Wed Jan 28 12:04:20 2015 Subject: [Pharmwaste] Will Supreme Court hear PhRMA appeal of Alameda or let law stand? Decision due Jan 28 In-Reply-To: <65AC0C9A3A6A474EAD8D56070FED66983C1E4F0B@MAIL.cityofithaca.org> References: <65AC0C9A3A6A474EAD8D56070FED66983C1E4F0B@MAIL.cityofithaca.org> Message-ID: <4B6970A4E28E994681D9EB5C39585D5250F98CCCBD@US001EX14V.user.root.acgov.org> Has anyone heard the status of this case as of today, the day of reckoning? From: pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of Ed Gottlieb Sent: Friday, January 23, 2015 6:15 AM To: pharmwaste@lists.dep.state.fl.us Subject: [Pharmwaste] Will Supreme Court hear PhRMA appeal of Alameda or let law stand? Decision due Jan 28 According to a Life Sciences Legal Update, the Supreme Court case docket shows a response to the Pharma lobby Writ is due by January 28, 2015. The response will be either to hear the case or to let the lower court ruling (supporting the law) stand. http://www.lifescienceslegalupdate.com/2015/01/articles/legislative-developments/drug-disposal-ordinance-supreme-court-writ-filed/?utm_source=Mondaq&utm_medium=syndication&utm_campaign=View-Original Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150128/15a844ba/attachment.htm From EGottlieb at cityofithaca.org Wed Jan 28 14:01:54 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Wed Jan 28 14:01:47 2015 Subject: [Pharmwaste] Still waiting for SC announcement Message-ID: <65AC0C9A3A6A474EAD8D56070FED66983E4AA2F6@MAIL.cityofithaca.org> I phoned the U.S. Supreme Court and learned that today was the estimated decision day. That still may turn out to be accurate. The staff have no way of knowing exactly when the Justices will make the announcement that they will hear the Alameda case or let the District court decision stand. By the way, I have heard the argument that the best outcome would be for the court to hear the case and uphold the law. That precedent would do more to prevent future legal challenges to similar laws than if they simply let the lower court ruling stand. If you want to be one of the first to know what they decide, check this link regularly: http://www.supremecourt.gov/search.aspx?filename=/docketfiles/14-751.htm Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150128/d582b533/attachment.htm From EGottlieb at cityofithaca.org Sat Jan 31 10:29:30 2015 From: EGottlieb at cityofithaca.org (Ed Gottlieb) Date: Sat Jan 31 10:30:41 2015 Subject: [Pharmwaste] Est cost of take back per site? Message-ID: <65AC0C9A3A6A474EAD8D56070FED66983E63AE76@MAIL.cityofithaca.org> The pharmaceutical lobby claims that the cost of take back programs is too high. I'd like to estimate what it would cost and see how that compares, percentage wise, to other industries with product stewardship programs. I don't know what percent of gross sales are used to pay for outreach, waste collection and disposal by industries with lifecycle programs. Maybe the folks at PSI have some numbers? Does the percent vary widely or are they in the same ballpark? Could a pharmaceutical program be done for a similar or lower percentage? A quick check shows there are approximately 67,000 pharmacies (Wiki) and 16,000 nursing homes (CDC) in the U.S. Couldn't find a number for narcotic treatment centers. It is not likely that every pharmacy, long term care facility, and narcotic treatment center will become a collection site, even if the cost of the program is covered. I'm going to optimistically assume high participation rate of 85,000 collection sites. In 2009, gross sales of pharmaceuticals in the US totalled 300 billion dollars [http://www.bls.gov/ppi/pharmpricescomparison.pdf]. With the growth of health care costs, it is safe to assume that this is now a low number. Not yet knowing what percent of gross sales other industries put into collection and disposal, I'm going to make a big assumption. I'd guess that most people would agree that 1/10 of 1% of gross sales is not a lot to cover the costs of a take back program. Using my assumptions, 300 million dollars is roughly $3500 per collection site per year. Obviously, the start-up cost for a pharmaceutical program is significantly higher than the ongoing costs since drop boxes need to be purchased, staff needs to be trained, and outreach materials developed. We should also assume there will be ongoing government oversight costs that need to be covered. There is an economy of scale that applies here. For example, if the manufactures chose to work together, one outreach program could be used nationwide, tweaking it for maximum effectiveness in different regions. Also, the cost of a collection box (roughly 7-9 hundred) will come down some with large volume purchases. Are my assumptions and quoted numbers reasonable? How does the $3500/site figure compare to the start up and maintenance costs of your take back program? Your thoughts are appreciated! Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150131/d4af649f/attachment.html From Margaret.Shield at kingcounty.gov Sat Jan 31 14:18:44 2015 From: Margaret.Shield at kingcounty.gov (Shield, Margaret) Date: Sat Jan 31 14:16:50 2015 Subject: [Pharmwaste] RE: Est cost of take back per site? In-Reply-To: <65AC0C9A3A6A474EAD8D56070FED66983E63AE76@MAIL.cityofithaca.org> References: <65AC0C9A3A6A474EAD8D56070FED66983E63AE76@MAIL.cityofithaca.org> Message-ID: <4B5D22CD2328F442862E4FC8982A612044F0A287@MAILQDC3.kc.kingcounty.lcl> Hi Ed, I've done various cost estimate scenarios over the years and I find that a per site estimate has its limitations. The costs of a medicine return system are greatly influenced by how program operations are designed and on the total amount of medicines collected. The amount of medicines collected per each drop-off site is influenced by how many nearby drop-off sites are also available to collect medicines from residents. There are both fixed and variable costs to be considered. Some costs, such as program promotion and administration are not directly related to the number of collection sites, and gain efficiencies with larger scales. Perhaps the best approach is to make reasonable assumptions about the collection system design, and then estimate costs for various numbers of collection sites. Please see attached for a public staff report to the King County Board of Health from May 2013. On pages 10-11 there is an summary of costs analysis conducted to estimate the cost of the Secure Medicine Return Regulations to drug manufacturers. The summary is: Total costs to all drug producers selling medicines in or into the county are estimated in the ballpark of $1 million per year, which is less than 0.1% of annual medicine sales in the county or roughly a few pennies per prescription in costs to the drug producers. The report states a lower cost estimate that assumes a medicine collection amoutnts similar to existing medicine return programs in Canada. The high estimate assumes a six-fold higher collection amounts similar to some of the existing medicine return programs in Europe. Both the lower and higher cost estimates included expenses that the drug producers likely can avoid in their program design, such as: ? law enforcement staff time for transportation of all collected medicines if controlled substances are included, which is no longer required under the new DEA rule for collection of controlled substances, and ? warehousing of drugs prior to final disposal, which can be avoided through program design where medicines are transported directly from collection sites to disposal facility. Margaret Shield PhD, Policy Liaison Local Hazardous Waste Management Program in King County cell 206-265-9732 Local Governments for Health and the Environment - www.lhwmp.org ________________________________ From: pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Ed Gottlieb [EGottlieb@cityofithaca.org] Sent: Saturday, January 31, 2015 7:32 AM To: pharmwaste@lists.dep.state.fl.us Subject: [Pharmwaste] Est cost of take back per site? The pharmaceutical lobby claims that the cost of take back programs is too high. I'd like to estimate what it would cost and see how that compares, percentage wise, to other industries with product stewardship programs. I don't know what percent of gross sales are used to pay for outreach, waste collection and disposal by industries with lifecycle programs. Maybe the folks at PSI have some numbers? Does the percent vary widely or are they in the same ballpark? Could a pharmaceutical program be done for a similar or lower percentage? A quick check shows there are approximately 67,000 pharmacies (Wiki) and 16,000 nursing homes (CDC) in the U.S. Couldn't find a number for narcotic treatment centers. It is not likely that every pharmacy, long term care facility, and narcotic treatment center will become a collection site, even if the cost of the program is covered. I'm going to optimistically assume high participation rate of 85,000 collection sites. In 2009, gross sales of pharmaceuticals in the US totalled 300 billion dollars [http://www.bls.gov/ppi/pharmpricescomparison.pdf]. With the growth of health care costs, it is safe to assume that this is now a low number. Not yet knowing what percent of gross sales other industries put into collection and disposal, I'm going to make a big assumption. I'd guess that most people would agree that 1/10 of 1% of gross sales is not a lot to cover the costs of a take back program. Using my assumptions, 300 million dollars is roughly $3500 per collection site per year. Obviously, the start-up cost for a pharmaceutical program is significantly higher than the ongoing costs since drop boxes need to be purchased, staff needs to be trained, and outreach materials developed. We should also assume there will be ongoing government oversight costs that need to be covered. There is an economy of scale that applies here. For example, if the manufactures chose to work together, one outreach program could be used nationwide, tweaking it for maximum effectiveness in different regions. Also, the cost of a collection box (roughly 7-9 hundred) will come down some with large volume purchases. Are my assumptions and quoted numbers reasonable? How does the $3500/site figure compare to the start up and maintenance costs of your take back program? Your thoughts are appreciated! Ed Gottlieb Chair, Coalition for Safe Medication Disposal Industrial Pretreatment Coordinator Ithaca Area Wastewater Treatment Facility 525 3rd Street Ithaca, NY 14850 (607) 273-8381 fax: (607) 273-8433 -------------- next part -------------- An HTML attachment was scrubbed... URL: http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150131/0f4d36de/attachment.htm -------------- next part -------------- A non-text attachment was scrubbed... Name: SMR Staff Report_KC BOH_16May2013.pdf Type: application/pdf Size: 846568 bytes Desc: SMR Staff Report_KC BOH_16May2013.pdf Url : http://lists.dep.state.fl.us/pipermail/pharmwaste/attachments/20150131/0f4d36de/SMRStaffReport_KCBOH_16May2013-0001.pdf