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<DIV><STRONG><FONT face=Arial size=4><SPAN class=152041014-06022006>Waste News -
column</SPAN></FONT></STRONG></DIV>
<DIV><FONT face=Arial size=2><STRONG><FONT size=4>Time for dialogue on waste
meds<BR></FONT>By:</STRONG> Scott Cassel<BR><B>January 30,
2006</B><BR> <BR>Drugs - we rely on them to treat headaches, depression,
cancer, and other ailments. But until recently, few have discussed the potential
impacts on the environment and, ironically, human health, caused by the disposal
of unwanted and waste pharmaceuticals. </DIV>
<P>Over a dozen disparate initiatives across the country are either studying the
problem or implementing ways to solve it, including take-back at pharmacies or
other collection points. While each represents progress, collectively they
threaten to create a patchwork of inefficient and conflicting programs. The time
is ripe for a national multi-stakeholder dialogue to agree on the extent of this
problem and develop joint priority solutions.
<P>There are three main sources of pharmaceuticals that reach our waterways:
normal excretion of unmetabolized, ingested drugs; disposal of medications down
the drain or toilet, or in the garbage; and excretion and disposal of animal
medications. Consequently, pharmaceuticals have the potential to enter waterways
from septic systems, wastewater treatment plants, and unlined landfills. Even
pharmaceuticals captured in leachate at lined landfills are typically
transported to wastewater treatment plants, where some pass through untreated.
<P>Last year, state and local government leaders asked the Product Stewardship
Institute to initiate a national dialogue on unwanted and waste pharmaceuticals
among key stakeholders, including representatives from pharmaceutical companies,
reverse distributors, retailers, and government agencies. PSI is currently
drafting a product stewardship action plan, based on more than 20 interviews,
which will form an objective basis for face-to-face meetings. Nearly all
stakeholders agreed to PSI's proposal to participate in four dialogue meetings
over a year, which PSI expects to result in joint initiatives.
<P>Several areas of agreement have started to emerge. First, all stakeholders
agree on the need to better understand the extent of the potential problem. The
U.S. Geological Survey detected pharmaceuticals in 80 percent of the 139 streams
tested in 2002. Issues to resolve are the degree to which the amounts detected
can impact the environment, the amount and percentage contributed by medications
that are disposed of as compared to excreted, and the level of precaution
necessary.
<P>A second emerging agreement is that pharmaceuticals should not be flushed
down the toilet. Still to be debated is whether they can safely be disposed of
in the trash, as some stakeholders propose. Third, most stakeholders recommend
that significant progress could be made by initially focusing resources on
managing unwanted and waste pharmaceuticals from nursing homes, hospice care,
and other long-term care facilities.
<P>Finally, and most significantly, many stakeholders believe that those who
want to voluntarily take back pharmaceuticals before the problem is fully
defined should face fewer regulatory barriers. Existing take-back pilots have
been constrained by the federal Controlled Substances Act, which authorizes the
U.S. Drug Enforcement Agency to strictly control possession of listed
substances. Some of these substances, such as prescribed narcotics, will likely
find their way into take-back programs along with nonlisted medications. The
current law, which ensures a continuous chain of custody to avoid illicit
diversion, is expensive and unsustainable for take-backs. Consequently, disposal
in the trash or via flushing has become the only available option for unwanted
controlled substances.
<P>Other significant issues remain, such as mail-back, reuse, and the role of
reverse distributors in take-backs. A national dialogue can save resources as
stakeholders share data and reach agreement in a single forum on issues of
national, regional and state significance.
<P>Cassel is executive director of the Product Stewardship Institute, <A
href="http://www.productstewardship.us">www.productstewardship.us</A>.</P></FONT>
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class=388124702-31032005>CONTACT INFORMATION</SPAN></STRONG></FONT></DIV>
<DIV align=left><FONT face=Arial color=#0000ff
size=2>******************************************</FONT></DIV>
<DIV align=left><FONT face=Arial color=#000000 size=2>Scott Cassel, Executive
Director</FONT></DIV>
<DIV align=left><FONT color=#0000ff><SPAN class=381342023-23032005><FONT
face=Arial color=#000000 size=2>Product Stewardship Institute,
Inc.</FONT></SPAN></DIV>
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