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<p class=MsoNormal><b><font size=4 face=Verdana><span style='font-size:14.0pt;
font-family:Verdana;font-weight:bold'>Rx for disposal</span></font></b></p>
<p class=MsoNormal><b><i><font size=2 face=Verdana><span style='font-size:10.0pt;
font-family:Verdana;font-weight:bold;font-style:italic'>Getting rid of unused
prescriptions isn't nearly as easy as you might imagine</span></font></i></b></p>
<p class=MsoNormal><font size=1 face=Verdana><span style='font-size:9.0pt;
font-family:Verdana'>BY BETTY BOOKER</span></font></p>
<p class=MsoNormal><font size=1 face=Verdana><span style='font-size:9.0pt;
font-family:Verdana'> </span></font></p>
<p class=MsoNormal><font size=1 face=Verdana><span style='font-size:9.0pt;
font-family:Verdana'>TIMES-DISPATCH STAFF WRITER</span></font></p>
<p class=MsoNormal><font size=1 face=Verdana><span style='font-size:9.0pt;
font-family:Verdana'> </span></font></p>
<p class=MsoNormal><font size=1 face=Verdana><span style='font-size:9.0pt;
font-family:Verdana'>Monday, August 21, 2006</span></font></p>
<p class=MsoNormal><font size=2 face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'><br clear=all>
</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>What do you do with old pills in your medicine cabinet --
the ones you, your kids and granny didn't use?</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Most people flush them. It's not against the law for
private citizens to do that.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Environmentalists don't like it much because medicines
contaminate drinking water.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Some people throw them in the garbage.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Law and drug enforcers don't like that.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Scavengers paw through trash for painkillers to use or
resell. Children and pets might inadvertently poison themselves. If the
medicines make it to the dump, they decompose and leech into the groundwater.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Don't give them to friends and relatives, either.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>They might have adverse effects. Plus, it's against the
law for pills to be used by anyone other than the person for whom they're
prescribed.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Don't leave leftovers where teens might sample them.
Pharmaceutical abuse is a growing problem.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>It's even hard to give them to the poor. Many free clinics
aren't taking medications anymore.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"We don't accept medicines that have been prescribed
for anyone else," says Susan Carr, director of clinical services for the
Fan Free Clinic.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"Until recently, we were able to accept donated
medicines," adds Mary Moore, spokeswoman for Crossover Ministry, a
nonprofit organization that provides health care for metro Richmond's uninsured
poor.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"But we now have a licensed pharmacy, and that's why
we can't take anything that doesn't come from a licensed source.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"At least once a week, we have someone calling
because their parent or spouse has died and they have perfectly good medicines
left over -- and we just cannot take them. It really is a terrible waste."</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Instead, Crossover buys in bulk for the uninsured from
drug manufacturers.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"The problem is that once medicine has been taken out
of the stock bottle in the pharmacy and put in another bottle, there's no way
to account for the condition of the medicines," says pharmacist Carol
Pugh, quality officer at the Virginia Association of Free Clinics.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>The medicines can't legally be dispensed a second time
because they might be contaminated, adulterated or degraded.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"There are probably a lot of good medicines that end
up getting trashed because of erring on the side of safety," she
continues. "People who used to take them in the past are realizing that's
not a practice we should be doing.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"It's very frustrating, because a lot of people need
medicines they can't afford," says Pugh, who is researching free clinics'
drug disposal options.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Charity clinics have to work with approved drug-disposal
companies licensed by the Drug Enforcement Administration. Biohazard containers
aren't secure enough for drug disposal.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"The private citizen [is] in a quandary," Pugh
says. "I don't think anybody's come up with a way for John Q. Public to
dispose of medicines."</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Ask your local pharmacy if it is willing to put your
unwanted pills through its biohazard disposal service, suggests Dr. Rodney
Stiltner, assistant director and acting director of VCU Health System's
pharmacy services.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>However, pharmacies generally are unwilling to do that
nowadays, says </span></font><font size=2 face=Verdana><span style='font-size:
10.0pt;font-family:Verdana'>Elizabeth Scott</span></font><font size=2
face=Verdana><span style='font-size:10.0pt;font-family:Verdana'> Russell,
executive director of the Virginia Board of Pharmacy.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"Pharmacies have to pay to have drugs destroyed, and
it's an expensive process" in a retail business with a low profit margin,
she says. Also, federal law prevents returning controlled substances to a
drugstore.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"This is a huge mess. In a nutshell, I do not
believe, in this point in time, there are any laws that prohibit private
citizens from flushing drugs. Whether it's a good idea or not, the jury's still
out."</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Hospitals' out-of-date medications are returned for credit
from manufacturers or are disposed of through a licensed disposal service,
Stiltner says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>That's what well-run hospitals do, says Tom Griffin,
director of Hospitals for a Healthy Environment in the state Department of
Environmental Quality's pollution prevention office.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Nursing homes that can prove unused medications have been
handled properly can donate them to free clinics, but that hasn't been widely
done, Russell says. The medicine has to go through a pharmacy that has to
ensure the integrity of the drug.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>It's against the law for nursing homes or hospices to give
a deceased resident's unused medications to a poor patient in the facility,
Russell says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>VCU's Stiltner sends people wanting to help overseas to
MAP International, a nonprofit group that gets and distributes donations of
medical products from corporations.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>But the global group doesn't take people's used meds, says
spokeswoman Nancy Butler.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Neither does the American Red Cross, says the </span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'>Richmond</span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'>
chapter's spokesman, Bill Harrison.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"I realize most people are honest, but we would never
give out donated medication because we don't know the origin of it," he
says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Nor does the Richmond-based International Mission Board of
the Southern Baptist Convention take supplies or medications anymore, says Dr.
Van Williams, a physician and medical director.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>States are just beginning to grapple with drug disposal
and recycling options, Russell says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Some states, such as </span></font><font size=2
face=Verdana><span style='font-size:10.0pt;font-family:Verdana'>California</span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'>, let
counties collect unused drugs from nursing homes, wholesalers and manufacturers
for distribution to the uninsured poor. </span></font><font size=2
face=Verdana><span style='font-size:10.0pt;font-family:Verdana'>Virginia</span></font><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'> has no
similar program, Russell says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Minnesota</span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'> has developed criteria for
disposing of medicines because they were getting in the water supply, Stiltner
says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Virginia</span></font><font size=2 face=Verdana><span
style='font-size:10.0pt;font-family:Verdana'>'s pharmacy board and the Department
of Environmental Quality "are trying to come up with a good way to deal
with this problem," Russell says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>So what do you do with unused prescription meds?</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"It's recommended not to dispose of medications in
their original container because there is a potential for re-use. You don't
know who will go through the trash," says VCU pharmacist Punam Patel.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"I don't have a good answer for that," the
pharmacy board's Russell says. "There's no law I know of that says a
private citizen can't dispose of them in their private residence."</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>So what's the answer?</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"I'd probably flush them," Pugh says.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"The best thing to say is that people are aware that
flushing is not the best thing to do for the environment," says Smith, of
the state pollution-prevention office. "However, flushing is probably one
of the best options."</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>But not the best in his environmentalist's view because
wastewater treatment plants treat bacteria, not drugs and chemicals.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>"I'd rather see people throw drugs in the landfill
where they'll have much less impact than going directly down the sink. But
that's just from the environmental side."</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Take care that pills and medicines are hidden and syringes
are in a hard-sided container so they don't stick the trash collectors.</span></font></p>
<p><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'>Don't put these hazardous things out in the trash can
until the garbage truck is coming down the alley. That way you can watch them
go straight into the truck's compactor.</span></font></p>
<p class=MsoNormal><font size=2 face=Verdana><span style='font-size:10.0pt;
font-family:Verdana'><br>
<TAGLINE type="std">Contact staff writer Betty Booker at <a
href="mailto:bbooker@timesdispatch.com">bbooker@timesdispatch.com</a> or (804)
649-6805.</span></font></p>
</TAGLINE>
<p><b><font size=2 color=black face=Verdana><span style='font-size:10.0pt;
font-family:Verdana;font-weight:bold'><!--/OMKT-->This story can be found at:</span></font></b><font
size=2 face=Verdana><span style='font-size:10.0pt;font-family:Verdana'> <a
href="http://www.timesdispatch.com/servlet/Satellite?pagename=RTD/MGArticle/RTD_BasicArticle&c=MGArticle&cid=1149190064713">http://www.timesdispatch.com/servlet/Satellite?pagename=RTD/MGArticle/RTD_BasicArticle&c=MGArticle&cid=1149190064713</a></span></font></p>
<p class=MsoNormal><font size=3 color=navy face="Times New Roman"><span
style='font-size:12.0pt;color:navy'> </span></font></p>
<p class=MsoNormal><font size=3 color=navy face="Times New Roman"><span
style='font-size:12.0pt;color:navy'> </span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Deborah L. DeBiasi</span></font></p>
<p class=MsoNormal><b><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy;font-weight:bold'>Email:
dldebiasi@deq.virginia.gov</span></font></b></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>WEB site address: </span></font><font
color=navy><span style='color:navy'><a href="www.deq.virginia.gov"><font
size=2><span style='font-size:10.0pt'>www.deq.virginia.gov</span></font></a></span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Virginia</span></font><font size=2
color=navy><span style='font-size:10.0pt;color:navy'> </span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'>Department</span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'> of Environmental
Quality</span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Office of Water Permit Programs</span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Industrial Pretreatment/Toxics Management
Program</span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Mail:
</span></font><font size=2 color=navy><span style='font-size:10.0pt;color:navy'>P.O.
Box 10009</span></font><font size=2 color=navy><span style='font-size:10.0pt;
color:navy'>, </span></font><font size=2 color=navy><span style='font-size:
10.0pt;color:navy'>Richmond</span></font><font size=2 color=navy><span
style='font-size:10.0pt;color:navy'>, </span></font><font size=2 color=navy><span
style='font-size:10.0pt;color:navy'>VA</span></font><font size=2 color=navy><span
style='font-size:10.0pt;color:navy'> </span></font><font size=2 color=navy><span
style='font-size:10.0pt;color:navy'>23240-0009</span></font><font size=2
color=navy><span style='font-size:10.0pt;color:navy'> </span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>Location: </span></font><font size=2
color=navy><span style='font-size:10.0pt;color:navy'>629 E. Main Street</span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'>, </span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'>Richmond</span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'>, </span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'>VA</span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'> </span></font><font
size=2 color=navy><span style='font-size:10.0pt;color:navy'>23219</span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>PH: 804-698-4028</span></font></p>
<p class=MsoNormal><font size=2 color=navy face="Times New Roman"><span
style='font-size:10.0pt;color:navy'>FAX: 804-698-4032</span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
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