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<P>Jeanie, many thanks for your input. I just returned from a meeting with DEA folks in DC. Yes, there many programs that do not involve law enforcement and might get by with it. the main challenge for these program is to ensure that no controlled substances are collected and handled. Our research has indicated that this is almost impossible.</P>
<P>Invariably controlled substances are commingled in the return. </P>
<P> </P>
<P>The question is "would the DEA come down on you if you stated that you're not collecting FCS and they show up in your sample?" Here's an unofficial statement from the DEA. "They might if they want to."</P>
<P> </P>
<P>Drug take-back program is a relatively new movement in the US whereas other countries have successfully implemented return systems without much problems, mostly direct return to the pharmacies. Historically, there has been a great deal of diversion in the US that spans all sector but particularly in our healthcare system (hosp, clinic) and pharmacy system (retail pharmacy, etc.). This is the rationale behind the DEA's "closed loop system" with first registrant and the Controlled Substance Act of 1970. </P>
<P> </P>
<P>Believe me, everyone wants to do the right thing but don't put yourself in any risk with the law. While our group work closely with federal agencies in the research of unused and expired medicines in the US, we DO NOT work for any federal or state agency. We are completely independent. We provide research support (data collection, analysis, reporting, etc.) to anyone or any group that wants to have the info for any number of reasons (program eval, monitoring, policy, QC, reliability, community education, etc.). We help groups do sampling to basically ensure that they are not collecting FCS when they are not supposed to. And we don't report any group to the law enforcement or DEA, because we are researchers only!</P>
<P> </P>
<P>Interestingly, our data are showing unusual post-market side effects. This is the only area where our researchers believe it is ethically an obligation for us to notify the FDA or drug manufacturers. </P>
<P> </P>
<P>I'd like to send your our Annual Survey so your group can be included in our National Directory. Again, congrats on your tremendous leadership and work in TX. Let me know how we can help.</P>
<P> </P>
<P>Matt<BR><BR><BR></P>
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<P class=MsoNormal><SPAN style="COLOR: #1f497d">I am from the Texas Panhandle Poison Center which is in Amarillo (not Lubbock). We are having our first take back program on September 12<SUP>th</SUP>. Law enforcement is involved. DEA has been our most significant obstacle, but we are finally getting there. We’ve also had discussions with the TX State Board of Pharmacy. It is my belief that there are programs in the State that are conducted without law enforcement involvement. From my correspondence with the DEA, they are beginning to “crack down” on these. There are many groups who do not understand all of the regulations and unfortunately, they are not summarized in any one place. <o:p></o:p></SPAN></P>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">Jeanie Jaramillo, PharmD<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">Managing Director, Texas Panhandle Poison Center<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">Assistant Professor, Texas Tech UHSC School of Pharmacy<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">1501 S. Coulter St. <o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">Amarillo, TX 79106<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">P: (806) 354-1611<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">C: (806) 672-0833<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">F: (806) 354-1667<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Monotype Corsiva'; COLOR: #1f497d; FONT-SIZE: 12pt">Cisco IP: 30412<o:p></o:p></SPAN></P></DIV>
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<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt">From:</SPAN></B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; FONT-SIZE: 10pt"> Matthew C. Mireles [mailto:mirelesmc@earthlink.net] <BR><B>Sent:</B> Wednesday, August 05, 2009 9:44 AM<BR><B>To:</B> Tony Madruga; McKinley,Gena; 'pharmwaste@lists.dep.state.fl.us'<BR><B>Cc:</B> john.r.prince@dvault.com; easmith@communityofcompetence.com; Karen Bartkowiak (karen.bartkowiak@dvault.com)<BR><B>Subject:</B> Re: [Pharmwaste] RE: Texas Pharmaceutical Disposal Programs<o:p></o:p></SPAN></P></DIV></DIV>
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<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">Gena,<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">We run the </SPAN><EM><B><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: blue; FONT-SIZE: 9pt">National Unused and Expired Medicines Registry</SPAN></B></EM><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> and conduct an annual survey of all the drug take-back programs in the US. We publish the survey data in our </SPAN><EM><B><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: blue; FONT-SIZE: 9pt">National Directory of Drug Take-Back and Disposal Programs</SPAN></B></EM><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">. The Directory lists all the programs in the nation. Please contact me if you wish to have a copy.<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">Our group is based in Houston, but most of our work in drug return system are in Maine and CA. We also are consulting with federal agencies in designing a national drug take back system.<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">There are a few take-back programs in TX (Plano, Dallas area). One is beginning in Corpus I believe. All of these are small community-based programs. In Houston, we ran one pilot study with senior citizens. One for-profit company in Houston has a mail-back system set up with shipping kits and an incineration unit in Carthage TX. Another large company in anticipation for a business venture has purchased a large industrial incineration facility in Chamber Co. <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">Since we provide technical assistance in designing these programs around the country, we highly encourage the involvement of law enforcement whenever there's a possibility of collecting controlled substances. Most of the programs in TX mentioned above all have law enforcement involvement. <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">We also publish a comprehensive </SPAN><EM><B><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: blue; FONT-SIZE: 9pt">manual of procedures</SPAN></B></EM><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> for drug take back. This manual has been selected as the official reference of instructions for an upcoming international conference on drug disposal in Maine (mainebenzo.org).<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">As far as partnership between city govt and retail pharmacies in TX, we have not seen this in our survey. CA, OR, and WA use this model for their take back system. In TX, the most promising initiative and partnership are coming from the Poison Center (Lubbock, Galveston, etc.) You may want to join the listserv and get involved right away. My advice for now is to proceed carefully. The DEA is keeping a close eye on TX. Our programs are in compliance with DEA regs.<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">I hope my info is useful. Please contact me if you have questions. By the way, I worked at UTMB before I move to Houston for grad school.<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"> <o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">Matthew C. Mireles, PhD, MPH<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">President and CEO<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">Community Medical Foundation for Patient Safety<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">6300 West Loop South, Suite 288<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">Bellaire, TX 77401<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">832-778-7777<o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"><A href="http://www.communityofcompetence.com">www.communityofcompetence.com</A><o:p></o:p></SPAN></P>
<P><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"><BR><BR> <o:p></o:p></SPAN></P>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt">-----Original Message----- <BR>From: Tony Madruga <BR>Sent: Aug 4, 2009 4:18 PM <BR>To: "McKinley, Gena" , "'pharmwaste@lists.dep.state.fl.us'" <BR>Cc: "john.r.prince@dvault.com" , "Karen Bartkowiak (karen.bartkowiak@dvault.com)" <BR>Subject: [Pharmwaste] RE: Texas Pharmaceutical Disposal Programs <BR><BR><BR><o:p></o:p></SPAN></P>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Hi Gena,<o:p></o:p></SPAN></P></DIV>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">I am not aware of any current programs in your area, however we can provide all of your unattended collection unit needs through our sister company Take Back Express.com.<o:p></o:p></SPAN></P></DIV>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">More information can be found at: <A href="http://www.takebackexpress.com/" target=_blank>http://www.takebackexpress.com</A><o:p></o:p></SPAN></P></DIV>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Regards,<o:p></o:p></SPAN></P></DIV></DIV>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Tony O. Madruga</SPAN><SPAN style="COLOR: black"><BR></SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">President</SPAN><SPAN style="COLOR: black"><BR></SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: navy; FONT-SIZE: 10pt">dVault® Companies, Inc.</SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><o:p></o:p></SPAN></P>
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<P style="MARGIN-BOTTOM: 12pt" class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; COLOR: black; FONT-SIZE: 10pt">From:</SPAN></B><SPAN style="FONT-FAMILY: 'Tahoma','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] On Behalf Of McKinley, Gena [Gena.McKinley@h-gac.com]<BR><B>Sent:</B> Tuesday, August 04, 2009 2:01 PM<BR><B>To:</B> 'pharmwaste@lists.dep.state.fl.us'<BR><B>Subject:</B> [Pharmwaste] Texas Pharmaceutical Disposal Programs</SPAN><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 9pt"><o:p></o:p></SPAN></P></DIV>
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<P class=MsoNormal><SPAN style="COLOR: black">Hello!<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: black"> <o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: black">I am in the process of working on a BMP guide for the management of pharmaceutical waste, and am looking for example programs in the State of Texas. I am also interested to know if any pharmacies in the State of Texas have partnered with municipalities in the collection of pharmaceuticals. Please contact me if you have any information. <o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: black"> <o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: black">Thanks!<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: black">Gena<o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="COLOR: black"> <o:p></o:p></SPAN></P>
<P class=MsoNormal><B><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Gena McKinley, MPH</SPAN></B><SPAN style="COLOR: black"><o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Environmental Planner</SPAN><SPAN style="COLOR: black"><o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Houston-Galveston Area Council</SPAN><SPAN style="COLOR: black"><o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Tel: 713-993-4529</SPAN><SPAN style="COLOR: black"><o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Fax: 713-993-4503</SPAN><SPAN style="COLOR: black"><o:p></o:p></SPAN></P>
<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Arial','sans-serif'; COLOR: black; FONT-SIZE: 10pt"><A href="http://www.h-gac.com/recycleguide" target=_blank>www.RecycleInfo.org</A> </SPAN><SPAN style="COLOR: black"><o:p></o:p></SPAN></P>
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