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<title>Re: [Pharmwaste] Sampling of med take back items</title>
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<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Nicely worded.And also the data has
already driven policy by leading to reduced first prescription duration.<o:p></o:p></span></font></p>
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<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Rod Larson
[mailto:larsonr@husson.edu] <br>
<b><span style='font-weight:bold'>Sent:</span></b> Friday, January 22, 2010
10:01 AM<br>
<b><span style='font-weight:bold'>To:</span></b> Dennis Lucia;
pharmwaste@lists.dep.state.fl.us; Gressitt, Stevan; Jeanie Jaramillo<br>
<b><span style='font-weight:bold'>Cc:</span></b> Allan Geisendorfer;
Jennifer_Crittenden@umit.maine.edu; Len Kaye; John Schloss<br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Pharmwaste] Sampling
of med take back items</span></font><o:p></o:p></p>
</div>
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12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='margin-bottom:12.0pt'><font size=2 face=Calibri><span
style='font-size:11.0pt;font-family:Calibri'>I don’t believe anybody was
mandating anything. A problem was posed and suggestions made to help
solve it. <br>
<br>
A great deal has been learned from tracking the types and quantity of drugs
being returned to this point. But we have just scratched the surface.
A drug take-program has many potential benefits to the environment and
society, in general. Four of these include:<br>
1. The reduction of environmental contamination.<br>
2. The reduction of recreational use of
prescribed and OTC medications.<br>
3. The reduction of inappropriate medication
sharing.<br>
4. An increase in knowledge regarding the how
medications are prescribed and used. <br>
<br>
The <st1:State w:st="on"><st1:place w:st="on">Maine</st1:place></st1:State>
project is fortunate to have the resources and expertise available (e.g., law
enforcement, government officials, pharmacists, researchers, students) to be
able to address all four of the issues listed above. While I disagree that
all the variables mentioned below are needed in order to extract useful and
meaningful information out of such projects, I see no harm in collecting what
we can (without violating privacy laws) for the sake of improving how
medications are used, stored, and safely disposed of. On the contrary, I
believe it would be irresponsible to throw away information that could be used
to benefit society, if one has the means and resources to collect, analyze and
report it. <br>
<br>
If someone doesn’t have the resources and/or expertise to do anything
beyond collecting and destroying the medications, this doesn’t mean that
their projects are not helpful. The projects obviously benefit society
and the environment tremendously in the first three ways listed above. <br>
<br>
Just my two cents.<br>
<br>
Rod<br>
</span></font><font size=2><span style='font-size:11.0pt'><br>
**************************************** <br>
Rodney A. Larson, Ph.D., R.Ph. <br>
Founding Dean <br>
School of Pharmacy<br>
<st1:place w:st="on"><st1:PlaceName w:st="on">Husson</st1:PlaceName> <st1:PlaceType
w:st="on">University</st1:PlaceType></st1:place><br>
<st1:address w:st="on"><st1:Street w:st="on">One College Circle</st1:Street> <br>
<st1:City w:st="on">Bangor</st1:City>, <st1:State w:st="on">Maine</st1:State> <st1:PostalCode
w:st="on">04401-2929</st1:PostalCode></st1:address> <br>
Phone: 207-941-7163 <br>
Email: <u><font color=blue><span style='color:blue'><a href="LarsonR@Husson.edu">LarsonR@Husson.edu</a><br>
</span></font></u>****************************************<br>
<br>
</span></font><font size=2 face=Calibri><span style='font-size:11.0pt;
font-family:Calibri'><br>
On 1/22/10 8:51 AM, "Dennis Lucia" <<a
href="djlucia@gw.dec.state.ny.us">djlucia@gw.dec.state.ny.us</a>> wrote:</span></font><o:p></o:p></p>
<p class=MsoNormal style='margin-bottom:12.0pt'><font size=2 face=Calibri><span
style='font-size:11.0pt;font-family:Calibri'>Before you attempt to mandate that
you need drug statistics for all collections. What have you learned from
the collections that have been held, where data on the types of drugs and
quantity has been recorded?<br>
<br>
Doing an analysis of every 1/10 or 1/20 or 1/100 will not tell you much and
requires that at each collection you have a trained pharmacist. By the
way, you do know that having anyone other than law enforcement handle the
unwanted controlled substances at a collection event is illegal. <br>
<br>
Are you planning to collect additional information in violation of privacy
laws.<br>
Like:<br>
Diagnosis; length of treatment; <br>
Did the patient have health insurance, type of health insurance;<br>
1st prescription or multiple times that it has been prescribed<br>
Male/female, age.<br>
Why did patient stop taking drug? Reaction, type of reaction? Got better? Died?<br>
You will also need info on the location where the collection takes place and
demographic on the patient, regarding their life style, and medical history.<br>
<br>
There are many variables that make the analysis complicated...<br>
<br>
Are you trying to get unwanted drugs out of households and properly disposed of
or are you trying to do a research study to analyze why patients don't take the
medications prescribed to them and why drugs are being over prescribed?<br>
<br>
Let's simplify the drug collections and work on the other issues in other
ways!!!<br>
<br>
<br>
<br>
<br>
Dennis J. Lucia, P.E.<br>
Pollution Prevention Unit<br>
Division of Environmental Permits<br>
New York State Department of Environmental Conservation<br>
625 Broadway 4th Fl.- SW<br>
<st1:place w:st="on"><st1:City w:st="on">Albany</st1:City>, <st1:State w:st="on">NY</st1:State>
<st1:PostalCode w:st="on">12233-1750</st1:PostalCode></st1:place><br>
(518) 402-9469<br>
Fax (518) 402-9168<br>
<br>
<br>
>>> "Gressitt, Stevan" <<a
href="Stevan.Gressitt@maine.gov">Stevan.Gressitt@maine.gov</a>> 1/22/2010
7:37 AM >>><br>
</span></font><font size=2 color=navy face=Arial><span style='font-size:10.0pt;
font-family:Arial;color:navy'>Your internal consistency idea looks good. I am
not the mathematician or statistician, but I suspect there is enough horsepower
on this list to advise. It might also be interesting to see the difference in
consistency at 1/10 1/20 1/100 depending on sixze as we all who are trying to
sample will probably do best if we adopt a “best practice” <br>
<br>
</span></font><font size=2 face=Calibri><span style='font-size:11.0pt;
font-family:Calibri'><br>
</span></font><font size=2 color="#993366" face="Goudy Old Style"><span
style='font-size:10.0pt;font-family:"Goudy Old Style";color:#993366'>Stevan
Gressitt, M.D., Medical Director<br>
Office of Adult Mental Health Services<br>
Department of Health and Human Services<br>
<st1:place w:st="on"><st1:PlaceName w:st="on">Marquardt</st1:PlaceName> <st1:PlaceType
w:st="on">Building</st1:PlaceType></st1:place>, 2nd Floor<br>
11 State House Station<br>
<st1:Street w:st="on"><st1:address w:st="on">32 Blossom Lane</st1:address></st1:Street><br>
<st1:place w:st="on"><st1:City w:st="on">Augusta</st1:City>, <st1:State w:st="on">ME</st1:State>
<st1:PostalCode w:st="on">04333-0011</st1:PostalCode></st1:place><br>
Ph: (207)287-4273<br>
Fax: (207)287-1022<br>
Cell Phone: (207) 441-0291<br>
E-Mail : <a href="stevan.gressitt@maine.gov">stevan.gressitt@maine.gov</a><br>
</span></font><u><font size=1 color=blue face="Goudy Old Style"><span
style='font-size:9.0pt;font-family:"Goudy Old Style";color:blue'><a
href="http://www.maine.gov/dhhs/mh/">http://www.maine.gov/dhhs/mh/</a><br>
</span></font></u><font size=2 color=navy face=Calibri><span style='font-size:
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<p style='margin-bottom:12.0pt'><b><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma;font-weight:bold'>From:</span></font></b><font
size=2 face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> <a
href="pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a>
[<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>]
<b><span style='font-weight:bold'>On Behalf Of </span></b>Jaramillo, Jeanie<br>
<b><span style='font-weight:bold'>Sent:</span></b> Wednesday, January 20, 2010
2:29 PM<br>
<b><span style='font-weight:bold'>To:</span></b> <a
href="pharmwaste@lists.dep.state.fl.us">pharmwaste@lists.dep.state.fl.us</a><br>
<b><span style='font-weight:bold'>Subject:</span></b> [Pharmwaste] Sampling of
med take back items<br>
</span></font><font size=2 face=Calibri><span style='font-size:11.0pt;
font-family:Calibri'><br>
I had no luck with having our epidemiologist help with a sampling protocol.
He’s already being pulled in many different directions. I did
want to mention that our next event (3/27) will likely be the last one in which
we conduct a full inventory. We will be collating the items collected by
participant (i.e. these 20 items all came from car #1), which will be a little
more work this time around. I believe this will allow us to validate
sampling techniques that we could use for future events. For instance, we
could pull out the data from every Xth participant, summarize it, and
extrapolate it to the total number of participants and then compare that to the
full inventory. I’m sure there’s some statistical method to
do that. <br>
<br>
</span></font><font face="Monotype Corsiva"><span style='font-family:"Monotype Corsiva"'>Jeanie
Jaramillo, PharmD<br>
Managing Director, <st1:place w:st="on"><st1:PlaceName w:st="on">Texas</st1:PlaceName>
<st1:PlaceName w:st="on">Panhandle</st1:PlaceName> <st1:PlaceName w:st="on">Poison</st1:PlaceName>
<st1:PlaceType w:st="on">Center</st1:PlaceType></st1:place><br>
Assistant Professor, <st1:place w:st="on"><st1:PlaceName w:st="on">Texas</st1:PlaceName>
<st1:PlaceName w:st="on">Tech</st1:PlaceName> <st1:PlaceName w:st="on">UHSC</st1:PlaceName>
<st1:PlaceType w:st="on">School</st1:PlaceType></st1:place> of Pharmacy<br>
<st1:Street w:st="on"><st1:address w:st="on">1501 S. Coulter St</st1:address></st1:Street>.
<br>
<st1:place w:st="on"><st1:City w:st="on">Amarillo</st1:City>, <st1:State w:st="on">TX</st1:State>
<st1:PostalCode w:st="on">79106</st1:PostalCode></st1:place><br>
P: (806) 354-1611<br>
C: (806) 672-0833<br>
F: (806) 354-1667<br>
Cisco IP: 30412<br>
<br>
</span></font><o:p></o:p></p>
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