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<P>Thanks for your response. The general consensus and responses so far have been "buyers beware". No one is willing to investigate or look into this because we are not dealing with controlled substance and in many cases prescription meds. Our theory has to do with the type of consumer base at these flea markets--not your average letter-writers to elected politicians but hard working, low income, minority shoppers who are trying to save money or stretch what little they have. We haven't seen too much of counterfeit activities, because words travel fast.</P>
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<P>One reliable source informed me that he only have to wait at the end of each month when big shopper-clubs (one starts with "S" and another starts with "C") dump their inventory in the dumpster. I suppose this is free enterprise and capitalism meeting healthcare needs. When there is a demand (even for expired OTCs), there will be a supply.</P>
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<P>Since our Foundation deals with patient safety we are constantly surveying the landscape for these incidents. OTCs at flea market probably won't register on anyone's radar, not even the health dept. There is no known cluster of illness associated with people using expired OTCs or buying them from flea markets or garage sales (I actually have seen garage sales with unused and expired meds). Therefore, business is virtually undetectable. Of course, when someone decides to tamper and alter the drugs, the entire equation will change very rapidly. And we epidemiologists will be ready for an outbreak investigation.</P>
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<P>Please keep us informed. Thanks.</P>
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<P>Matthew Mireles, <BR><BR><BR></P>
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<P class=MsoNormal><SPAN style="FONT-FAMILY: 'Calibri','sans-serif'; COLOR: #002060; FONT-SIZE: 11pt">I have another theory. Just as we’ve seen a surge in abandoned household waste, we might also be seeing the result of closure or abandonment of convenience stores or any type of store that carries OTC’s. An acquaintance of mine was hired as part of a crew to clean out a few Hollywood Video stores. Being a dumpster diver by nature, he came home with a large sack of videos (none of them good). The inside of his truck looks like a flea market jam packed with other stuff he’s collected doing this type of work. Unless his experience is not the norm, these crews are typically made up of illegals and others that are paid cash daily for their work. They scrap and recycle whatever has value, keep what they want and dispose of some. Could be another source. <o:p></o:p></SPAN></P>
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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"> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <B>On Behalf Of </B>Barry Fernandez<BR><B>Sent:</B> Wednesday, March 24, 2010 9:18 AM<BR><B>To:</B> Sue Dayton; Matthew C. Mireles; Gressitt,Stevan; pharmwaste@lists.dep.state.fl.us; rxnews@listserve.com<BR><B>Cc:</B> linkfilion@communityofcompetence.com; easmith@communityofcompetence.com<BR><B>Subject:</B> RE: [Pharmwaste] FW: Google Alert - unused medicine disposal<o:p></o:p></SPAN></P></DIV></DIV>
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<P style="MARGIN-BOTTOM: 12pt"><SPAN style="FONT-SIZE: 10pt">Stockpiles of expired OTC meds can only be coming from one of very few places. Disposal facilities or reverse distributors. I'm not suggesting that the businesses themselves are involved in the diversion, but as with any business, inventory sometines tends to "leak" at the hands of employees. If I were you I'd get in touch with the agency tasked with regulating drugs and cosmetics in your state. In Florida it happens to be the Department of Health, division of Medical Quality Assurance (MQA). They can track where the meds originated using the lot numbers. Expired is one thing, but if these medications were recalled for some reason the risk to the unsuspecting public could be deadly in some cases.<BR><BR>Best Regards,<BR>Barry<BR><BR>Clean Fuels of Florida, Inc.<BR>D. Barry Fernandez, President<BR>2635 NE 4th Avenue<BR>Pompano Beach, FL 33064<BR>Tel: 954-791-9588<BR>Fax: 954-791-9366<BR>Cell: 305-216-4941<BR>Toll Free: 800-725-8711<BR>barry@clean-fuels.net <<A href="mailto:barry@clean-fuels.net" target=_blank>mailto:barry@clean-fuels.net</A>><BR>www.clean-fuels.net <<A href="http://www.clean-fuels.net/" target=_blank>http://www.clean-fuels.net/</A>> <BR><BR><BR>________________________________<BR><BR>From: Sue Dayton [<A href="mailto:sdayton@swcp.com" target=_blank>mailto:sdayton@swcp.com</A>]<BR>Sent: Wednesday, March 24, 2010 9:29 AM<BR>To: 'Matthew C. Mireles'; 'Gressitt,Stevan'; pharmwaste@lists.dep.state.fl.us; rxnews@listserve.com<BR>Cc: linkfilion@communityofcompetence.com; easmith@communityofcompetence.com<BR>Subject: RE: [Pharmwaste] FW: Google Alert - unused medicine disposal<BR><BR><BR><BR>I just went to a flea market in SC outside of Columbia. SAME deal. There was at least 3 troughs (2’ x 10 ‘) holding mountains, piled on top of each other, of various over-the-counter meds. I was flabbergasted! <BR><BR><BR><BR>Where are they getting these? <BR><BR><BR><BR>Sue Dayton<BR><BR>Blue Ridge Environmental Defense League<BR><BR>North Carolina Healthy Communities Program<BR><BR>PO BOX 44<BR><BR>Saxapahaw, NC 27340<BR><BR>(336) 525-2003<BR><BR>sdayton@swcp.com<BR><BR><BR><BR><BR><BR><BR><BR>Our lives begin to end the day we become silent about things that matter. - Martin Luther King Jr.<BR><BR><BR><BR><BR><BR><BR><BR>________________________________<BR><BR>From: pharmwaste-bounces@lists.dep.state.fl.us [<A href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">mailto:pharmwaste-bounces@lists.dep.state.fl.us</A>] On Behalf Of Matthew C. Mireles<BR>Sent: Monday, March 22, 2010 2:30 PM<BR>To: Gressitt,Stevan; pharmwaste@lists.dep.state.fl.us; rxnews@listserve.com<BR>Cc: linkfilion@communityofcompetence.com; easmith@communityofcompetence.com<BR>Subject: Re: [Pharmwaste] FW: Google Alert - unused medicine disposal<BR><BR><BR><BR>We have been receiving very interesting stories about unused and expired medicines through our new patient safety reporting system called Share Our Stories (S.O.S.). One in particular deals with unused and expired meds (UEMs) showing up at a weekend flea market... <BR><BR><BR><BR>S.O.S. is an anonymous system for patients and families to report medical adverse experiences as well as give us good suggestions about patient safety and healthcare outcomes. However, most of the reports that we have received involved adverse medication events (drug interactions) or side effects that presumably caused the patient to discontinue the meds (non-adherence) and stockpile them at home or work.<BR><BR><BR><BR><BR><BR>Excerpt from original story:<BR><BR><BR><BR>I recently went to a local flea market and found many vendors selling medicine. They ranged from tylenol, pepcid, zyrtec, prevacid, to robitussin. Some of the medication, in fact most of it was expired. Some of the med boxes had certain parts of the box torn off. Some of the boxes had a statement that " The makers of Pepcid Complete od not manufacture store brands." I would like to know what the quote means and would also like to know what pottential risks there are to taking expired meds. I am a senior nursing major and medicine is a big part of what<BR><BR>I recently went to a local flea market and found many vendors selling medicine. They ranged from tylenol, pepcid, zyrtec, prevacid, to robitussin. Some of the medication, in fact most of it was expired. Some of the med boxes had certain parts of the box torn off. Some of the boxes had a statement that " The makers of Pepcid Complete od not manufacture store brands." I would like to know what the quote means and would also like to know what pottential risks there are to taking expired meds. I am a senior nursing major and medicine is a big part of what I do. This recent discovery troubles me. Please help. Thank you for your time.<BR><BR><BR><BR><BR><BR><BR><BR><BR><BR><BR><BR>Matthew C. Mireles, PhD, MPH<BR><BR>Community Medical Foundation for Patient Safety<BR><BR><BR><BR><BR><BR><BR><BR><BR><BR><BR><BR><BR> -----Original Message-----<BR> From: "Gressitt, Stevan"<BR> Sent: Mar 21, 2010 6:26 PM<BR> To: pharmwaste@lists.dep.state.fl.us, rxnews@listserve.com<BR> Subject: [Pharmwaste] FW: Google Alert - unused medicine disposal<BR> <BR> <BR> <BR><BR> I would be interested if anyone runs into any other examples of this.<BR><BR> <BR><BR> Stevan Gressitt, M.D., Medical Director<BR><BR> Office of Adult Mental Health Services<BR><BR> Department of Health and Human Services<BR><BR> Marquardt Building, 2nd Floor<BR><BR> 11 State House Station<BR><BR> 32 Blossom Lane<BR><BR> Augusta, ME 04333-0011<BR><BR> Ph: (207)287-4273<BR><BR> Fax: (207)287-1022<BR><BR> Cell Phone: (207) 441-0291<BR><BR> E-Mail : stevan.gressitt@maine.gov<BR><BR> <A href="http://www.maine.gov/dhhs/mh/">http://www.maine.gov/dhhs/mh/</A><BR><BR> <BR><BR> Confidentiality Notice: This e-mail message, including any attachments, is for the sole use of the intended recipient(s). It may contain confidential and privileged information. Any unauthorized review, copy, use, disclosure, or distribution is prohibited. If you are not the intended recipient, please note that any dissemination, distribution or copying of this is strictly prohibited. Please contact me by reply e-mail or telephone and destroy all copies of this message.<BR><BR> The Department of Health and Human Services (DHHS) does not discriminate on the basis of disability, race, color, creed, gender, sexual orientation, age, or national origin, in admission to, access to, or operations of its programs, services, or activities, or its hiring or employment practices. This notice is provided as required by Title II of the Americans with Disabilities Act of 1990 and in accordance with the Civil Rights Act of 1964 as amended, Section 504 of the Rehabilitation Act of 1973, as amended, the Age Discrimination Act of 1975, Title IX of the Education Amendments of 1972 and the Maine Human Rights Act and Executive Order Regarding State of Maine Contracts for Services. Questions, concerns, complaints or requests for additional information regarding the ADA may be forwarded to DHHS’ ADA Compliance/EEO Coordinators, 11 SHS-221 State Street, Augusta, Maine 04333, 207-287-4289 (V), 207-287-3488 (V), 1-800-606-0215 (TTY). <BR><BR> <BR><BR> REDBRIDGE: Warning over bogus medicine collections <<A href="http://www.google.com/url?sa=X&q=http://www.guardian-series.co.uk/news/5074038.REDBRIDGE__Warning_over_bogus_medicine_collections/&ct=ga&cad=7:1:0&cd=g0eIVl7uMXE&usg=AFQjCNFaI0W-njiVy2MmpHXVITwQa-T3Zg">http://www.google.com/url?sa=X&q=http://www.guardian-series.co.uk/news/5074038.REDBRIDGE__Warning_over_bogus_medicine_collections/&ct=ga&cad=7:1:0&cd=g0eIVl7uMXE&usg=AFQjCNFaI0W-njiVy2MmpHXVITwQa-T3Zg</A>><BR> Guardian Series<BR> People with any concerns or questions on the scam or on the disposal of medicines should speak to their GP or local pharmacist. ...<BR><BR> <BR> See all stories on this topic <<A href="http://news.google.com/news/story?ncl=http://www.guardian-series.co.uk/news/5074038.REDBRIDGE__Warning_over_bogus_medicine_collections/&hl=en">http://news.google.com/news/story?ncl=http://www.guardian-series.co.uk/news/5074038.REDBRIDGE__Warning_over_bogus_medicine_collections/&hl=en</A>> <BR><BR> <BR><BR> <BR> <BR> <BR> --<BR> <BR> Stevan Gressitt, M.D., Medical Director<BR> Office of Adult Mental Health Services<BR> Department of Health and Human Services<BR> Marquardt Building, 2nd Floor<BR> 11 State House Station<BR> Augusta, ME 04333-0011<BR> Ph: (207)287-4273<BR> Fax: (207)287-1022<BR> Cell Phone: (207) 441-0291<BR> E-Mail : stevan.gressitt@maine.gov</SPAN><o:p></o:p></P></DIV></ZZZbody></ZZZhtml></BLOCKQUOTE></ZZZ![endif]--></ZZZ!--[if></ZZZ![endif]--></ZZZ!--[if></ZZZ![endif]--></ZZZ!--[if></ZZZmeta></ZZZmeta></BODY>