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<p style="TEXT-ALIGN: center; MARGIN: 0in 0in 0pt" class="MsoNormal" align="center"><b><font size="3"><font face="Cambria">International Association of Drug Waste Prevention, Disposal, and Medicine Safety Organizations </font></font></b></p>
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<p style="TEXT-ALIGN: center; MARGIN: 0in 0in 0pt" class="MsoNormal" align="center"><font size="3"><font face="Cambria">The charter meeting of an <b>International Association of Drug Waste Prevention, Disposal, and Medicine Safety Organizations </b></font></font></p>
<p style="TEXT-ALIGN: center; MARGIN: 0in 0in 0pt" class="MsoNormal" align="center"><font size="3"><font face="Cambria">is proposed for Sunday October 10, 2010, 5:30 PM EST during the 2010 International Symposium on Safe Medicine in Portland, Maine. </font></font></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">The safe disposal of unused and unwanted medication has become a significant issue at this time. Prescription medications have quickly become the drug of choice for abuse in this and many other countries around the world.<span> </span>They remain available in nearly every household, and there remains a widespread myth that prescription medications are safe to consume for recreational purposes.<span> </span>The environmental impact is just starting to become known, as researchers study the trace amounts in drinking water from sewage and landfill runoff.<span> </span></font></font></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">There are many diverse parties involved in the efforts to collect and dispose of these unwanted medications legally and safely.<span> </span>These include, in the United States, the Drug Enforcement Administration (DEA,) Food and Drug Administration (FDA,) Environmental Protection Agency (EPA,) wastewater treatment plants, landfill managers, pharmaceutical manufacturers, and a wide variety of health care professionals.<span> </span>Currently, these groups are not working together in a systematic or organized fashion and are working under conflicting mandates.<span> </span></font></font></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">A group is forming with the intent of bringing all parties together in order to find solutions.<span> </span>A few concerned medical professionals, academics, law enforcement, and citizens created a project in the State of Maine to collect unwanted medications from its elderly residents.<span> </span>The initial project was funded by the EPA, and subsequently by the State of Maine. <span> </span>Given the widespread benefits of such a program it has been expanded such that all citizens in Maine can now participate. It is from this group that interest in forming an inclusive association evolved.</font></font></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">It has been known for some time that there have been many small take-back programs operating throughout the country with little guidance or oversight by appropriate authorities.<span> </span>Without involvement by law and or drug enforcement (e.g., DEA), many programs were inadvertently operating without legal sanction.<span> </span>Currently, it is difficult to gain approval for take-back programs due to a wide variety of state laws and regulations that each program has to abide by within their jurisdictions.<span> </span>Federal law is explicit and relatively restrictive on what a take-back program can do.<span> </span>Efforts are needed to coordinate the efforts by the multiple parties involved in order to achieve a prompt and effective response to this growing problem.<span> </span></font></font></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">Other countries throughout the world have become concerned about the environmental and abuse problems as well.<span> </span>There are likely lessons to be learned from those countries that have addressed this issue, and new possibilities for addressing the prescription drug abuse epidemic world wide.</font></font></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">Thus, the formation of an international organization that brings together the knowledge, skills, authority and expertise of the diverse population of interested parties is being proposed.<span> </span>The primary function of the organization will be to gather best practice information, assist in policy and rule-making on worldwide, national and local levels in order to facilitate the collection and safe destruction of unused and unwanted medications, and disseminate its findings to those who can make a difference .<span> </span>Most importantly, such an association will work to bring all the parties together and working constructively and collaboratively towards solving the problem of unused medications in our environment and society.<span> </span>Such an association will also assist with the prevention of the waste in the first place through improving adherence and best prescribing practices.</font></font></p>
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<p style="TEXT-ALIGN: justify; MARGIN: 0in 0in 0pt" class="MsoNormal"><font size="3"><font face="Cambria">Towards the end of last year’s International Symposium on Pharmaceuticals in the Home and Environment (now called the International Symposium on Safe Medicine) a number of people began drafting a statement addressing drug disposal. There was inadequate time to work through editing and reaching consensus. That draft document is attached below in an effort to give all attendees adequate advance information. Please review this statement prior to the conference as it will be referred to in our on-site discussions. </font></font></p>
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<p style="TEXT-ALIGN: justify; MARGIN: 0in 0in 0pt" class="MsoNormal"><b><span style="FONT-SIZE: 15pt">THE MAINE DECLARATION</span></b><span style="FONT-SIZE: 15pt"> as proposed on October 20, 2009 at the International Symposium on Pharmaceuticals in the Home and Environment in the City of Northport, Maine is as follows:</span><span style="FONT-FAMILY: 'Times New Roman', 'serif'"></span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">To encourage a decrease in the amount of drugs wasted and a reduction in the costs of dispensing and related healthcare costs, adverse drug events, inappropriate international drug donations, and the disposal of unused prescription drugs, and in support of the Athens Declaration of August 3<sup>rd</sup>, 2007, we, a diverse group of stakeholders, support the following five measures:</span><span style="FONT-FAMILY: 'Times New Roman', 'serif'; FONT-SIZE: 11pt"></span></p>
<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">1. Limited first-time prescriptions on selected drugs based on returns data as initiated by the State of Maine.</span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">2. Opposition to financial penalties for consumers on these initial prescriptions.</span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">3. Involvement of third party payers in the drug waste reduction process.</span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">4. Evaluation of all aspects of refill systems used by mail-order pharmacies to reduce waste.</span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">5. Participation of manufacturers, distributors, prescribers, hospitals, clinics, and pharmacies to assist with foremost improving adherence and concordance and improving patient outcomes and the reduction of <span style="COLOR: #00000a">medication</span> waste.</span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="COLOR: #00000a; FONT-SIZE: 11pt">We call upon governments, NGO's, private insurers, and citizens to improve and refine dispensing policies and procedures to reduce medication waste.</span><span style="FONT-SIZE: 11pt"> </span><span style="FONT-FAMILY: 'Times New Roman', 'serif'; FONT-SIZE: 11pt"></span></p>
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<p style="MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="FONT-SIZE: 11pt">We call upon patients to recognize the need f<span style="COLOR: #00000a">o</span>r medicine to be taken as intended if it is to be effective.</span><span style="FONT-FAMILY: 'Times New Roman', 'serif'; FONT-SIZE: 11pt"></span></p>
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<p style="LINE-HEIGHT: 150%; MARGIN: 0in 0in 0pt" class="MsoNormal"><span style="LINE-HEIGHT: 150%; FONT-SIZE: 11pt">We call upon others to endorse these principles with us for the betterment of the health of the environment and citizens in the United States and internationally.</span></p>
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<p style="LINE-HEIGHT: 150%; MARGIN: 0in 0in 0pt" class="MsoNormal"><b><font face="Cambria"><font size="3">Questions regarding this particular session can be sent to the conference organizers or to: </font></font></b></p>
<p><font size="3"><font face="Times New Roman"><span style="COLOR: black">Stevan Gressitt, M.D.<br>Faculty Associate, University of Maine Center on Aging<br>Founding Director, Maine Institute for Medicine Safety<br>University of New England, College of Pharmacy<br>
Department of Pharmaceutical Sciences <br>Associate Professor of Clinical Psychiatry<br>University of New England, College of Osteopathic Medicine<br>716 Stevens Avenue <br>Portland, Maine 04103<br></span><span><u><span style="COLOR: blue"><a href="mailto:gressitt@gmail.com" target="_blank">gressitt@gmail.com</a></span></u></span></font></font><font size="3"><font face="Times New Roman"><span style="COLOR: black"> <br>
Cell: 207-441-0291 </span></font></font></p>
<p><font size="3"><font face="Times New Roman"><span><u><span style="COLOR: blue"><a href="http://www.benzos.une.edu/" target="_blank">www.benzos.une.edu</a></span></u></span><span style="COLOR: black"> </span></font></font></p>
<p style="LINE-HEIGHT: 150%; MARGIN: 0in 0in 0pt" class="MsoNormal"><u><span style="LINE-HEIGHT: 150%; FONT-FAMILY: 'Times New Roman', 'serif'; COLOR: blue; FONT-SIZE: 10pt"><a href="http://www.safemeddisposal.com/" target="_blank">www.safemeddisposal.com</a></span></u><span style="LINE-HEIGHT: 150%; FONT-SIZE: 10pt"></span></p>
<br clear="all"><br>-- <br>
<div>Stevan Gressitt, M.D.<br>Faculty Associate, University of Maine Center on Aging<br>Academic Member, Athens Institute for Education and Research</div>
<div>Athens, Greece</div>
<div>Founding Director, Maine Institute for Medicine Safety<br>University of New England, College of Pharmacy<br>Department of Pharmaceutical Sciences <br>Associate Professor of Clinical Psychiatry<br>University of New England, College of Osteopathic Medicine<br>
716 Stevens Avenue <br>Portland, Maine 04103<br><a href="mailto:gressitt@gmail.com" target="_blank">gressitt@gmail.com</a> <br>Cell: 207-441-0291 </div>
<div><a href="http://www.benzos.une.edu/" target="_blank">www.benzos.une.edu</a> </div>
<div><a href="http://www.safemeddisposal.com/" target="_blank">www.safemeddisposal.com/</a><br><br></div><br><br></div><br>