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<P>Thanks so much for this suggestion. I'll try to track down this book by Ehrenfeld. We are a nonprofit medical research group based in Houston. Many of us are researchers who study high-hazard industries, including health care. We most interested in the man-made systems that are designed, developed and operated to the limits of human performance and safety. Some are characterized by low probability-high consequence events, such as a catastrophic failure. Most are highly reliable and beat the odds of a disaster that affect people and environment. I'm an epidemiologist and very interested in emerging diseases and outbreaks directly or indirectly related to safety risks and dangers of these systems. Their failures are often categorized as technological disasters. Our questions are how do certain organization learn about these risks and dangers and why some can operate reliably and safey and others can't.<BR><BR>Recently in the news, an alarming statistic was announced "Americans consumer 70% of the world's opiates and pain killers". If you know of the reference to this statistic, please let us know.</P>
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<P>Matthew Mireles</P>
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<BLOCKQUOTE style="BORDER-LEFT: #0000ff 2px solid; PADDING-LEFT: 5px; MARGIN-LEFT: 0px">-----Original Message----- <BR>From: Buxbaum.Diane@epamail.epa.gov <BR>Sent: Feb 1, 2011 9:57 AM <BR>To: "Matthew C. Mireles" <MIRELESMC@EARTHLINK.NET><BR>Cc: "Elizabeth A. Smith PhD" <EASMITH@COMOFCOM.COM>, "Gilliam,Allen" <GILLIAM@ADEQ.STATE.AR.US>, 'Stevan Gressitt' <GRESSITT@GMAIL.COM>, pharmwaste <PHARMWASTE@LISTS.DEP.STATE.FL.US>, pharmwaste-bounces@lists.dep.state.fl.us <BR>Subject: RE: [Pharmwaste] Well it was bound to occur somewhere... <BR><BR><FONT size=2 face=sans-serif>One can go back further. The former editor of the magazine, Conservation Biology and professor at Rutgers, David Ehrenfeld in 1978 wrote an excellent book, <I><U>The Arrogance of Humanism. </U></I>It tell the story very early on about the potential for unexpected outcomes of human technological advances. I think the concept of "First Do No Harm" and the Precautionary Principles are really valuable foundations upon which to make decisions. We are a mature species, I believe, but maybe not. </FONT><BR><BR><FONT size=2 face=sans-serif>Diane D. Buxbaum, MPH</FONT> <BR><FONT size=2 face=sans-serif>Environmental Scientist</FONT> <BR><FONT size=2 face=sans-serif>U.S.Environmental Protection Agency, Region 2</FONT> <BR><FONT size=2 face=sans-serif>Division of Enforcement and Compliance Assistance</FONT> <BR><FONT size=2 face=sans-serif>290 Broadway</FONT> <BR><FONT size=2 face=sans-serif> New York, NY 10007</FONT> <BR><FONT size=2 face=sans-serif>Ph. 212-637-3919</FONT> <BR><FONT size=2 face=sans-serif>Fx 212-637-4086</FONT> <BR><FONT size=2 face=sans-serif>buxbaum.diane@epa.gov</FONT> <BR><BR><BR><BR><BR><BR><FONT color=#5f5f5f size=1 face=sans-serif>From: </FONT><FONT size=1 face=sans-serif>"Matthew C. Mireles" <mirelesmc@earthlink.net></FONT> <BR><FONT color=#5f5f5f size=1 face=sans-serif>To: </FONT><FONT size=1 face=sans-serif>"Gilliam,Allen" <GILLIAM@adeq.state.ar.us>, 'Stevan Gressitt' <gressitt@gmail.com>, pharmwaste <pharmwaste@lists.dep.state.fl.us></FONT> <BR><FONT color=#5f5f5f size=1 face=sans-serif>Cc: </FONT><FONT size=1 face=sans-serif>"Elizabeth A. Smith PhD" <easmith@comofcom.com></FONT> <BR><FONT color=#5f5f5f size=1 face=sans-serif>Date: </FONT><FONT size=1 face=sans-serif>01/28/2011 10:30 AM</FONT> <BR><FONT color=#5f5f5f size=1 face=sans-serif>Subject: </FONT><FONT size=1 face=sans-serif>RE: [Pharmwaste] Well it was bound to occur somewhere...</FONT> <BR><FONT color=#5f5f5f size=1 face=sans-serif>Sent by: </FONT><FONT size=1 face=sans-serif>pharmwaste-bounces@lists.dep.state.fl.us</FONT> <BR>
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<BR><BR><BR><FONT size=2 face=Arial>In most human endeavors, one solution may create other problems or unpredicted, unintended consequences. A good read is Tenner's "When Technology Bites Back" (Princeton Press). Weren't we supposed to be a paperless society about 15 years ago with electronic mail and communication?</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><FONT size=2 face=Arial>New stories like that coming from Jakarta will only demonstrate that some individuals and organizations look for any opportunities to satisfy their greed and corruption. Not too long ago, the president of a well-known commerical reverse distributor was arrested for stealing controlled substances for personal use.</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><FONT size=2 face=Arial>Drug take-back and return programs are still a nascent initiative across the nation. There are still inadequate data to support evidence that these programs are even effective or "successful". What would be the best measurements or indicators? Recently, we have been encouraged by more groups collecting usable data from drug collection. Some day, it may be possible by comparing and analysis good data to truly appreciate and understand the magnitude of this problem that has a significant impact on public health, patient safety, healthcare cost, environment, legal system and society (you can add to this list...). at the same, there should be some level of oversight and monitoring. Who should be tasked with this? Who would have the authority to do so?</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><FONT size=2 face=Arial>Moreover, it is very important to know who is involved in any drug collection in the US, probably around the world too. In 2008 we started an annual survey and publish the National Directory of Drug Take-Back and Disposal Programs. today, we have an official roster of more than 420 such programs with more interest from our international community to be included in this Directory. some have already expressed concerns about our survey and the info we compile; some have refused to be participate in the survey. Please know that we collect survey data only for research purposes to compare programs and to observe trends. For example, of all the drug take-back programs and events, about 80% came into operations in 2009. There is still no consensus on how define or categorize unused and expired meds. about 50% of the programs directly involve law enforcement. Very few programs participate in data collection with the National Registry.</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><FONT size=2 face=Arial>With funding we want to put the info into public domain for other researchers and policy makers. For now, an updated roster of programs will be available on websites soon after all the surveys are compiled sometime later this spring. The roster is often requested by federal agencies and others for review, but we are not compelled to report or even share our data.</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><FONT size=2 face=Arial>If you have good ideas and suggestions, let us know.</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><FONT size=2 face=Arial>Matthew Mireles<BR></FONT>
<P><FONT size=2 face=Arial>-----Original Message----- <BR>From: "Gilliam, Allen" <BR>Sent: Jan 28, 2011 8:42 AM <BR>To: 'Stevan Gressitt' , pharmwaste <BR>Subject: RE: [Pharmwaste] Well it was bound to occur somewhere... <BR><BR></FONT><BR><FONT color=#004080 size=2 face=Calibri>Just now seeing the tip of the iceberg….</FONT> <BR><FONT color=#004080 size=2 face=Calibri> </FONT> <BR><FONT size=2 face=Tahoma><B>From:</B> pharmwaste-bounces@lists.dep.state.fl.us [</FONT><A href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target=_blank><FONT size=2 face=Tahoma>mailto:pharmwaste-bounces@lists.dep.state.fl.us</FONT></A><FONT size=2 face=Tahoma>] <B>On Behalf Of </B>Stevan Gressitt<B><BR>Sent:</B> Thursday, January 27, 2011 9:24 PM<B><BR>To:</B> pharmwaste<B><BR>Subject:</B> [Pharmwaste] Well it was bound to occur somewhere...</FONT> <BR><FONT size=2 face=Arial> </FONT> <BR><A href="http://www.thejakartaglobe.com/news/depok-police-search-for-leader-of-expired-drug-reselling-ring/419491" target=_blank><FONT color=blue size=2 face=Arial><U>http://www.thejakartaglobe.com/news/depok-police-search-for-leader-of-expired-drug-reselling-ring/419491</U></FONT></A> <BR><FONT size=2 face=Arial> </FONT> <BR><BR><FONT size=2 face=Arial>Stevan Gressitt, M.D.<BR>Faculty Associate, University of Maine Center on Aging<BR>Academic Member, Athens Institute for Education and Research</FONT> <BR><FONT size=2 face=Arial>Athens, Greece</FONT> <BR><FONT size=2 face=Arial>Founding Director, International Institute for Pharmaceutical 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</FONT><FONT color=blue size=2 face=Arial><U><BR></U></FONT><A href="mailto:gressitt@gmail.com" target=_blank><FONT color=blue size=2 face=Arial><U>gressitt@gmail.com</U></FONT></A><FONT size=2 face=Arial> <BR>Cell: 207-441-0291 </FONT><BR><A href="http://www.benzos.une.edu/" target=_blank><FONT color=blue size=2 face=Arial><U>www.benzos.une.edu</U></FONT></A><FONT size=2 face=Arial> </FONT><BR><A href="http://www.safemeddisposal.com/" target=_blank><FONT color=blue size=2 face=Arial><U>www.safemeddisposal.com</U></FONT></A><FONT size=2 face=Arial> </FONT><BR><FONT size=2 face=Arial> </FONT><TT><FONT size=2>---<BR>Note: As a courtesy to other listserv subscribers, please post messages to the listserv in plain text format to avoid the garbling of messages received by digest recipients.<BR>---<BR>TO SUBSCRIBE, go to: </FONT></TT><A href="http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste" target=_blank><TT><FONT size=2>http://lists.dep.state.fl.us/cgi-bin/mailman/listinfo/pharmwaste</FONT></TT></A><TT><FONT size=2> <BR>TO UNSUBSCRIBE, DO NOT REPLY TO THE LISTSERV. Please send an e-mail to pharmwaste-unsubscribe@lists.dep.state.fl.us -- the subject line and body of the e-mail should be blank.<BR>If you believe you may be subscribed with a different email address, please visit the subscriber listing at </FONT></TT><A href="http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste" target=_blank><TT><FONT size=2>http://lists.dep.state.fl.us/cgi-bin/mailman/roster/pharmwaste</FONT></TT></A><TT><FONT size=2> <BR>FOR PROBLEMS: Contact List Administrator Laurie.Tenace@dep.state.fl.us <BR>SEND MAIL to the list server at: pharmwaste@lists.dep.state.fl.us<BR></FONT></TT><BR></P></BLOCKQUOTE></BODY>