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<DIV><A
href="http://www.chron.com/disp/story.mpl/metropolitan/7416082.html">http://www.chron.com/disp/story.mpl/metropolitan/7416082.html</A></DIV>
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<DIV style="FONT: 10pt arial">----- Original Message ----- </DIV>
<DIV
style="FONT: 10pt arial; BACKGROUND: #e4e4e4; font-color: black"><B>From:</B>
<A title=mirelesmc@earthlink.net href="mailto:mirelesmc@earthlink.net">Matthew
C. Mireles</A> </DIV>
<DIV style="FONT: 10pt arial"><B>To:</B> <A
title=Buxbaum.Diane@epamail.epa.gov
href="mailto:Buxbaum.Diane@epamail.epa.gov">Buxbaum.Diane@epamail.epa.gov</A>
; <A title=easmith@comofcom.com
href="mailto:easmith@comofcom.com">easmith@comofcom.com</A> </DIV>
<DIV style="FONT: 10pt arial"><B>Cc:</B> <A
title=pharmwaste-bounces@lists.dep.state.fl.us
href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</A>
; <A title=gressitt@gmail.com href="mailto:gressitt@gmail.com">'Stevan
Gressitt'</A> ; <A title=easmith@comofcom.com
href="mailto:easmith@comofcom.com">Elizabeth A. Smith PhD</A> ; <A
title=pharmwaste@lists.dep.state.fl.us
href="mailto:pharmwaste@lists.dep.state.fl.us">pharmwaste</A> ; <A
title=GILLIAM@adeq.state.ar.us
href="mailto:GILLIAM@adeq.state.ar.us">Gilliam,Allen</A> </DIV>
<DIV style="FONT: 10pt arial"><B>Sent:</B> Monday, February 14, 2011 11:04
AM</DIV>
<DIV style="FONT: 10pt arial"><B>Subject:</B> RE: [Pharmwaste] Well it was
bound to occur somewhere...</DIV>
<DIV><BR></DIV>
<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>
<P> </P>
<P>Matthew Mireles</P>
<P> </P>
<P> </P>
<P><BR> </P>
<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>
<HR noShade>
<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
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