<div><b style><u><span style="font-size:20.0pt;line-height:115%;color:black">Try page 1 of attached<br></span></u></b></div><div><b style><u><span style="font-size:20.0pt;line-height:115%;color:black"><br></span></u></b></div>
<div><b style><u><span style="font-size:20.0pt;line-height:115%;color:black"><br></span></u></b></div><div><b style><u><span style="font-size:20.0pt;line-height:115%;color:black">Rationale
for a Concerted Focus on Unused Pharmaceuticals</span></u></b></div>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><b style><span style="font-size:9.0pt;line-height:115%;color:black">Ilene S.
Ruhoy, MD</span></b></p>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><span style="font-size:9.0pt;line-height:115%;color:black">Doctoral Candidate</span></p>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><span style="font-size:9.0pt;line-height:115%;color:black">University of Nevada, Las Vegas</span></p>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><span style="font-size:9.0pt;line-height:115%;color:black">Department of Environmental Studies</span></p>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><b style><span style="font-size:9.0pt;line-height:115%;color:black">Stevan
Gressitt, MD</span></b></p>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><span style="font-size:9.0pt;line-height:115%;color:black">Maine Benzodiazepine Study Group, The Drug
Disposal Group, </span></p>
<p class="MsoNormal" align="center" style="text-align:center;text-autospace:none"><span style="font-size:9.0pt;line-height:115%;color:black">Medical Director, Northeast Occupational
Exchange,</span></p>
<p align="center" style="text-align:center"><span style="font-size:9.0pt;color:black">Corresponding Author: 314 Clark Road, Unity, Maine, 04988
207-441-0291 <a href="mailto:gressitt@uninets.net">gressitt@uninets.net</a> </span></p>
<p align="center" style="text-align:center"><b><span style="font-size:9.0pt;font-family:"Batang","serif";color:maroon">2<sup>nd </sup>INTERNATIONAL SYMPOSIUM ON </span></b><b><span lang="EN-GB" style="font-size:9.0pt;font-family:"Batang","serif";color:maroon">ENVIRONMENT</span></b></p>
<p class="MsoNormal" align="center" style="text-align:center;line-height:normal"><b><span lang="EN-GB" style="font-size:9.0pt;font-family:"Batang","serif";color:maroon">August 2-3,
2007, Athens, Greece</span></b></p>
<p class="MsoNormal" style="text-autospace:none"><b style><span style="color:black">Abstract:</span></b></p>
<p class="MsoNormal" style="text-align:justify;text-indent:.5in;text-autospace:none"><span style> </span><span style="font-size:9.0pt;line-height:115%;color:black">Unused and unwanted
consumer pharmaceuticals have a negative impact on public health. The lack of
effective and efficient methods of drug disposal has resulted in unwelcome
social, cultural, ecological, and global effects. </span></p>
<p class="MsoNormal" style="text-align:justify;text-indent:.5in;text-autospace:none"><span style="font-size:9.0pt;line-height:115%;color:black">Among the many issues pertinent to unused consumer medication, we
have comprehensively explored and addressed six specific and significant
problems;</span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt;color:black"><span style>1)<span style="font:7.0pt "Times New Roman"">
</span></span></span><b style><span style="font-size:9.0pt;color:black">Childhood Poisoning</span></b><span style="font-size:9.0pt;color:black">: Unintentional pharmaceutical poisonings
of children, resulting in unnecessary morbidity and mortality.</span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt;color:black"><span style>2)<span style="font:7.0pt "Times New Roman"">
</span></span></span><b style><span style="font-size:9.0pt;color:black">"Pharming"</span></b><span style="font-size:9.0pt;color:black">: Theft and social use, misuse, and abuse
of pharmaceuticals by teenagers, adults, and older adults. </span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt;color:black"><span style>3)<span style="font:7.0pt "Times New Roman"">
</span></span></span><b style><span style="font-size:9.0pt;color:black">Excessive Accumulation and Polypharmacy</span></b><span style="font-size:9.0pt;color:black">: Polypharmacy, non-compliance and/or poor
adherence to medication regimens, and medication errors contributes to
accumulation and poor patient outcome. </span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt;color:black"><span style>4)<span style="font:7.0pt "Times New Roman"">
</span></span></span><b style><span style="font-size:9.0pt;color:black">Unintended Environmental Exposure</span></b><span style="font-size:9.0pt;color:black">: Potential deleterious effects on wildlife
and humans due to drug deposition in surface and ground waters as a result of
both disposal and excretion pathways. </span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt;color:black"><span style>5)<span style="font:7.0pt "Times New Roman"">
</span></span></span><b style><span style="font-size:9.0pt;color:black">Inappropriate Humanitarian Drug Donations</span></b><span style="font-size:9.0pt;color:black">: Under-regulated and poorly controlled
methods of international donations to countries in need, resulting in massive
amounts of “gifts” of unused and expired pharmaceuticals. Expired and unwanted
drugs ultimately become accumulated waste, some of which may be hazardous, due
in part to the lack of an environmentally sound disposal or destruction method.
</span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt"><span style>6)<span style="font:7.0pt "Times New Roman"">
</span></span></span><b style><span style="font-size:9.0pt;color:black">Pharmacoeconomics</span></b><span style="font-size:9.0pt;color:black">: Unused medications contribute to wasted
health care dollars. The purchase costs of drugs to the consumer, the insurance
carrier, and the taxpayer have continued to increase in the past decade. </span></p>
<p class="MsoNormal" style="margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:83.5pt;margin-bottom:.0001pt;text-align:justify;line-height:normal;text-autospace:none"><span style="font-size:9.0pt"> </span></p>
<p class="MsoNormal" style="margin-left:.5in;text-indent:.5in"><span style="font-size:9.0pt;line-height:115%">These issues define the problem of
proper disposal of unused pharmaceuticals and beg for acceptable solutions to
protect human and environmental health.</span></p><br><br><div class="gmail_quote">On Fri, Mar 9, 2012 at 2:46 PM, Joel Kreisberg <span dir="ltr"><<a href="mailto:drkreisberg@teleosis.org">drkreisberg@teleosis.org</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><div dir="ltr">I hope this helps.<br><br>Joel<br><br><br><div class="gmail_quote">On Fri, Mar 9, 2012 at 6:53 AM, Tenace, Laurie <span dir="ltr"><<a href="mailto:Laurie.Tenace@dep.state.fl.us" target="_blank">Laurie.Tenace@dep.state.fl.us</a>></span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div>
<div>
<div>
<div><div><p class="MsoNormal"><span style="font-family:"Times New Roman","serif";color:#1f497d">Please note the sender was Deb Hoffman, not me.</span></p><p class="MsoNormal"><span style="font-family:"Times New Roman","serif";color:#1f497d">Laurie</span></p>
<p class="MsoNormal"><span style="font-family:"Times New Roman","serif";color:#1f497d"> </span></p>
<div><br><br></div>
<div style="FONT-FAMILY:Courier New;FONT-SIZE:9pt"><i><font face="Arial">Please take a few minutes to share your comments on the service you received from the department by clicking on this link. <a href="http://survey.dep.state.fl.us/?refemail=Laurie.Tenace@dep.state.fl.us" target="_blank">DEP Customer Survey</a>.</font></i></div>
<div style="FONT-FAMILY:Courier New;FONT-SIZE:9pt"><p class="MsoNormal" style="margin-left:.5in"><b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif"">From:</span></b><span style="font-size:10.0pt;font-family:"Tahoma","sans-serif""> Hoffman, Deb [mailto:<a href="mailto:deb.hoffman@epa.state.oh.us" target="_blank">deb.hoffman@epa.state.oh.us</a>] <br>
<b>Sent:</b> Friday, March 09, 2012 8:22 AM<br><b>To:</b> <a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a><br><b>Subject:</b> seeking info</span></p>
</div></div><p class="MsoNormal" style="margin-left:.5in"> </p><p class="MsoNormal" style="margin-left:.5in">Greetings,</p><p class="MsoNormal" style="margin-left:.5in"> </p><p class="MsoNormal" style="margin-left:.5in">
I’m trying to find a single document or two that briefly cover the reasons for pharmaceutical collections. In other words, while we all are regularly bombarded with articles on pharmaceuticals in our waterways and we all know the drug diversion groups want to get them out of medicine cabinets; I’m having trouble finding one good document to explain what these dangers are, with statistics and/or facts.</p>
<p class="MsoNormal" style="margin-left:.5in"> </p><p class="MsoNormal" style="margin-right:0in;margin-bottom:12.0pt;margin-left:.5in">I’m specifically looking for something short – maybe 2 pages maximum. </p>
<p class="MsoNormal" style="margin-left:.5in">Any good ideas?</p><p class="MsoNormal" style="margin-left:.5in"> </p><p class="MsoNormal" style="margin-left:.5in">Thanks,<br>Deb</p>
<p class="MsoNormal" style="margin-left:.5in"> </p><p class="MsoNormal" style="margin-left:.5in"> </p><p class="MsoNormal" style="margin-left:.5in">Deb Hoffman</p><p class="MsoNormal" style="margin-left:.5in">
Environmental Specialist</p><p class="MsoNormal" style="margin-left:.5in">Division of Materials and Waste Management</p><p class="MsoNormal" style="margin-left:.5in">Ohio EPA</p><p class="MsoNormal" style="margin-left:.5in">
<a href="tel:614.728.5353" value="+16147285353" target="_blank">614.728.5353</a></p><p class="MsoNormal" style="margin-left:.5in"> </p></div></div></div></div><br>---<br>
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<br></blockquote></div><span class="HOEnZb"><font color="#888888"><br><br clear="all"><br>-- <br><div dir="ltr"><span style="font-family:garamond,serif">Dr. Joel Kreisberg, DC, MA, CCH</span><br style="font-family:times new roman,serif">
<span style="font-family:garamond,serif"><a href="http://www.joelkreisberg.com" target="_blank">www.joelkreisberg.com</a><br style="font-family:garamond,serif">
</span><font style="font-family:garamond,serif" size="2"><a href="http://www.drkreisberg.org" target="_blank">www.drkreisberg.org</a></font><br><span style="font-family:garamond,serif"><a href="http://www.teleosis.org/" target="_blank">www.teleosis.org</a></span><br style="font-family:garamond,serif">
<span style="font-family:garamond,serif"><a href="mailto:drkreisberg@teleosis.org" target="_blank">drkreisberg@teleosis.org</a></span><br><span style="font-family:garamond,serif"><a href="tel:510-558-7285%20Ext%20102" value="+15105587285" target="_blank">510-558-7285 Ext 102</a></span><br>
</div><br>
</font></span></div>
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<br></blockquote></div><br><br clear="all"><br>-- <br>Stevan Gressitt, M.D.<br>Faculty Associate, University of Maine Center on Aging<br>Academic Member, Athens Institute for Education and Research<br>Athens, Greece<br>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>314 Clark Road<br>Unity, Maine, 04988<br>
<a href="mailto:gressitt@gmail.com" target="_blank">gressitt@gmail.com</a> <br>Cell: 207-441-0291<br><a href="http://www.benzos.une.edu" target="_blank">www.benzos.une.edu</a><br><a href="http://www.safemeddisposal.com" target="_blank">www.safemeddisposal.com</a><br>