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<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Hi Deb,
<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">The link below has a 2-page fact sheet describing the problem w/statistics. Citations to statistics are in 2<sup>nd</sup> link:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">General:
<a href="http://www.takebackyourmeds.org/pdf-files/what-is-take-back-your-meds-2">
http://www.takebackyourmeds.org/pdf-files/what-is-take-back-your-meds-2</a><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D">Citations:
<a href="http://www.takebackyourmeds.org/pdf-files/citations-what-is-take-back-your-meds">
http://www.takebackyourmeds.org/pdf-files/citations-what-is-take-back-your-meds</a> <o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
<p class="MsoNormal"><b><span style="font-size:10.0pt;font-family:"Arial","sans-serif";color:#1F497D">Cheri Grasso
</span></b><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:7.5pt;font-family:"Arial","sans-serif";color:#1F497D">Pharmaceuticals Project
</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:7.5pt;font-family:"Arial","sans-serif";color:#1F497D">Local Hazardous Waste Management Program in King County</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:7.5pt;font-family:"Arial","sans-serif";color:#1F497D">130 Nickerson Street, Suite 100 | Seattle, WA 98109 | 206-263-3089</span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:7.5pt;font-family:"Arial","sans-serif";color:#1F497D">Local Governments for Health and the Environment
<a href="www.lhwmp.org%20"><span style="color:blue">www.lhwmp.org</span></a> <o:p>
</o:p></span></p>
<p class="MsoNormal"><span style="font-size:7.5pt;font-family:"Arial","sans-serif";color:#1F497D">Protect our Kids, Families, the Environment
<a href="www.takebackyourmeds.org"><span style="color:blue">www.takebackyourmeds.org</span></a></span><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D"><o:p> </o:p></span></p>
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<p class="MsoNormal"><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""> pharmwaste-bounces@lists.dep.state.fl.us [mailto:pharmwaste-bounces@lists.dep.state.fl.us]
<b>On Behalf Of </b>Stevan Gressitt<br>
<b>Sent:</b> Friday, March 09, 2012 12:41 PM<br>
<b>To:</b> Joel Kreisberg<br>
<b>Cc:</b> Tenace, Laurie; deb.hoffman@epa.state.oh.us; pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> Re: [Pharmwaste] FW: seeking info<o:p></o:p></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><b><u><span style="font-size:20.0pt;color:black">Try page 1 of attached</span></u></b><o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
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<p class="MsoNormal"><b><u><span style="font-size:20.0pt;color:black">Rationale for a Concerted Focus on Unused Pharmaceuticals</span></u></b><o:p></o:p></p>
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<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<b><span style="font-size:9.0pt;color:black">Ilene S. Ruhoy, MD</span></b><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<span style="font-size:9.0pt;color:black">Doctoral Candidate</span><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<span style="font-size:9.0pt;color:black">University of Nevada, Las Vegas</span><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<span style="font-size:9.0pt;color:black">Department of Environmental Studies</span><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<b><span style="font-size:9.0pt;color:black">Stevan Gressitt, MD</span></b><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<span style="font-size:9.0pt;color:black">Maine Benzodiazepine Study Group, The Drug Disposal Group,
</span><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center;text-autospace:none">
<span style="font-size:9.0pt;color:black">Medical Director, Northeast Occupational Exchange,</span><o:p></o:p></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><o:p></o:p></p>
<p align="center" style="text-align:center"><b><span style="font-size:9.0pt;font-family:Batang;color:maroon">2<sup>nd
</sup>INTERNATIONAL SYMPOSIUM ON </span></b><b><span lang="EN-GB" style="font-size:9.0pt;font-family:Batang;color:maroon">ENVIRONMENT</span></b><o:p></o:p></p>
<p class="MsoNormal" align="center" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:center">
<b><span lang="EN-GB" style="font-size:9.0pt;font-family:Batang;color:maroon">August</span></b><b><span lang="EN-GB" style="font-size:9.0pt;color:maroon"> </span></b><b><span lang="EN-GB" style="font-size:9.0pt;font-family:Batang;color:maroon">2-3, 2007, Athens,
Greece</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-autospace:none">
<b><span style="color:black">Abstract:</span></b><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:justify;text-indent:.5in;text-autospace:none">
<span style="font-size:9.0pt;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><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;text-align:justify;text-indent:.5in;text-autospace:none">
<span style="font-size:9.0pt;color:black">Among the many issues pertinent to unused consumer medication, we have comprehensively explored and addressed six specific and significant problems;</span><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt;color:black">1)</span><span style="font-size:7.0pt;color:black">
</span><b><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><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt;color:black">2)</span><span style="font-size:7.0pt;color:black">
</span><b><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><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt;color:black">3)</span><span style="font-size:7.0pt;color:black">
</span><b><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><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt;color:black">4)</span><span style="font-size:7.0pt;color:black">
</span><b><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><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt;color:black">5)</span><span style="font-size:7.0pt;color:black">
</span><b><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><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt">6)</span><span style="font-size:7.0pt">
</span><b><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><o:p></o:p></p>
<p class="MsoNormal" style="margin-left:83.5pt;text-align:justify;text-autospace:none">
<span style="font-size:9.0pt"> </span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in;text-indent:.5in">
<span style="font-size:9.0pt">These issues define the problem of proper disposal of unused pharmaceuticals and beg for acceptable solutions to protect human and environmental health.</span><o:p></o:p></p>
<p class="MsoNormal" style="margin-bottom:12.0pt"><o:p> </o:p></p>
<div>
<p class="MsoNormal">On Fri, Mar 9, 2012 at 2:46 PM, Joel Kreisberg <<a href="mailto:drkreisberg@teleosis.org">drkreisberg@teleosis.org</a>> wrote:<o:p></o:p></p>
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<p class="MsoNormal" style="margin-bottom:12.0pt">I hope this helps.<br>
<br>
Joel<br>
<br>
<o:p></o:p></p>
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<p class="MsoNormal">On Fri, Mar 9, 2012 at 6:53 AM, Tenace, Laurie <<a href="mailto:Laurie.Tenace@dep.state.fl.us" target="_blank">Laurie.Tenace@dep.state.fl.us</a>> wrote:<o:p></o:p></p>
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<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="color:#1F497D">Please note the sender was Deb Hoffman, not me.</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="color:#1F497D">Laurie</span><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto"><span style="color:#1F497D"> </span><o:p></o:p></p>
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<p class="MsoNormal" style="margin-bottom:12.0pt"><o:p> </o:p></p>
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<p class="MsoNormal"><i><span style="font-size:9.0pt;font-family:"Arial","sans-serif"">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>.</span></i><span style="font-size:9.0pt;font-family:"Courier New""><o:p></o:p></span></p>
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<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;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><o:p></o:p></p>
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<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Greetings,<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;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.<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;margin-bottom:12.0pt;margin-left:.5in">
I’m specifically looking for something short – maybe 2 pages maximum. <o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Any good ideas?<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Thanks,<br>
Deb<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Deb Hoffman<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Environmental Specialist<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Division of Materials and Waste Management<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
Ohio EPA<o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<a href="tel:614.728.5353" target="_blank">614.728.5353</a><o:p></o:p></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;margin-left:.5in">
<o:p></o:p></p>
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<p class="MsoNormal"><span style="color:#888888"><br>
<br clear="all">
<br>
<span class="hoenzb">-- <o:p></o:p></span></span></p>
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<p class="MsoNormal"><span style="font-family:"Garamond","serif";color:#888888">Dr. Joel Kreisberg, DC, MA, CCH</span><span style="color:#888888"><br>
</span><span style="font-family:"Garamond","serif";color:#888888"><a href="http://www.joelkreisberg.com" target="_blank">www.joelkreisberg.com</a><br>
</span><span style="font-size:10.0pt;font-family:"Garamond","serif";color:#888888"><a href="http://www.drkreisberg.org" target="_blank">www.drkreisberg.org</a></span><span style="color:#888888"><br>
</span><span style="font-family:"Garamond","serif";color:#888888"><a href="http://www.teleosis.org/" target="_blank">www.teleosis.org</a><br>
<a href="mailto:drkreisberg@teleosis.org" target="_blank">drkreisberg@teleosis.org</a></span><span style="color:#888888"><br>
</span><span style="font-family:"Garamond","serif";color:#888888"><a href="tel:510-558-7285%20Ext%20102" target="_blank">510-558-7285 Ext 102</a></span><o:p></o:p></p>
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<p class="MsoNormal"><o:p> </o:p></p>
</div>
<p class="MsoNormal" style="margin-bottom:12.0pt"><br>
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<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><o:p></o:p></p>
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