<div dir="ltr"><div><div><div>Interesting conversation. I hadn't thought about the Selenium concentration argument. It does point to the "one product at at time" nature of the disposal issues. Having said that. Many if not most supplements are essentially food based products and thus do not qualify for incineration in medical or pharmacuetical level incineration. Sure as Lawrence says, water or landfill isn't a good place. However, the cost does not justify this perspective. Most supplements can actually go into the compost though some might argue that fish oils are animal products and small compost systems don't do well with animal products. Still, supplements are basically concentrated food and thus do not require a disposal process beyond what food requires. Thus, where I live, the compost bin is the best place and solid waste stream appropriate (if I can say that without offending anyone). As I mentioned, indeed, Ross has an interesting point about chromium and selenium, however, in the grand scheme of things--based on my knowledge of prescribing supplements- (I have a private practice in nutritional medicine)- trace minerals make up a very small--even trace amount of the overall volume of nutritional supplements sold in the US-- Fish oils, Vit. B, C, D, E dominate. <br><br></div>So my perspective has been, focus on key elements of the problem. Nutriceuticals and supplements overall are dwarfed by pharmaceutical products in terms of the overall risks and consequences in the environment. I agree it's easier to tell people just to throw it all in one place. If the costs was such that we could do this for all medicinal products, sure why not--best for the consumer. But given that the argument is that the pharmacuetical companies should pick up the tab, which when scaled to the US will not be insignificant. My position is to leave supplements out of this waste stream. <br><br></div>For the record. Our 2009 data found that 10% of what was collected in the Bay Area samples were nutritional supplements and in 2013 5% of the San Francisco inventory samples were nutritional supplements. <br><br></div>Joel<br></div><div class="gmail_extra"><br clear="all"><div><div class="gmail_signature"><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><font face="georgia, serif" size="2"><span style="color:rgb(0,0,0)">Dr. Joel Kreisberg, DC, </span><span style="color:rgb(0,0,0)">CCH, ACC</span> |<a href="http://goog_807379531" target="_blank">t</a><span style="color:rgb(0,0,0)"><a href="http://www.teleosis.org" target="_blank">eleosis.org </a></span><span style="color:rgb(0,0,0)">|</span><span style="color:rgb(0,0,0)"><a href="mailto:drkreisberg@teleosis.org" style="color:rgb(17,85,204)" target="_blank">drkreisberg@t</a><a href="http://eleosis.org" target="_blank">eleosis.org</a> |</span><span style="color:rgb(0,0,0)">510-558-7285 Ext 102</span></font></div><div><font size="4"><span style="font-family:garamond,serif;color:rgb(0,0,0)"><br></span></font></div></div></div></div></div></div></div></div>
<br><div class="gmail_quote">On Fri, Aug 14, 2015 at 8:11 AM, Lawernce Kenemore Jr. <span dir="ltr"><<a href="mailto:ldkjr100@gmail.com" target="_blank">ldkjr100@gmail.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
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<div style="max-width:590px"><font style="font-size:14px" size="3">Throwing them in the trash or flushing them only continues to contribute to the contamination of our water systems and effects the eco-system. It would be a poor response to tell someone to flush or throw in the trash from a Pharmaceutical professional.</font></div><div style="max-width:590px"><font style="font-size:14px" size="3">Coming soon an in home destruction of pharmaceuticals-OTC-vitamins supplements.</font></div><div style="max-width:590px"><font style="font-size:14px" size="3">FillAboxrecycling.com Stat-Medicament-Disposal</font></div><div style="max-width:590px"><font style="font-size:14px" size="3">Larry Kenemore Jr.</font></div><br><div class="gmail_extra"><br><div class="gmail_quote">On Fri, Aug 14, 2015 at 9:54 AM, <span dir="ltr"><<a href="mailto:pharmwaste-request@lists.dep.state.fl.us" target="_blank">pharmwaste-request@lists.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">Send Pharmwaste mailing list submissions to<br>
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<br>Today's Topics:<br>
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1. Vitamins and Supplements (Tiemeier, Amy)<br>
2. FW: Vitamins and Supplements (Bunnell, Ross)<br>
<br><br>---------- Forwarded message ----------<br>From: "Tiemeier, Amy" <<a href="mailto:Amy.Tiemeier@stlcop.edu" target="_blank">Amy.Tiemeier@stlcop.edu</a>><br>To: "<a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a>" <<a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a>><br>Cc: <br>Date: Fri, 14 Aug 2015 09:27:49 -0500<br>Subject: [Pharmwaste] Vitamins and Supplements<br><div link="blue" vlink="purple" lang="EN-US"><div><p class="MsoNormal">Good Friday Morning!<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">I wanted to get the group’s thoughts on the necessity of incinerating vitamins and supplements vs just throwing them in the trash or flushing them. <u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">Our non-profit has noticed that a fair amount of what we get in our drop boxes are large bottles of vitamins and supplements that are expired. As we pay for incineration by weight and are reliant on donations to support our incineration, we were wondering if we could remove vitamins and supplements from the list of items we accept and rather advise people to throw them in the trash or flush them. It doesn’t seem like these types of items are the ones we are worried about especially as they come from naturally occurring sources. That being said, I wanted to get the thoughts of the experts on the list serve who understand the environmental impact of these things better than I do.<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">Thank you for any input or insight you have.<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal">Warm Regards,<u></u><u></u></p><p class="MsoNormal">Amy Tiemeier<u></u><u></u></p><p class="MsoNormal"><u></u> <u></u></p><p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:black">Amy Tiemeier, Pharm.D., BCPS</span><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#1f497d"><u></u><u></u></span></p><p class="MsoNormal"><i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959">Director, Community Partnerships<u></u><u></u></span></i></p><p class="MsoNormal"><i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959">Associate Director, Office of Experiential Education</span></i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959"><u></u><u></u></span></p><p class="MsoNormal"><i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959">Associate Professor, Department of Pharmacy Practice</span></i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959"><u></u><u></u></span></p><p class="MsoNormal"><span style="color:#1f497d"> </span><span style="font-size:10.5pt;color:black"><u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:black"><img src="cid:d928d1654a567c7c79fcca62a38b263e" alt="cid:image001.png@01CFC03C.37B3BA50" height="36" width="245"><u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:#7f7f7f">4588 Parkview Place, St. Louis, MO 63110-1088</span><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:black"><u></u><u></u></span></p><p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:#7f7f7f">Office: <a href="tel:314.446.8554" value="+13144468554" target="_blank">314.446.8554</a> | Fax: <a href="tel:314.446.8386" value="+13144468386" target="_blank">314.446.8386</a><u></u><u></u></span></p><p class="MsoNormal"><i><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif""><a href="mailto:amy.tiemeier@stlcop.edu" target="_blank"><span style="color:blue">amy.tiemeier@stlcop.edu</span></a><span style="color:#7f7f7f"><u></u><u></u></span></span></i></p><p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:black"><img src="cid:dcfa03f8eeab5678072685fe2cf9839a" alt="cid:image002.png@01CFC03C.37B3BA50" height="50" border="0" width="180"><u></u><u></u></span></p><p class="MsoNormal"><a href="http://www.stlcop.edu/index.html" target="_blank"><span style="font-size:14.0pt;font-family:"Times New Roman","serif";color:blue;text-decoration:none"><img src="cid:e670b9ef8fe88880435b83c48cd9a53a" alt="cid:image003.png@01CFC03C.37B3BA50" height="18" border="0" width="18"></span></a><a href="https://www.facebook.com/STLCOP" target="_blank"><span style="font-size:14.0pt;font-family:"Times New Roman","serif";color:blue;text-decoration:none"><img src="cid:98c03773bacc18b0b0a161c2257341dc" alt="cid:image004.png@01CFC03C.37B3BA50" height="18" border="0" width="18"></span></a><a href="https://twitter.com/STLCOPedu" target="_blank"><span style="font-size:14.0pt;font-family:"Times New Roman","serif";color:blue;text-decoration:none"><img src="cid:f46de94480755ff2b9ad804790ea12c5" alt="cid:image005.png@01CFC03C.37B3BA50" height="18" border="0" width="18"></span></a><a href="https://www.flickr.com/photos/stlcop/sets" target="_blank"><span style="font-size:14.0pt;font-family:"Times New Roman","serif";color:#1f497d;text-decoration:none"><img src="cid:3a75d0dd095ecefdfb83b43dbea95974" alt="cid:image006.png@01CFC03C.37B3BA50" height="18" border="0" width="18"></span></a><span style="font-size:12.0pt;font-family:"Cambria","serif";color:black"><u></u><u></u></span></p><p class="MsoNormal"><u></u> <u></u></p></div></div><br><br>---------- Forwarded message ----------<br>From: "Bunnell, Ross" <<a href="mailto:Ross.Bunnell@ct.gov" target="_blank">Ross.Bunnell@ct.gov</a>><br>To: "'<a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a>'" <<a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a>><br>Cc: <br>Date: Fri, 14 Aug 2015 14:57:38 +0000<br>Subject: [Pharmwaste] FW: Vitamins and Supplements<br>
<div link="blue" vlink="purple" lang="EN-US">
<div>
<p class="MsoNormal"><span style="color:black">Amy:<br>
<br>
<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:black">Although it doesn’t squarely address your question, I’d like to offer some insight from Connecticut DEEP’s experience with retail pharmacies that may inform this issue.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:black"><br>
In our inspections of retail pharmacies in Connecticut, we have made some surprising findings, including some relating to the management of vitamins and nutritional supplements. More specifically, we have found that many vitamins contain sufficiently high
concentrations of selenium or chromium as to be regulated as “toxic” hazardous wastes when they are disposed of. (I should note that chromium is a rather unique issue for CT because the federal HW regs and most states provide an exemption from HW requirements
for wastes that contain primarily trivalent chromium, which is the type of chromium that is found in vitamins; however CT does not adopt this exemption, meaning that many vitamins will be classified as HW for chromium in CT, where they would not be in most
other states).<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:black"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:black">Obviously vitamins and other nutritional substances contain a “nutritive” rather than a “toxic” amount of such metals when consumed in the recommended dosage. However, when large amounts of vitamins are disposed
of at the same time, the potential exists for this disposal to result in a slug of contaminant being released into the environment all at once. This might argue in favor of managing the vitamins/nutritional supplements the same as the other pharmaceuticals
that are collected – namely, in a manner that will ensure that any toxic constituents are properly managed and are not released into the environment.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:black"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:black">On a similar note, believe it or not, we have also found that some “energy” bars contain enough chromium to be classified as a “toxic” hazardous waste in CT. Apparently, chromium is believed to boost energy, and
some manufacturers add it to their energy bars to appeal to consumers who think that it enhances the effectiveness of the product.<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:black"><u></u> <u></u></span></p>
<p class="MsoNormal"><span style="color:black">--Ross Bunnell, CT DEEP<u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:black"><u></u> <u></u></span></p>
<div>
<div style="border:none;border-top:solid #e1e1e1 1.0pt;padding:3.0pt 0in 0in 0in">
<p class="MsoNormal"><b>From:</b> <a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a> [mailto:<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us" target="_blank">pharmwaste-bounces@lists.dep.state.fl.us</a>]
<b>On Behalf Of </b>Tiemeier, Amy<br>
<b>Sent:</b> Friday, August 14, 2015 10:28 AM<br>
<b>To:</b> <a href="mailto:pharmwaste@lists.dep.state.fl.us" target="_blank">pharmwaste@lists.dep.state.fl.us</a><br>
<b>Subject:</b> [Pharmwaste] Vitamins and Supplements<u></u><u></u></p>
</div>
</div>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal">Good Friday Morning!<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal">I wanted to get the group’s thoughts on the necessity of incinerating vitamins and supplements vs just throwing them in the trash or flushing them.
<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal">Our non-profit has noticed that a fair amount of what we get in our drop boxes are large bottles of vitamins and supplements that are expired. As we pay for incineration by weight and are reliant on donations to support our incineration,
we were wondering if we could remove vitamins and supplements from the list of items we accept and rather advise people to throw them in the trash or flush them. It doesn’t seem like these types of items are the ones we are worried about especially as they
come from naturally occurring sources. That being said, I wanted to get the thoughts of the experts on the list serve who understand the environmental impact of these things better than I do.<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal">Thank you for any input or insight you have.<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal">Warm Regards,<u></u><u></u></p>
<p class="MsoNormal">Amy Tiemeier<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal"><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:black">Amy Tiemeier, Pharm.D., BCPS</span><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#1f497d"><u></u><u></u></span></p>
<p class="MsoNormal"><i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959">Director, Community Partnerships<u></u><u></u></span></i></p>
<p class="MsoNormal"><i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959">Associate Director, Office of Experiential Education</span></i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959"><u></u><u></u></span></p>
<p class="MsoNormal"><i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959">Associate Professor, Department of Pharmacy Practice</span></i><span style="font-size:10.0pt;font-family:"Palatino Linotype","serif";color:#595959"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="color:#1f497d"> </span><span style="font-size:10.5pt;color:black"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:black"><img src="cid:5cc58aedf7b19f7c602d62b6e9624a2b" alt="cid:image001.png@01CFC03C.37B3BA50" height="36" width="245"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:#7f7f7f">4588 Parkview Place, St. Louis, MO 63110-1088</span><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:black"><u></u><u></u></span></p>
<p class="MsoNormal"><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif";color:#7f7f7f">Office: <a href="tel:314.446.8554" value="+13144468554" target="_blank">314.446.8554</a> | Fax: <a href="tel:314.446.8386" value="+13144468386" target="_blank">314.446.8386</a><u></u><u></u></span></p>
<p class="MsoNormal"><i><span style="font-size:10.5pt;font-family:"Arial Narrow","sans-serif""><a href="mailto:amy.tiemeier@stlcop.edu" target="_blank">amy.tiemeier@stlcop.edu</a><span style="color:#7f7f7f"><u></u><u></u></span></span></i></p>
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