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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link="#0563C1" vlink="#954F72"><div class=WordSection1><p class=MsoNormal>Good news that it appears that contradictory program has quietly been phased out.<o:p></o:p></p><p class=MsoNormal>In the past, the USFWS had an educational program called SMARxT Disposal that was a partnership with PhRMA and APhA. Many members of this listserv will remember that a large number of agencies and organizations joined in a sign-on comment letter sent to U.S. FWS in 2011 asked them to promote the use of medicine take-back programs to align their disposal guidance with that of other federal agencies as well as state and local agencies.<o:p></o:p></p><p class=MsoNormal style='margin-left:.25in'>A <a href="http://www.takebackyourmeds.org/usfws-letter">December 2011 letter</a> from an Assistant Director at U.S. Fish & Wildlife Services, responding to our comment letter, confirmed:<o:p></o:p></p><p class=MsoNormal style='margin-left:.5in'>“...we have always maintained that the campaign’s existing guidance should be considered interim due to new potential advances in science and new policy developments. <b>As you have accurately described, our sister agencies are now promoting the use of medicine take-back programs as the safest method for disposal of leftover medications, and they recommend trash disposal only if a take-back program is not available.</b> Given these developments and the fact that the Administration has elevated the medication disposal issue as a public health concern, <b>we are bringing the SMARxT Disposal campaign up-to-date with the current guidance and encourage the use of medicine take-back programs where available</b>, while clarifying that disposal of unwanted medicines in the household trash is a transitional measure until drug take-back systems are available to all communities.”<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>The American Pharmacists Association <a href="http://www.pharmacist.com/apha-advocacy-issues">website</a> also recommends medicine take-back to combat prescription drug abuse:<o:p></o:p></p><p style='mso-margin-top-alt:0in;margin-right:0in;margin-bottom:0in;margin-left:.25in;margin-bottom:.0001pt;line-height:13.5pt;background:white'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>APhA supports legislative, regulatory, and private sector efforts that address prescription drug abuse, misuse and treatment. We acknowledge that any effort must balance the need for patient/consumer access to medications for legitimate medical purposes with the need to prevent diversion and abuse. Pharmacists’ knowledge, accessibility, and expertise, puts them in a unique position to help combat this epidemic. APhA believes prescription drug abuse should be addressed using multipronged approach that includes medication-assisted treatment, abuse-deterrent formulations, access to treatment, integrated prescription drug monitoring programs, guidelines, <b>and access to prescription drug take back receptacles and programs</b>.<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Interestingly and confusingly, the domain name <a href="http://www.smarxtdisposal.net/">http://www.smarxtdisposal.net/</a> has been taken over by a Japanese marketing firm. In recent months, it’s been advertising steroids for body building (ironically) and now loans for debt relief. <o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Margaret Shield, PhD</span></i><o:p></o:p></p><p class=MsoNormal><b><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Community Environmental Health Strategies, LLC</span></i></b><b><o:p></o:p></b></p><p class=MsoNormal><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'><a href="mailto:margaret.shield@CEHstrategies.com"><span style='color:blue'>margaret.shield@CEHstrategies.com</span></a></span></i><o:p></o:p></p><p class=MsoNormal><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>mobile: 206-499-545</span></i><o:p></o:p></p><p class=MsoNormal><a name="_MailEndCompose"><o:p> </o:p></a></p><span style='mso-bookmark:_MailEndCompose'></span><div><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b>From:</b> Pharmwaste [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b>On Behalf Of </b>Susan Boehme<br><b>Sent:</b> Monday, April 11, 2016 9:04 AM<br><b>To:</b> Tenace, Laurie <Laurie.Tenace@dep.state.fl.us>; 'pharmwaste@lists.dep.state.fl.us' <pharmwaste@lists.dep.state.fl.us><br><b>Subject:</b> Re: [Pharmwaste] what federal agencies actually say about medicine disposal<o:p></o:p></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='color:#1F497D'>The summary of advice from the federal government is interesting. At one point USFWS also had advice (contradictory to EPA). Is that still the case? My quick search didn’t reveal it. And does USGS also post advice? <o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'>Susan E. Boehme Ph.D.<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'>Principal Consultant<br>ERM<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'>Sediment and Watershed Integrated Management Practice (SWiM)<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Cambria",serif;color:black'><o:p> </o:p></span></p><p class=MsoNormal><i><span style='font-family:"Cambria",serif;color:black'>295 Madison Avenue, Suite 8A<o:p></o:p></span></i></p><p class=MsoNormal><i><span style='font-family:"Cambria",serif;color:black'>New York, NY 10017<o:p></o:p></span></i></p><p class=MsoNormal><i><span style='font-family:"Cambria",serif;color:black'><o:p> </o:p></span></i></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'>T: +1 212 803 0206 </span><span style='font-size:10.0pt;color:#1F497D'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'>F: +1 212 447 1904<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'>M: +1 917 345 4514 <br></span><span style='color:#1F497D'><a href="mailto:susan.boehme@ERM.com" title="mailto:eric.stern@ERM.com"><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:blue'>susan.boehme@ERM.com</span></a></span><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:#1F497D'> </span><span style='color:#1F497D'><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Arial",sans-serif;color:navy'><a href="http://www.erm.com/" title="http://www.erm.com/"><span style='color:black'>www.erm.com</span></a><o:p></o:p></span></p></div><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'><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 [<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">mailto:pharmwaste-bounces@lists.dep.state.fl.us</a>] <b>On Behalf Of </b>Tenace, Laurie<br><b>Sent:</b> Monday, April 11, 2016 8:01 AM<br><b>To:</b> 'pharmwaste@lists.dep.state.fl.us'<br><b>Subject:</b> [Pharmwaste] what federal agencies actually say about medicine disposal<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='color:#1F497D'>Please note this did not originate with me and please always contact me if your posts do not go through – Laurie<o:p></o:p></span></p><p class=MsoNormal><span style='color:#1F497D'><o:p> </o:p></span></p><div><div style='border:none;border-top:solid #E1E1E1 1.0pt;padding:3.0pt 0in 0in 0in'><p class=MsoNormal><b><span style='color:#1F497D'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='color:#1F497D'><o:p> </o:p></span></b></p><p class=MsoNormal><b>From:</b> <a href="mailto:margaret.shield@cehstrategies.com">margaret.shield@cehstrategies.com</a> [<a href="mailto:margaret.shield@cehstrategies.com">mailto:margaret.shield@cehstrategies.com</a>] <br><b>Sent:</b> Thursday, April 7, 2016 4:14 PM<br><b>To:</b> 'Pharmwaste' <<a href="mailto:pharmwaste-bounces@lists.dep.state.fl.us">pharmwaste-bounces@lists.dep.state.fl.us</a>><br><b>Subject:</b> what federal agencies actually say about medicine disposal<o:p></o:p></p></div></div><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>Good afternoon,<o:p></o:p></p><p class=MsoNormal>There’s persistent incomplete information circulating about federal medicine disposal guidances pertaining to trash disposal, aka “in home disposal” of medicines. <o:p></o:p></p><p class=MsoNormal><u>None</u> of the federal agencies recommend trash disposal as <u>the</u> way to dispose of medicines. <o:p></o:p></p><p class=MsoNormal><u>All</u> federal agencies recommend medicine take-back programs as better than “in-home disposal”. <o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>It’s easy to verify this, but to make it easier, see the attached 3 page handout showing the current medicine disposal positions of EPA, DEA, and FDA for clarification in cases of confusion. Please apply as needed until the symptoms are gone.<o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal>I hope the FDA will listen to the comments it is receiving and soon remove its guidance to flush certain medications. Interestingly, even for those especially dangerous medicines, FDA recommends use of a medicine take-back program first.<o:p></o:p></p><p class=MsoNormal style='mso-margin-top-alt:6.0pt;margin-right:0in;margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;line-height:14.45pt;background:white'><b><span style='font-size:10.5pt;font-family:"Helvetica",sans-serif;color:#333333'>Flushing of Certain Medicines </span></b><span style='font-size:10.5pt;font-family:"Helvetica",sans-serif;color:#333333'><o:p></o:p></span></p><p class=MsoNormal style='margin-left:.5in;line-height:14.45pt;background:white'><span style='font-size:10.5pt;font-family:"Helvetica",sans-serif;color:#333333'>There is a small number of medicines that may be especially harmful and, in some cases, fatal with just one dose if they are used by someone other than the person for whom the medicine was prescribed. <span style='background:yellow;mso-highlight:yellow'>To prevent accidental ingestion of these potentially dangerous medicines by children, or pets, it is recommended that these medicines be disposed of quickly through a medicine take-back program or by transferring them to a DEA-authorized collector. If these disposal options are not readily available, it is recommended that these medicines be flushed down the sink or toilet as soon as they are no longer needed.</span> Click here for a <a href="http://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm#Flush_List"><span style='color:#005F9F'>list of medicines recommended for disposal by flushing.</span></a><o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Margaret Shield, PhD</span></i><o:p></o:p></p><p class=MsoNormal><b><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Community Environmental Health Strategies, LLC</span></i><o:p></o:p></b></p><p class=MsoNormal><a href="mailto:margaret.shield@CEHstrategies.com"><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif;color:blue'>margaret.shield@CEHstrategies.com</span></i></a><o:p></o:p></p><p class=MsoNormal><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>mobile: 206-499-5452</span></i><o:p></o:p></p><p class=MsoNormal><o:p> </o:p></p><p class=MsoNormal><span style='font-size:12.0pt;font-family:"Times New Roman",serif'><o:p> </o:p></span></p><div class=MsoNormal align=center style='text-align:center'><span style='font-size:12.0pt;font-family:"Times New Roman",serif'><hr size=3 width="100%" align=center></span></div><p class=MsoNormal><span style='font-size:7.5pt;font-family:"Arial",sans-serif;color:black'><br>This electronic mail message may contain information which is (a) LEGALLY PRIVILEGED, PROPRIETARY IN NATURE, OR OTHERWISE PROTECTED BY LAW FROM DISCLOSURE, and (b) intended only for the use of the Addressee (s) names herein. If you are not the Addressee(s), or the person responsible for delivering this to the Addressee (s), you are hereby notified that reading, copying, or distributing this message is prohibited. If you have received this electronic mail message in error, please contact us immediately at (617) 646-7800 and take the steps necessary to delete the message completely from your computer system. Thank you,<br><br>Please visit ERM's web site: <a href="http://www.erm.com">http://www.erm.com</a></span><span style='font-size:12.0pt;font-family:"Times New Roman",serif'><o:p></o:p></span></p></div></body></html>