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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>Ed,<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'>I applaud the effort for the UB Pharmacy School in helping the public to alleviate unused/unwanted substances, however, I truly feel the public would be better served by the utilization of drug collection kiosk receptacles at local pharmacies authorized to collect and/or law enforcement due to the process of incineration for end stage disposal. Assured Waste Solutions offers this type of service as well as a few other companies across the US. The key is the state funding of this type of program as I am not aware of any NY programs offering incentives to pharmacies for the installation of kiosk receptacles. I believe the majority of retail pharmacies would participate in a drug collection kiosk receptacle program if there was available funding, however, it is hard for a smaller pharmacy to justify paying to get rid of ultimate users waste.<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'>If ultimate users use the Deterra pouches, do they have to pay for additional pouches when they have more unused/unwanted substances? The point is offering the public through state funding the ability to seemingly “participate in a take back day everyday” at authorized collectors vs. having to wait on additional pouches to include having to purchase these. I am certainly not advocating for the non-use of Deterra pouches as again, this may make sense in certain circumstances, however, the public needs to be offered additional options on a larger scale.<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><div><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:black'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:10.0pt;font-family:"Arial","sans-serif";color:#4F81BD'>Best Regards,</span></b><b><span style='font-size:14.0pt;font-family:"Arial","sans-serif";color:#4F81BD'><o:p></o:p></span></b></p><p class=MsoNormal><b><span style='font-size:26.0pt;font-family:"Edwardian Script ITC";color:#1F497D'><o:p> </o:p></span></b></p><p class=MsoNormal><b><span style='font-size:26.0pt;font-family:"Edwardian Script ITC";color:#1F497D'>Doug Bowman</span></b><b><span style='font-size:9.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><o:p></o:p></span></b></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'><img width=158 height=67 id="Picture_x0020_1" src="cid:image001.png@01D1F938.4B373890" alt="cid:image001.png@01D04167.051E8EB0"><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>V.P. Operations<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>704-884-0008 Office<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>704-616-9528 Cell<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";color:#1F497D'>704-865-7519 Fax<o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:11.0pt;font-family:"Calibri","sans-serif";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 [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b>On Behalf Of </b>Ed Gottlieb<br><b>Sent:</b> Wednesday, August 17, 2016 4:04 PM<br><b>To:</b> pharmwaste@lists.dep.state.fl.us<br><b>Cc:</b> jmulcahy@Verdeenvirotech.com; marcener@buffalo.edu<br><b>Subject:</b> [Pharmwaste] 20,000 drug disposal pouches for WNY<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='color:black'>UB pharmacy school & Mallinckrodt partner to provide 20,000 Deterra drug disposal pouches to Buffalo, NY.<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='color:black'><a href="http://www.buffalo.edu/news/releases/2016/08/021.html" target="_blank">http://www.buffalo.edu/news/releases/2016/08/021.html</a><o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'><br>I don't recall seeing this claim (in linked story above) before:<o:p></o:p></span></p><p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='color:black'>"With 30 seconds and a little warm water, the environmentally friendly pouches deactivate pills, patches or liquid medications, rendering them safe for landfills and easy to dispose."<o:p></o:p></span></p><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>On June 30th, I sent a long list of questions (below) to Verde Technologies, the manufacturer of the Deterra (previously, "Medsaway") pouch. On July 20, the VP of Sales with Verde, told me he would have the answers sent right over. I emailed him a reminder a couple of days ago. Still hoping to receive documentation showing that this activated carbon adsorption system is a viable disposal option that meets DEA requirements. <o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'><o:p> </o:p></span></p><div><div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>Ed Gottlieb<br>Chair, Coalition for Safe Medication Disposal<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>Industrial Pretreatment Coordinator<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>Ithaca Area Wastewater Treatment Facility<br>525 3</span><sup><span style='color:black'>rd</span></sup><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'> Street<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>Ithaca, NY 14850<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>(607) 273-8381<o:p></o:p></span></p></div><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>fax: (607) 273-8433<br><br>I have a number of questions regarding the research done on Medsaway®, and activated carbon in general, that I hope you can answer:<br><br>1. You report deactivation results, for a number of medications, from 94.3-100% after seven days. For Oxycontin, you report 99% within four days, with the majority within one day. Is day-by-day deactivation information for the full range of tested medications available? This relates to questions 2, 3, & 5 below. <br>2. Do the directions for Medsaway® instruct the user to place it in the trash after it is sealed or do they suggest storing it securely for a period of time before disposal?<br>3. Do you know of any ANSI, or similar, standard that applies to products trying to meet the DEA definition of non-recoverable? If a Medsaway® package is diverted from the trash soon after it is filled, at least some drugs will be recoverable. Without an accepted standard, and with DEA being on record as not willing to evaluate products, how can compliance with the DEA standard be determined in such a situation? <br>4. Is the once per day mixing methodology used in your experiments representative what would be expected from the actual use of the product (mixed when: first used, placed and transported in a garbage truck, dumped at the land fill, and during trash compaction)? <o:p></o:p></span></p><div><p class=MsoNormal style='mso-margin-top-alt:auto;margin-bottom:12.0pt'><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'>5. If the Medsaway® bag is torn before deactivation is complete, wouldn't the medication containing liquid drain away from the activated carbon? And, in a landfill, wouldn't medication dissolved by rainfall flow downward, away from the activated carbon? In other words, is it reasonable to conclude that in real world conditions, the product is not likely to deactivate a significant amount of any remaining medication once the bag is broken and the liquid drained?<br>6. Do the tested medications include examples of all pill/capsule types or might there be some untested varieties that are slower to dissolve in water?<br>7. You report that "little of the original drug [Fentanyl] content was recovered from activated carbon using water and alcohol. Can you please tell me what percent is a "little"? <br>8. Would pulverizing the activated carbon effect the amount of drug recovered?<br>9. Did you try to extract drugs other than Fentanyl and, if so, what were the results? <br>10. Is it possible that other solvents would be more effective at extraction?<br>11. Has it been established that there are no drugs that can be extracted from activated carbon by heating? Your description of the carbon reactivation process seems to indicate that if a drug becomes volatile when heated to 100-649 degrees C, it could be extracted. <br>12. The amount of activated carbon provided has obviously been calculated to be more than enough to deactivate 30 pills, the number tested. Apparently [http://www.mallinckrodt.com/corporate-responsibility/safe-drug-disposal], the directions say it is designed to inactivate 10-15 pills. If usage directions are not followed, have you determined the percent deactivation for a worst case scenario, where the Medsaway® bag is totally filled with more than 30 pills?<br>13. Do you know why Medsaway® was scaled to this capacity? It is my experience, from running take back events, that even regular take back users bring, on average, more that one pound of drugs for disposal. This is clearly many times the capacity of a Medsaway® bag. <br> </span><span style='color:black'><o:p></o:p></span></p></div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma","sans-serif";color:black'><o:p> </o:p></span></p></div></div></div></div></div></div></body></html>