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</o:shapelayout></xml><![endif]--></head><body lang=EN-US link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><a name="_MailEndCompose"><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>The tragedy of prescription drug abuse, addiction, and overdose deaths that is devastating our communities is prompting such actions.<o:p></o:p></span></a></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>I believe that saving a life is priceless. I also did want to think about the impact and sustainability of this approach, so I did some quick calculations on the population reach and estimated costs. <br>(In this, I’m setting aside consideration of the product’s effectiveness or appropriateness in the solid waste stream.)<o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>Population reach: 80,000 pouches provides a one-time use for just under <b>1% of Virginia’s 8.3 million population</b>.<o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>Manufacturer’s list price of the Deterra pouch for maximum of 45 pills is $5.99.<o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>80,000 pouches x $5.99 = $479,200.<o:p></o:p></span></b></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>But it’s a bulk purchase, so let’s say there’s a 30% discount, making total cost roughly <b>$335,440.<o:p></o:p></b></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></b></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>If the unwanted pill is a 20 mg oxycodone and the user puts the max of 45 pills in each pouch, that’s 45 x 20 mg = 900 mg. <o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>900 mg = 0.001984 pounds of medicine per pouch x 80,000 pouches = <b>158.72 pounds of medicines</b><o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>$335,440 / 158.72 pounds is $2,113.40 per pound of medicine.</span></b></span><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>Secure medicine drop box programs cost on the order of 400 to 1000 fold less per pound (ie. $2-5 per pound), and can easily accept much large of amounts of medicines than 45 pills.<o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>Mailers are more expensive per pound than drop-off programs, but even they are hugely more cost effective than these pouches. Programs that collect unwanted medicines through secure drop boxes or mailers utilize high temperature incineration for final disposal, which the DEA recognizes as non-retrievable destruction.<o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>VA’s AG is accomplishing some good education about the dangers of medicine abuse with this program but it’s not sustainable based on the cost.<o:p></o:p></span></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></p><div><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Margaret Shield, PhD<o:p></o:p></span></i></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><b><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Community Environmental Health Strategies, LLC<o:p></o:p></span></i></b></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Smart Science & Policy for Our Health and Environment<o:p></o:p></span></i></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>Seattle, WA <o:p></o:p></span></i></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'></span><a href="mailto:margaret.shield@CEHstrategies.com"><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>margaret.shield@CEHstrategies.com</span></i></span><span style='mso-bookmark:_MailEndCompose'></span></a><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'><o:p></o:p></span></i></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>mobile: 206-499-5452<o:p></o:p></span></i></span></p><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'></span><a href="http://www.CEHstrategies.com"><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'>www.CEHstrategies.com</span></i></span><span style='mso-bookmark:_MailEndCompose'></span></a><span style='mso-bookmark:_MailEndCompose'><i><span style='font-size:10.0pt;font-family:"Candara",sans-serif'> <o:p></o:p></span></i></span></p></div><p class=MsoNormal><span style='mso-bookmark:_MailEndCompose'><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'><o:p> </o:p></span></span></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><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'>From:</span></b><span style='font-size:11.0pt;font-family:"Calibri",sans-serif'> Pharmwaste [mailto:pharmwaste-bounces@lists.dep.state.fl.us] <b>On Behalf Of </b>Ed Gottlieb<br><b>Sent:</b> Friday, October 14, 2016 5:33 AM<br><b>To:</b> pharmwaste@lists.dep.state.fl.us<br><b>Subject:</b> [Pharmwaste] Mallinckrodt donations continue<o:p></o:p></span></p></div></div><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal style='margin-bottom:12.0pt'><span style='font-size:10.0pt;font-family:"Tahoma",sans-serif;color:black'>Mallinckrodt donates 80,000 pouches to the AG of VA. <br><br>A minor point...the story incorrectly states that the activated carbon will "break down" drugs. That statement is a hot link to the Mallinckrodt website; which correctly says, "deactivate".<br><br><a href="http://www.roanoke.com/news/local/roanoke/attorney-general-secures-drug-disposal-kits-to-curb-opioid-crisis/article_5a32fe4d-0378-5d99-9a4f-f445ec674136.html" target="_blank">http://www.roanoke.com/news/local/roanoke/attorney-general-secures-drug-disposal-kits-to-curb-opioid-crisis/article_5a32fe4d-0378-5d99-9a4f-f445ec674136.html</a><o:p></o:p></span></p><div><p class=MsoNormal><span style='font-size:10.0pt;font-family:"Tahoma",sans-serif;color:black'>Ed Gottlieb<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'>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<o:p></o:p></span></p></div></div></div></div></div></div></body></html>