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<div class=Section1>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Right to the core of the problem as usual,
Charles! And, indeed, that is the model that has been in place in British Columbia for almost 10 years. And, it is the model receiving a lot of play in the US because . . . well . . . it makes sense. </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Major hurdle right now is US Drug
Enforcement Agency regulations that do not allow pharmacies to receive
controlled substances. It is very difficult for pharmacies and nearly
impossible for you-and-me-medication-taker to know whether the medication is a
controlled substance. You have to know that oxycodone, for example, is a Schedule
II controlled substance (see table in 21 CFR1308.12). There are 4 other
Schedules of controlled substances 21 CFR 1308.11 & 13-15). This is not
intuitive stuff, neither is it marked on the Rx label. In a collection, you
only get maybe 5 or 10% controlled substances but you never know when one will show
up so you have to have authorized personnel at the collection at all times. Only
persons that are registered with DEA to receive controlled substances once they
have been dispensed (e.g., reverse distribution facilities; very few if any
pharmacies are registered) or law enforcement personnel are authorized to
receive controlled substances from a consumer. And, that registrant or law
enforcement officer must witness the destruction of those controlled
substances. That means actually see them being flushed or being burned. The
intent of all this is, of course, to prevent these controlled substances from
being diverted to intentional or unintentional illicit use. Many of the
controlled substances are opiates and stimulants so you get the idea about
diversion potential.</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Good news is that DEA is finally coming
around to considering a rule change that removes this impediment for
collections of unused medications. Timetable unknown. That will probably ease
up the main impediment to pharmacy-based take back. Well, it will if we can
figure out the always tough question of “who will pay.”</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Jack</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<div>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>John L. (Jack) Price</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Environmental Manager</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Hazardous Waste Management MS 4555</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Florida Department of Environmental Protection</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>2600 Blair Stone Road</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Tallahassee</span></font><font
color=blue><span style='color:blue'>, FL 32399-2400</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Phone:850.245.8751</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Fax: 850.245.8811</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>john.l.price@dep.state.fl.us</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>www.dep.state.fl.us/waste</span></font></p>
<p class=MsoNormal><font size=1 color=black face=Arial><span style='font-size:
7.5pt;font-family:Arial;color:black'>Please Note: Florida has a very
broad public records law. Most written communications to or from state
officials regarding state business are public records available to the public
and media upon request. Your e-mail is communications and may therefore
be subject to public disclosure.</span></font></p>
</div>
<div>
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face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabindex=-1>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
sqg-program-bounces@lists.dep.state.fl.us
[mailto:sqg-program-bounces@lists.dep.state.fl.us] <b><span style='font-weight:
bold'>On Behalf Of </span></b>Emery, Charles<br>
<b><span style='font-weight:bold'>Sent:</span></b> Tuesday, November 21, 2006
5:07 PM<br>
<b><span style='font-weight:bold'>To:</span></b> Perrigan, Glen;
Sqg-program@lists.dep.state.fl.us; flhhw@lists.dep.state.fl.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> RE: [Sqg-program] FW:
Unwanted Meds in the Landfill Questions - foodfor thought</span></font></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<div>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>The sad thing about all of this is the
easiest solution for individuals would have been for people to have been
allowed to take their waste pills back to pharmacies and have the pharmacy add
the waste pills to their normally generated waste pills to be sent back to
the redistributions centers for disposal as a waste.</span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
</div>
<p><font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Charles
Emery III</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Environmental
Manager</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>South
District FDEP</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Box
2549</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Fort
Myers, FL 33902-2549</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Phone
(239) 332-6975</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>FAX
(239) 332-6969</span></font> <br>
<font size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'>Charles.Emery@DEP.STATE.FL.US.</span></font>
</p>
<blockquote style='margin-top:5.0pt;margin-right:0in;margin-bottom:5.0pt'>
<p class=MsoNormal style='margin-bottom:12.0pt'><font size=2 face=Tahoma><span
style='font-size:10.0pt;font-family:Tahoma'>-----Original Message-----<br>
<b><span style='font-weight:bold'>From:</span></b>
sqg-program-bounces@lists.dep.state.fl.us
[mailto:sqg-program-bounces@lists.dep.state.fl.us]<b><span style='font-weight:
bold'>On Behalf Of </span></b>Perrigan, Glen<br>
<b><span style='font-weight:bold'>Sent:</span></b> Tuesday, November 21, 2006
4:39 PM<br>
<b><span style='font-weight:bold'>To:</span></b>
Sqg-program@lists.dep.state.fl.us; flhhw@lists.dep.state.fl.us<br>
<b><span style='font-weight:bold'>Subject:</span></b> [Sqg-program] FW:
Unwanted Meds in the Landfill Questions - foodfor thought</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Farouk: Thanks for asking some important
questions about this issue. Some food for thought:</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<ol style='margin-top:0in' start=1 type=1>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>The idea is to prevent these medicines from getting
into our wastewater treatment plants, right? </span></font></li>
</ol>
<p class=MsoNormal style='margin-left:.25in'><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial'>I don’t think at this point we
can prevent medications from getting into our wastewater treatment plants
because unabsorbed medications and their metabolites are excreted from humans
no matter how we dispose with the unused medications. However, we can reduce or
delay the quantity that goes there by reducing the amounts that are flushed in
favor of disposal with the garbage. </span></font></p>
<ol style='margin-top:0in' start=2 type=1>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>So, let us send them to landfills with the garbage,
right?</span></font> </li>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>After landfilling them, they will come out with the
leachate, right or wrong?</span></font> </li>
</ol>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'> Not necessarily.
Recall that some of our garbage is bound for waste to energy where the fate of
organics (many pharms are organics) is quite different than in a landfill.
Landfill fate: As I understand it, we do not monitor leachate for
pharmaceuticals or their metabolites at this time. If that is the case, we do
not know what fraction of pharmaceuticals report to leachate v. are transformed
v. are sequestered in a landfill environment. There is research going on right
now at U of F on fate of ~10 pharmaceuticals in simulated landfill environment
(results about 10 months out). </span></font></p>
<ol style='margin-top:0in' start=4 type=1>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>The leachate goes to the wastewater treatment plants,
right? </span></font></li>
</ol>
<p class=MsoNormal style='margin-left:.25in'><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial'>Yes it does. If we do determine that
we need to remove pharmaceuticals from wastewater to certain maximum
concentrations, it would seem to me to be much easier and more cost effective
to pretreat ~100 leachate sources (landfills) rather than every drop of
wastewater from every toilet, urinal and sink drain in the state. Perhaps
selected pretreatment would even reduce wastewater pharmaceutical loadings such
that treatment of all wastewater would be unnecessary or at least cheaper. </span></font></p>
<ol style='margin-top:0in' start=5 type=1>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Finally, we are back to square one, right? </span></font></li>
</ol>
<p class=MsoNormal style='margin-left:.25in'><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial'>Not at all: we are taking a basic,
reasoned and practical proactive step to reduce or delay the environmental
burden. That step is based upon incomplete science that suggests that we have a
problem but is not conclusive about that. The answer to “What is
the solution?” is even more inconclusive than the answer to “What
is the problem? How serious is that problem?” We need to carefully
consider whether expensive regulations, e.g., new and tougher wastewater
treatment standards and processes, are warranted given suggestive but
inconclusive knowledge about the problem we are trying to solve. </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>As always, I welcome your thoughts and am
open to discussing at any time. Please copy David and Victor as I do not
have their email addresses. Thanks again for your feedback. </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'>Best, Jack.</span></font></p>
<p class=MsoNormal><font size=3 color=blue face=Arial><span style='font-size:
12.0pt;font-family:Arial;color:blue'> </span></font></p>
<div>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>John L. (Jack) Price</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Environmental Manager</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Hazardous Waste Management MS 4555</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Florida Department of Environmental Protection</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>2600 Blair Stone Road</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Tallahassee</span></font><font
color=blue><span style='color:blue'>, FL 32399-2400</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Phone:850.245.8751</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Fax: 850.245.8811</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>john.l.price@dep.state.fl.us</span></font></p>
<p class=MsoAutoSig><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>www.dep.state.fl.us/waste</span></font></p>
<p class=MsoNormal><font size=1 color=black face=Arial><span style='font-size:
7.5pt;font-family:Arial;color:black'>Please Note: Florida has a very
broad public records law. Most written communications to or from state
officials regarding state business are public records available to the public
and media upon request. Your e-mail is communications and may therefore be
subject to public disclosure.</span></font></p>
</div>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabIndex=-1>
</span></font></div>
</div>
<div>
<p class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'> </span></font></p>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'> Farouk M.
El-Shamy [mailto:felshamy@pascocountyfl.net] <br>
<b><span style='font-weight:bold'>Sent:</span></b> Friday, November 17, 2006
10:16 AM<br>
<b><span style='font-weight:bold'>To:</span></b> Perrigan, Glen<br>
<b><span style='font-weight:bold'>Cc:</span></b> David James; Victor Norka<br>
<b><span style='font-weight:bold'>Subject:</span></b> </span></font></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> </span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Glen: I received a copy of your flyer on proper disposal of
unneeded medicine. I just have a thought to share with you.</span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'> </span></font></p>
<ol style='margin-top:0in' start=6 type=1>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>The idea is to prevent these medicines from getting
into our wastewater treatment plants, right?</span></font> </li>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>So, let us send them to landfills with the garbage,
right?</span></font> </li>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>After landfilling them, they will come out with the
leachate, right or wrong?</span></font> </li>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>The leachate goes to the wastewater treatment plants,
right?</span></font> </li>
<li class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Finally, we are back to square one, right?</span></font>
</li>
</ol>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'> </span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>How about that for a Friday morning?</span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'> </span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Sincerely,</span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'> </span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Farouk</span></font></p>
</blockquote>
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