[Pharmwaste] Waste News - column: Time for dialogue on waste meds

Scott Cassel scott at productstewardship.us
Mon Feb 6 09:02:37 EST 2006

Waste News - column
Time for dialogue on waste meds
By: Scott Cassel
January 30, 2006
Drugs - we rely on them to treat headaches, depression, cancer, and
other ailments. But until recently, few have discussed the potential
impacts on the environment and, ironically, human health, caused by the
disposal of unwanted and waste pharmaceuticals. 

Over a dozen disparate initiatives across the country are either
studying the problem or implementing ways to solve it, including
take-back at pharmacies or other collection points. While each
represents progress, collectively they threaten to create a patchwork of
inefficient and conflicting programs. The time is ripe for a national
multi-stakeholder dialogue to agree on the extent of this problem and
develop joint priority solutions. 

There are three main sources of pharmaceuticals that reach our
waterways: normal excretion of unmetabolized, ingested drugs; disposal
of medications down the drain or toilet, or in the garbage; and
excretion and disposal of animal medications. Consequently,
pharmaceuticals have the potential to enter waterways from septic
systems, wastewater treatment plants, and unlined landfills. Even
pharmaceuticals captured in leachate at lined landfills are typically
transported to wastewater treatment plants, where some pass through

Last year, state and local government leaders asked the Product
Stewardship Institute to initiate a national dialogue on unwanted and
waste pharmaceuticals among key stakeholders, including representatives
from pharmaceutical companies, reverse distributors, retailers, and
government agencies. PSI is currently drafting a product stewardship
action plan, based on more than 20 interviews, which will form an
objective basis for face-to-face meetings. Nearly all stakeholders
agreed to PSI's proposal to participate in four dialogue meetings over a
year, which PSI expects to result in joint initiatives. 

Several areas of agreement have started to emerge. First, all
stakeholders agree on the need to better understand the extent of the
potential problem. The U.S. Geological Survey detected pharmaceuticals
in 80 percent of the 139 streams tested in 2002. Issues to resolve are
the degree to which the amounts detected can impact the environment, the
amount and percentage contributed by medications that are disposed of as
compared to excreted, and the level of precaution necessary. 

A second emerging agreement is that pharmaceuticals should not be
flushed down the toilet. Still to be debated is whether they can safely
be disposed of in the trash, as some stakeholders propose. Third, most
stakeholders recommend that significant progress could be made by
initially focusing resources on managing unwanted and waste
pharmaceuticals from nursing homes, hospice care, and other long-term
care facilities. 

Finally, and most significantly, many stakeholders believe that those
who want to voluntarily take back pharmaceuticals before the problem is
fully defined should face fewer regulatory barriers. Existing take-back
pilots have been constrained by the federal Controlled Substances Act,
which authorizes the U.S. Drug Enforcement Agency to strictly control
possession of listed substances. Some of these substances, such as
prescribed narcotics, will likely find their way into take-back programs
along with nonlisted medications. The current law, which ensures a
continuous chain of custody to avoid illicit diversion, is expensive and
unsustainable for take-backs. Consequently, disposal in the trash or via
flushing has become the only available option for unwanted controlled

Other significant issues remain, such as mail-back, reuse, and the role
of reverse distributors in take-backs. A national dialogue can save
resources as stakeholders share data and reach agreement in a single
forum on issues of national, regional and state significance. 

Cassel is executive director of the Product Stewardship Institute,

Scott Cassel, Executive Director
Product Stewardship Institute, Inc.
137 Newbury Street, 7th Floor
Boston, MA 02116
617-236-4855 (ph)
617-859-9889 (fax) 
scott at productstewardship.us
www.productstewardship.us <blocked::http://www.productstewardship.us/> 
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