[Pharmwaste] 20, 000 drug disposal pouches for WNY + Cordant Health program

Ed Gottlieb EGottlieb at cityofithaca.org
Thu Aug 18 12:51:20 EDT 2016


Doug,

We are in agreement on many points.
Pharmacy kiosks are desirable (convenient & low cost per pound).
The lack of secure funding is why there are so few of them.

I differ on your suggestion that state funding is key.  I would argue that EPR is a fair, reasonable, and proven way to fund take back.

Return pouches are usually paid for by the consumer.  In the case of the UB give-away, I do not know if there is a limit placed on how many are taken per household.

I suspect that mail pouch give away programs, like the two recently mentioned (Cordant & Mallinckrodt), are already know to be, or are going to prove to be, short term.  Pouches are a relatively high cost method of disposal.  These programs seem to me to be an easy way for a sponsor to get public exposure for doing a good deed while setting a limit on the cost.

Pouches will probably become an important tool to reach the home bound and rural locations that can not easily access pharmacy or police kiosks.

Regarding the extent of the eleven state Cordant funded program, I have learned that they are working with Sharps Compliance.  So far, only 1000 pouches (almost 1 gallon capacity) have been delivered for distribution.

Ed Gottlieb
Chair, Coalition for Safe Medication Disposal
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381
fax: (607) 273-8433
________________________________
From: Doug Bowman [Dbowman at assuredwaste.com]
Sent: Thursday, August 18, 2016 10:21 AM
To: Ed Gottlieb; pharmwaste at lists.dep.state.fl.us
Cc: jmulcahy at Verdeenvirotech.com; marcener at buffalo.edu
Subject: RE: [Pharmwaste] 20,000 drug disposal pouches for WNY

Ed,

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.

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.



Best Regards,

Doug Bowman
[cid:image001.png at 01D04167.051E8EB0]
V.P. Operations
704-884-0008 Office
704-616-9528 Cell
704-865-7519 Fax

From: Pharmwaste [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Ed Gottlieb
Sent: Wednesday, August 17, 2016 4:04 PM
To: pharmwaste at lists.dep.state.fl.us
Cc: jmulcahy at Verdeenvirotech.com; marcener at buffalo.edu
Subject: [Pharmwaste] 20,000 drug disposal pouches for WNY

UB pharmacy school & Mallinckrodt partner to provide 20,000 Deterra drug disposal pouches to Buffalo, NY.
http://www.buffalo.edu/news/releases/2016/08/021.html

I don't recall seeing this claim (in linked story above) before:
"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."
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.

Ed Gottlieb
Chair, Coalition for Safe Medication Disposal
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381
fax: (607) 273-8433

I have a number of questions regarding the research done on Medsaway®, and activated carbon in general, that I hope you can answer:

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.
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?
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?
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)?
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?
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?
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"?
8. Would pulverizing the activated carbon effect the amount of drug recovered?
9. Did you try to extract drugs other than Fentanyl and, if so, what were the results?
10. Is it possible that other solvents would be more effective at extraction?
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.
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?
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.


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