Rx for Action
- Floods of PPCPs in combined sewer overflows
- Fish on Prozac: Anxious, anti-social, aggressive
- New permanent takeback program proving to be a success
- PPCP legislative updates
- Researchers identify high-risk chemicals for Great Lakes region
- Pharmaceuticals found in sharks in Florida
- New medicine collection program availaible soon for C-U area residents
- Pharmaceutical research at IAGLR 2013
- Illinois-Indiana Sea Grant
- NOAA National Sea Grant Office
- Sea Grant Great Lakes Network
- Environmental Protection Agency
- Product Stewardship Institute
- Extension Links
U of I Extension
Visiting Extension Specialist, Pollution Prevention
Visiting Science Writer
May 30, 2013 PPCP legislative updates
PharmaceuticalsCalifornia SB 727 Medical Waste:Pharmaceutical Product Stewardship Program
Connecticut HB 6439 Disposal and Collection of Unused Medication
Illinois HB 1343 Pharmaceutical Disposal, and
HB 0072 Safe Pharmaceutical Disposal
Maine SB 881 Improve the Unused Pharmaceutical Disposal Program
Massachusetts S.399 Pharmaceutical and Personal Care Product-Laden Wastewater,
HB1977 Drug Disposal by Mail, and
HB 2033 Safe Disposal of Prescription Drugs
Michigan HR 103 Drug Take Back Awareness Week
New Hampshire SB 44 Disposal of Controlled Substances by Law Enforcement Officers
New York A00228 Establishing the Disposal of Prescription Drugs Program,
A01584/S00642 Establishing the Drug Manufacturer Collection Program,
A01609 Disposal of Drugs, Drug Disposal Sites and Home Pharmaceutical Collection,
A05465/S03985 Implementing a Drug Disposal Demonstration Program, and
A05610 Drug Management and Collection Program
Oregon HB 2075 Disposal of Prescription Drugs
Pennsylvania HB 1194 Retailers of Pharmaceutical Drugs to Implement Drug Collection System, and
HB 2466 Collection and Disposal of Medicines
Utah HJR020 Provides for studying ways to prevent drug abuse by young people and ways to promote prescription drug disposal when taking medication is no longer necessary, and
HB0120 Amends the Division of Occupational and Professional Licensing Act related to commercial and academic detailing for prescription drugs
West Virginia HB 2113 Establishing a two-year pilot program on the disposal of unused pharmaceuticals
Personal Care ProductsFederal SB 696 Safe Chemicals Act of 2013, and
HB 1385 Safe Cosmetics and Personal Care Products Act of 2013
Massachusetts H 1990 Safe Cosmetics, and
HB 2062 Healthy Cosmetics
Minnesota SB 466 An Act Protecting Children from Exposure to Harmful Chemicals,
HF 605 Companion bill to SB466, and
SF 1166/HF 1322 Triclosan and Antibacterial Compounds Sales Prohibition
New York AB 4765 In relation to enacting the Safe Cosmetics Act of 2013
Oregon HB 3162 High Priority Chemicals of Concern in Products
Written by Laura Kammin and Corrie Layfield
University of Wisconsin Extension has launched a website for healthcare facilities that want to reduce pharmaceutical waste. The site also suggests actions that will help consumers reduce the amount of unused medications in their homes. Check out the new website at: http://www.uwm.edu/shwec/pharmaceuticalwaste/
May 3, 2013 Michigan Department of Environmental Quality announces household drug collection grant program
2013 Community Pollution Prevention Grant Program: Household Drug Collections
GRANT DESCRIPTION: Grant funding is available through the Michigan Community Pollution Prevention (P2) Grant Program for the development of ongoing household drug collection programs. These programs should include strategies and projects that promote environmental stewardship and awareness through the collection and incineration of unused household medications, including controlled and non-controlled substances within Michigan communities. The Michigan Department of Environmental Quality (DEQ) will provide matching grants to non-profit organizations, local and tribal governments, local health departments, municipalities, and regional planning agencies to fund drug collection programs.
Requests for funding will be accepted from May 1, 2013, through May 31, 2013. Evidence of pharmaceutical waste has been detected in groundwater and drinking water in the Great Lakes region. The technologies and equipment required to remove these compounds from drinking and waste water are expensive and are currently not widely deployed by communities. Successful drug collection programs will prevent pharmaceutical waste from being released into and accumulating in the environment and reduce the incidence of abuse of prescription drugs.
The purpose of these grants is to increase public access to free, convenient, safe and environmentally optimal drug collection programs, and to foster the development of successful models and approaches that can be implemented in other areas of the state. Proposals for projects of various scopes and costs are welcome.
GRANT OBJECTIVE: This grant request will target the following objectives:
- Develop and implement a household drug collection program that provides a free, convenient, and simple method for the population of a geographically defined area of Michigan to regularly dispose of unused medications, both controlled and non-controlled substances, in an environmentally optimal manner.
- Identify demographic indicators that have an impact on the success or failure of the drug collection program. This will inform citizens regarding the implementation of future drug collection programs in different areas of the state.
- Collect metrics, minimally including collection dates, collection participant numbers, and collection volumes and weights for at least prescription and non-prescription (over the counter) drugs collected.
- Collect questionnaire data from a sample of the population residing in and adjacent to the area served.
- Increase the deployment of equipment needed for the collection of both controlled and non-controlled pharmaceuticals.
- Serve as a resource for other organizations interested in implementing a drug collection program.
ELIGIBLE RECIPIENTS: Local and tribal governments, non-profit organizations, local health departments, municipalities, and regional planning agencies are eligible to receive funding.
ELIGIBLE ACTIVITIES: The following activities are eligible under the Community P2 Grants Household Drug Collection Program:
- Grant funds can be used to fund employee salaries or employ graduate students to administer a household drug collection program.
- Grant funding can be used to hire consultants to implement portions of the household drug collection program.
- Grant funds can be used to support local drug collection programs.
- Grant funds can be used to collect and analyze data to assess the effectiveness of the drug collection program and to identify potential improvements.
- Grant funds can also be used to develop training programs and education and outreach materials.
AVAILABILITY OF FUNDS: The match requirement of at least 25 percent has been established by law. The maximum dollar amount requested should be based upon what is needed to carry out the identified tasks and products. Total grant fund requests must be no larger than$100,000; however, local match expenditures can bring total project expenditures over the $100,000 limit. Project contracts can run for one or two years and will be on a cost-reimbursement basis.
MATCHING REQUIREMENTS: Organizations receiving grants are required to match total project costs by at least 25 percent. Grantee contributions may include dollars, in-kind goods and services, and/or third party contributions.
DUE DATE: Proposals are due no later than May 31, 2013.
FURTHER INFORMATION: To learn more call the DEQ Environmental Assistance Center at 1-800-662-9278, or you may visit the Community P2 Webpage at http://www.michigan.gov/deq/0,4561,7-135-3585_62565---,00.html for more information.
Amidst continued Congressional and U.S. Environmental Protection Agency (USEPA) deliberation on how to address the persistence of pharmaceuticals in the environment, Michigan has made some headway not seen in other states. In 2012, the Michigan Department of Environmental Quality (MDEQ) produced a 22 minute Pharmaceutical Waste Tutorial to educate Michigan health care providers. The tutorial provides a quick, simple approach to managing pharmaceuticals in a health care setting to assist in meeting the many complex regulations that apply to pharmaceuticals.
The federal Resource Conservation and Recovery Act (RCRA) describes how all businesses with hazardous waste (i.e., waste that is toxic, corrosive, ignitable and/or reactive as defined under the federal RCRA) must be managed and disposed. As a general matter, anywhere between 5 and 15 percent of a pharmacy's inventory is expected to meet the definition of hazardous waste.
Unlike most states, Michigan's hazardous waste regulations are found under the state's Natural Resource and Environmental Protection Act, Part 111, of Act 451, and the Part 111 rules promulgated thereunder (the state hazardous waste regulations). In Michigan, the state hazardous waste regulations are implemented instead of the federal hazardous waste regulations as detailed in the federal regulations (see 40 CFR Part 272, Subpart X). Since Michigan's hazardous waste program is implemented under state regulations, Michigan was able to promulgate rules and independently establish pharmaceuticals as Universal Waste.
As of December 16, 2004, businesses in Michigan have been able to manage their pharmaceutical waste in accordance with the universal waste rules for pharmaceuticals. These rules ease the regulatory burden, provide for safe collection and transportation, and prescribe for disposal at a hazardous waste disposal facility authorized to handle pharmaceuticals. At the federal level, only batteries, pesticides, mercury-containing equipment, and electric bulbs (lamps) are acknowledged as universal waste types that can be managed under the streamlined universal waste standards.
Since 2009, due to growing public and health care interest, Michigan has worked to clarify the regulations that apply to health care and help residents understand how to safely store and dispose of unused medications to prevent their release to its water resources. Amidst significant scientific uncertainty regarding the human health effects associated with long-term exposure to the low levels of pharmaceuticals and the current data suggesting problematic environmental consequences, Michigan embarked on a collaborative campaign focused on education and better managing what it presently can control–its inventory of waste medications. The campaign advocates that all National Institute for Occupational Safety and Health (NIOSH) hazardous drugs, regardless of origin – household or business, and all business pharmaceuticals be incinerated at authorized hazardous waste incinerators. At minimum, the campaign advocates all residential pharmaceuticals, with the exception of NOISH hazardous drugs, be incinerated at solid waste incinerators authorized to destroy pharmaceuticals.
While pharmaceuticals were first detected in our environment in the 1970's, it wasn't until 1998, that concern about their persistence emerged, following the detection of heart medication in the North Sea when sampling for pesticides. This detection triggered a U.S. investigation into the type and level of pharmaceuticals present in our environment. By 2002, the U.S. Geological Survey (USGS) had confirmed the presence of pharmaceuticals in the environment across much of the U.S. at very low levels. Since then, Congress has advocated further research and collaboration across the many agencies who govern the review, use, handling, and disposal of pharmaceuticals.
This research led to the August 2008 Managing Pharmaceutical Waste: A 10-Step Blueprint for Health care Facilities in the United States, the August 2010 Draft USEPA Guidance Document: Best Management Practices for Unused Pharmaceuticals at Health Care Facilities, the 2011 U.S. Government Accountability Office Report Action Needed to Sustain Agencies' Collaboration on Pharmaceuticals in Drinking Water, the May 2012 Inspector General Report USEPA Inaction in Identifying Hazardous Waste Pharmaceuticals May Result in Unsafe Disposal, and the September 2012 USEPA letter Recommendation on the Disposal of Household Pharmaceuticals Collected by Take-Back Events, Mail-Back, and Other Collection Programs. Finally, in November 2012, the USEPA, USGS, U.S. Department of Agriculture, and U.S. Food & Drug Administration issued a Memorandum of Understanding for improving and sustaining coordination and collaboration on issues related to pharmaceuticals in drinking water across the U.S.
As the USEPA and other agencies continue to review pharmaceuticals as an emerging contaminant of concern to determine a grander course of action, the MDEQ has taken more immediate action to better control and manage its inventory of waste medications. While the USEPA better qualifies the impact of pharmaceuticals in the environment and how to remove excreted pharmaceuticals from our wastewater, the MDEQ has taken action, collaborating with stakeholders on a threefold approach focused on:
- increasing awareness of this issue,
- identifying ways to better manage our inventory of waste pharmaceuticals, and
- instituting measures to minimize the amount of unused pharmaceuticals generated.
April 10, 2013 EPA launches new Hazardous Waste Pharmaceuticals Wiki
From the EPA:
EPA has developed a "Hazardous Waste Pharmaceuticals Wiki" as a platform to facilitate the sharing of expertise among the healthcare industry and other stakeholders to help make accurate hazardous waste determinations for waste pharmaceuticals and increase compliance with hazardous waste regulations among the healthcare community.
In addition to information about which pharmaceuticals are hazardous waste, the Hazardous Waste Pharmaceuticals Wiki will help users find guidance documents, state-specific information, manufacturer's information, and more. We encourage all healthcare stakeholders to share their expertise, and state-specific approaches in making hazardous waste determinations for pharmaceuticals.
The Hazardous Waste Pharmaceutical Wiki can be viewed by anyone at: http://hwpharms.wikispaces.com (no registration is necessary to view)
Experts who wish to contribute or edit content for the Wiki can register by sending an e-mail request to HWPharmsWiki@epa.gov. Please use a professional email address, not a personal email address, when contacting EPA to request access to the Wiki. Your email address will not be made public.
Please help us spread the word by forwarding this email to other interested parties.
April 4, 2013 Triclosan study uncovers surprising results
Perhaps the most interesting discovery from a new study on triclosan has little to do with the chemical or its impacts. The combined field and lab experiment was designed to shed some light on what happens when bacteria living in river sediment are exposed to triclosan, an antibacterial commonly used in soaps, cleaners, and even disinfected plastics. And it did. But it also revealed that wastewater effluent causes very different ecosystems to look alike overtime.
The process is known as biotic homogenization. The forces behind it are complex, but the result is much simpler: ecosystems that used to be different–housed different species, had different chemical concentrations, or shared different relationships with neighboring environments–become similar. Researchers at Loyola University of Chicago saw this process in action while testing the chemical characteristics of two Chicago-area rivers for their study on triclosan. Upstream of wastewater treatment plants, researchers found that the two rivers had distinct concentrations of chemicals like phosphorus and nitrogen and housed different communities of bacteria. But downstream of the treatment plants, the bacterial communities looked the same.
"We were surprised to see how effectively the treatment plant effluents homogenized the bacterial communities from these two very different rivers, but it make sense given the fact that the effluents affected the chemical composition of the two rivers in the same way," said John Kelly, Associate Professor at Loyola University Chicago. Dr. Kelly presented the findings of this study to the Illinois Sustainable Technology Center in March. "We are hoping to repeat these analyses at other sites throughout the U.S. to determine how widespread this phenomenon might be."
The long-term impacts of biotic homogenization are not clear. Although past studies on birds, plants, and fish indicate that less diversity across ecosystems may make it harder for species to recover from disturbances like fires, pollution, or spikes in insect populations, the relationship between bacterial community diversity and ecosystem stability has not been studied as extensively. For a review of some of these studies, visit fish.washington.edu/research/oldenlab/pdf/2008/ELS_2008.pdf.
But biotic homogenization was not the only unexpected result. The study also found that triclosan–an antibacterial–does not reduce the overall amount of bacteria living in river sediment, as researchers expected. The abundance of triclosan-resistant bacteria increased with triclosan exposure, and the mixture of species changed, but the total number of bacteria stayed roughly the same. One reason may be that bacteria adapt so quickly to triclosan that the species that survived had already had a chance to recover by the time the researchers collected their samples. Kelly told his audience at the Illinois Sustainable Technology Center that they hope to conduct more experiments to determine if there is a dip in bacteria population earlier on.
"The ability of the sediment bacterial communities to adapt to this potent antimicrobial compound was quite remarkable," Kelly said. "But we still have questions to answer regarding the potential implications of the increases in resistance and the changes in community composition that we observed."
To view Kelly's presentation, visit www.istc.illinois.edu/about/sustainability_seminars.cfm.
For further reading:
Drury, B., E. Rosi-Marshall, and J.J. Kelly. 2013. Wastewater treatment effluent reduces the abundance and diversity of benthic bacterial communities in urban and suburban rivers. Applied and Environmental Microbiology.
March 26, 2013 No more antibacterial soap for Minnesota government
On March 4, Minnesota Governor Mark Dayton signed an executive order that will phase out the use of triclosan in products that state agencies buy. As of June 2013, the agencies will no longer be allowed to purchase soap or other products that contain the antibacterial chemical. While state agencies won't have a choice about buying triclosan, consumers in Minnesota will still have to read their product labels.
Minnesota Senate Bill (SF 1166), which sought to prohibit the sale of personal care products, cosmetics, or cleaning products
containing triclosan, triclocarban, or similar antibacterial compounds, did not receive enough votes to make it out of the Senate Commerce Committee last week.
Recent research has added to concern over the health and environmental impacts that triclosan may have. Studies indicate that triclosan interferes with normal development and function of the brain and reproductive system, possibly resulting in altered behavior, learning disabilities, or infertility. After going through the wastewater treatment process and entering the environment, triclosan can also transform in the presence of sunlight into one of several different kinds of dioxins. This family of chemicals has been linked to cancer and hormone disruption.
Several manufactures, including Johnson & Johnson, have announced that they will remove triclosan from their products. Though many consumers have already altered their buying habits in response to the 2010 Food and Drug Administration advisement that products with triclosan are no more effective than washing with plain old-fashioned soap and water.
Photo courtesy of Anna McCartney, Pennsylvania Sea Grant
March 15, 2013 Save the date: Pharmaceutical waste stewardship summit to be held in Milwaukee in June 2013
Program highlights include:
- Status of EPR bills introduced at local, state, and federal levels
- Learn from best performing medicine take-back program operators in the Great Lakes
- Hear about recent Wisconsin study estimating the costs of take-back programs
- Network with experts on wide ranging issues, from drug abuse to environmental impacts
March 11, 2013 UpClose with Maria Sepulveda
The latest UpClose provides an in-depth look at the process of designing, implementing, and communicating the results of studies on pharmaceutical pollution. Researchers at Purdue University talk with IISG's science writer, Anjanette Riley, about their current study on the effects of pharmaceutical chemicals found in Lake Michigan on several organisms at the bottom of the food chain.
The IISG-funded study is led by Dr. Maria Sepulveda, who has spent the last decade studying the impacts of environmental contaminants on fish and other wildlife. She is joined by Dr. Cecon Mahapatra, a research scientist specializing in the genes involved in toxicity, and Chris Klinkhamer, a Masters student with a background in engineering. The project is among the first to collect data on two common contaminants in Lake Michigan and takes an important step towards the goal of securing the long-term health of the lake.
Just a few months before the study is scheduled to be completed, Dr. Supulveda and her research team explain the results seen so far, what they mean for wildlife in the lake, and the complex, and sometimes rocky, process of conducting a year-long study on live organisms.
Click here to read what Maria, Cecon, and Chris had to say, and view previous issues in the series at UpClose.
For a print copy of this behind-the-scenes interview, contact Laura Kammin at email@example.com or 217-333-1115.
Written by: Anjanette Riley, IISG Science Writer
March 1, 2013 New Sea Grant PPCP working group formed
On February 6 and 7, members of eight Sea Grant programs attended a workshop in Jacksonville, Florida to discuss strategies for reducing the amount of pharmaceuticals and personal care products (PPCPs) in the nation's waterways. This marks the first time that Sea Grant specialists, educators and communicators have come together to build a nation-wide partnership on this topic. The Keeping Pharmaceuticals and Personal Care Products (PPCPs) Out of the Environment workshop was funded by the NOAA National Sea Grant Office and organized by Illinois-Indiana Sea Grant.
The meeting provided an opportunity for representatives from New York, Pennsylvania, and Illinois-Indiana Sea Grant to mentor others by sharing their award-winning work on reducing PPCPs in the Great Lakes basin. Since 2006, IISG has helped 63 communities in Illinois, Indiana, Wisconsin and Michigan with single-day or permanent collection programs, ensuring the proper disposal of 9.65 million pills (81,813 pounds of unused medication). In 2010, the Sea Grant programs in Pennsylvania, New York, Illinois-Indiana and Ohio teamed up on the Undo the Great Lakes Chemical Brew project which has educated over 1 million people in the Great Lakes region about PPCPs and collected over 2.7 million pills.
The workshop opened the door for this successful regional effort to further develop into a strong national partnership. Workshop attendees from Oregon, North Carolina, Georgia, Florida, and Southern California shared their PPCP research and education efforts to date, and the group discussed how the eight programs might work together moving forward.
If your Sea Grant Program wasn't able to participate in the workshop, it isn't too late to join the new Sea Grant PPCP working group. Just contact Laura Kammin at firstname.lastname@example.org or 217-333-1115 for more information.
March 1, 2013 Pharmaceutical research...what it isn't telling us
It is a challenge faced by many scientists: ensuring that solutions in beakers, numbers in computer models, and cells on slides match what is happening outside the lab. And for those studying pharmaceutical pollution in waterways, it is no different. Nearly two decades of results have shown that pharmaceutical chemicals are common in lakes and rivers and that many are harmful to fish and wildlife. But most of those findings come from studies conducted in the lab–where you don't find the variability in temperatures, dissolved oxygen, and presence of other chemicals that you do in lakes and rivers–and using concentrations high above what has actually been found in waterways. Research into pharmaceutical pollution is on the rise, but it still reveals little about the risks these chemicals pose to the wildlife and humans that are exposed to them.
That is the conclusion of a new global analysis of pharmaceutical research published early this year in Environmental Science and Technology. For this report, British researchers conducted a detailed analysis of more than 200 studies focusing on pharmaceuticals in waterways that receive water from treatment plants. The studies came from 28 academic journals, 41 countries, and a dozen years of research.
Perhaps their most surprising discoveries had little to do with the results, but the process of conducting a study itself. For example, a closer look revealed that the findings of most studies cannot be reliably generalized to other water bodies, organisms, or even seasons. These studies tended to rely on 'grab sampling', a common testing method that captures only a snap-shot in time and doesn't represent what is happening in the waterway overtime. This means that the impacts of a chemical on fish living in one location in May says little about what fish are experiencing downriver or in December.
The ability to generalize results is made even more difficult by the fact that studies have clustered around a few waterways near populated areas. In the United States, this means California and the Northeastern seaboard. And on a global scale, this means that most of the world has seen little or no research on pharmaceutical pollution in receiving waters–including all of Africa.
The British researchers also discovered that the studies conducted so far are focused on a small proportion of the pharmaceuticals being prescribed–fewer than 4 percent. Most of these are antibiotics, antiepileptics, cardiovascular drugs, and painkillers. The focus on these chemicals is understandable, especially in the U.S., where cardiovascular drugs and painkillers are among the most prescribed medicines. But focusing on a few chemicals, even after numerous studies suggest that some pose no risk to wildlife, leaves a lot unknown about major classes of pharmaceuticals, including antidepressants and cancer treatments.
Hughes, S.R., Kay, P., and Brown, L.E. 2013. Global synthesis and critical evaluation of pharmaceutical data sets collected from river systems. Environmental Science and Technology (47): 661-677.
Written by: Anjanette Riley, IISG Science Writer
February 26, 2013 Yellow Jug Old Drugs program releases new PSAs on proper disposal of unwanted medicine
The Yellow Jug Old Drugs program has recently released a series of public service announcements about properly disposing of unused medications. The short spots can be found here: http://www.youtube.com/user/GreatLakesCleanWater?feature=watch
As part of the Michigan Community Pollution Prevention Grant Program, the Michigan Department of Environmental Quality awarded the Yellow Jug Old Drugs program a $77,125 grant to educate people on the need for proper disposal of their expired and unused medications. The Yellow Jug Old Drugs program works in partnership with local pharmacies to collect and dispose of unused drugs in a safe and approved manner.
In addition to producing the PSAs, the grant funding will be used to:
* Produce and broadcast a 30 minute documentary in cooperation with CMU Public Broadcasting
* Adapt informational material for accessibility for persons with disabilities
* Translate printed material into Spanish and Arabic
* Work with local substance abuse prevention agencies to educate citizens about the importance of proper disposal to help reduce prescription drug abuse
* Provide outreach to Michigan pharmacies and pharmacy students
January 16, 2013 Doctors urged to prescribe lower medication dosages to reduce patient side effects and protect the environment
A new paper in the journal Science of the Total Environment argues that carefully lowering dosages of many medications has the potential to not only lead to more effective treatment, but also reduce environmental impacts of pharmaceuticals.
Christian G. Daughton and Ilene Sue Ruhoy, in "Lower-dose prescribing: minimizing "side effects" of pharmaceuticals on society and the environment" put forth the idea that the most important variable in achieving a successful outcome of prescription use is through dose. The rise of large, controlled clinical trials and one-size-fits all recommended dosages has led to over-treatment for some patients and more side effects, which, in turn, can result in patients discontinuing their medicine use and accumulating those unused medications in their homes. These unwanted medicines might be flushed down the drain, tossed in the trash, or stored insecurely in the home (where they can lead to accidental poisonings or be misused by other family members).
Improved information sharing might be one tool to help doctors feel more secure about prescribing lower dosages, which in turn may decrease some adverse side effects patients experience from over-treatment and also allow patients to feel that they are more actively participating in their healthcare choices. The authors also note that lower doses for the same medicines are generally prescribed in the European Union and Japan, and that when dosing suggestions are revisited after the release and use of a new drug, they are almost always revised downward.
In addition to fewer side effects, lower dosages may also result in less environmental contamination from pharmaceuticals. One of the primary ways pharmaceuticals enter the environment is through human wastewater containing ingested or topical medicines. Daughton and Ruhoy suggest that if less medicine is used, fewer pharmaceutical compounds will be excreted or washed off, consequently leading to lower levels of drugs in the environment. The authors summarize this approach as sustainable prescribing, an idea that views the patient as not only the person taking the medicine, but also includes the environment and bystanders, such as people who could be hurt by accidental poisoning or prescription drug diversion and abuse.
The full article is available at:
Written by: Corrie Layfield
Despite extensive efforts, Wisconsin programs collect just 2 percent of household pharmaceutical waste; the remainder is landfilled, flushed, or stored indefinitely, posing health and environmental risks
|MADISON, Wisc.---More than 4 million pounds of prescription and over-the-counter (OTC) household medications in Wisconsin get improperly stored or discarded via landfilling or flushing each year, resulting in potential human and environmental toxicity risks, according to a new study by the University of Wisconsin-Extension and the Product Stewardship Institute (PSI). This staggering statistic holds true despite costly and time-intensive voluntary efforts to manage leftover pharmaceuticals safely.
"We've gathered the best available data to estimate how much waste is being produced and how it's being managed in Wisconsin," says Steve Brachman, waste reduction specialist with University of Wisconsin-Extension. "And, despite the rapid growth of ongoing drug take-back programs, we found that most people are still throwing their drugs away, flushing them, or storing them indefinitely."
The urgency behind addressing the problem of household pharmaceutical waste disposal stems from the health, safety, and environmental dangers associated with improperly storing or discarding OTC and non-OTC medications. First, controlled substances stored in the home are linked to drug abuse, overdose, or accidental ingestion by children and pets. In fact, according to the U.S. Centers for Disease Control and Prevention, more people die from prescription drug abuse and poisonings than from traffic accidents. Second, pharmaceuticals that are flushed or landfilled can contaminate surface waters and threaten aquatic ecosystems. This is because wastewater treatment plants are not designed to eliminate all pharmaceuticals. Drugs that are disposed of in household trash and taken to landfills may eventually end up in landfill leachate, much of which is treated at these same wastewater treatment plants.
"There is clearly a great need for consumer outreach and education about this important issue," says Scott Cassel, PSI's founder and chief executive officer. "When used as intended, medications can mean the difference between life and death for some people. But when they're mismanaged, the consequences can be devastating."
Given public safety concerns about pharmaceuticals disposal, over the past two years, the U.S. Drug Enforcement Administration (DEA) has funded five one-day drug take-back events for many communities in Wisconsin and around the country. However, since these programs were never intended to be permanent, Brachman says, when the DEA funding dries up, local governments will be faced with an enormous challenge of securing sustainable funding to keep these programs running.
"We need a system that allows us to meet the high and growing demand for pharmaceutical take-back programs without posing a burden on state or local governments," says Brachman.
"We believe that the producers of these pharmaceuticals should step forward and work with us to devise and carry out a long-term solution to this multi-faceted problem," Cassel adds. "It's not just environmental; it's not just health and safety-related; and it's not just financial. It's all of the above."
The report, which was written under contract with the Wisconsin Department of Natural Resources (WI DNR), also cites high costs, lack of sustainable funding, consumer inconvenience, government regulation of controlled substances, limited in-state capacity for pharmaceuticals destruction, inadequate program promotion, and low public awareness as barriers to effective waste pharmaceutical collection programs in Wisconsin. It then evaluates successful industry-run programs in Canada, France, Spain, Sweden, and Australia, and suggests that they serve as models for Wisconsin.
To view the report in its entirety, visit http://dnr.wi.gov/topic/HealthWaste/documents/2012HouseholdPharmStudy.pdf.
About the Product Stewardship Institute (PSI)
The Product Stewardship Institute (PSI) is a national nonprofit organization dedicated to reducing the health and environmental impacts of consumer products. PSI brings together key stakeholders with differing interests to develop product end-of-life solutions in a collaborative manner, with a focus on having manufacturers assume primary financial and managerial responsibility. With a robust membership base of 47 state governments and over 200 local governments, as well as partnerships with more than 80 companies, organizations, universities, and non-U.S. governments, PSI advances both voluntary programs and legislation to promote industry-led product stewardship initiatives. For more information, visit PSI online at www.productstewardship.us. You can also follow PSI on Twitter at twitter.com/ProductSteward and on Facebook at facebook.com/ProductStewardship.
About University of Wisconsin-Extension
University of Wisconsin-Extension provides statewide access to university resources and research so the people of Wisconsin can learn, grow, and succeed at all stages of life. UW-Extension carries out this tradition of the Wisconsin Idea-extending the boundaries of the university to the boundaries of the state-through its four divisions of continuing education, cooperative extension, entrepreneurship and economic development, and broadcast and media innovations. Visit UW-EXT online at www.uwex.edu.
A new agreement between four federal agencies aimed at improving collaboration on issues related to pharmaceuticals in drinking water is now underway. Under the agreement, the Environmental Protection Agency (EPA), Department of Agriculture (USDA), Health and Human Services (HHS), and Department of Interior (DOI) will share research on the causes of pharmaceutical pollution and its effects on human health. The agencies will also conduct joint studies to investigate the impact of pharmaceuticals and related contaminants on the environment.
The collaboration is expected to help the EPA gain access to data needed to determine whether a pharmaceutical should be regulated under the Safe Drinking Water Act. The EPA has worked with other federal agencies in the past to collect this data, but always informally. This collaboration comes after a 2011 recommendation by the Government Accountability Office called for a formal mechanism for coordinating research on pharmaceuticals that pose the greatest threat to public health.
Pharmaceuticals can enter drinking water from several pathways, including discharges from wastewater facilities and agricultural runoff that carries manure into nearby lakes and rivers. Flushing medicines down the toilet or throwing them in the trash can also result in increased levels of pharmaceutical chemicals in water supplies.
For more information on the agreement, visit http://water.epa.gov/scitech/swguidance/ppcp/upload/mou_pharm_drinking_water12182012.pdf.
Written by: Anjanette Riley, IISG Science Writer
December 21, 2012 DEA releases proposed regulations for disposal of controlled substances
The proposed regulations would continue to allow law enforcement agencies to conduct take-back events, administer mail-back programs or maintain collection boxes at their facilities. In addition, the DEA proposes to allow authorized manufactures, distributors, reverse distributors and retail pharmacies to voluntarily administer mail-back programs or collection receptacles. Pharmacies would also be allowed to maintain receptacles at long term care facilities. Funding for these voluntary programs is not provided.
December 4, 2012 Introducing UpClose
What better way to learn about the latest research on pharmaceuticals and personal care products than to hear it directly from the people doing the research? From the field to the lab, UpClose takes you behind the scenes with the scientists who are working to make sense of this complicated topic.
The first issue of UpClose highlights the work of Dr. Timothy Strathmann, an environmental engineer at University of Illinois Urbana-Champaign. Dr. Strathmann has dedicated more than a decade to understanding the chemical principles at work behind environmental challenges such as ensuring long-term water quality and developing renewable energy. In more recent years, he and his students have been working to develop processes that could be used to treat wastewater contaminated with pharmaceuticals and other consumer products. The Strathmann Research Group has also conducted studies that investigate processes that degrade aquatic contaminants in natural environments.
IISG science writer, Anjanette Riley, sat down with Dr. Strathmann to talk in detail about what happens to pharmaceuticals at a chemical level when water is treated, the risk these chemicals may pose after they are broken down, and how his research is helping to develop new, more efficient treatment technologies needed to ensure sustainable water quality.
October 2, 2012 Working together to keep people, pets and wildlife safe
In an effort to eliminate accidental poisonings and reduce environmental contamination caused by pharmaceuticals, the American Veterinary Medical Association (AVMA) and Illinois-Indiana Sea Grant (IISG) have released a new guide for pet owners that contains important strategies for the proper storage and disposal of medicines.
"This brochure carries an important message," explains Dr. Douglas Aspros, president of AVMA."Many people don't understand how dangerous medications can be to their pets or to the environment. Prescription medications are the number one cause of accidental poisonings in pets, so it is important to make sure you store medicines out of reach of pets and dispose of them properly."
Prescription for Safety: How to Dispose of Unwanted Medicine identifies and describes 5 simple Do's and Don'ts of pharmaceutical stewardship: 1) Use as directed, 2) Store correctly, 3) Don't flush, 4) Don't share or sell, and 5) Properly dispose. The brochure also provides pet owners with information on locating local medicine collection programs, as well as what to do if a program is not available nearby.
Proper storage of prescription and over-the-counter medications is necessary. Each year, more than 25,000 pets are accidentally poisoned when they consume human or veterinary medicines they find around the home or in the garbage. The disposal method for expired or unused medications is also important. Studies have found low levels of pharmaceuticals in lakes, rivers and drinking water around the country.
"While the potential human health impacts are still uncertain," said Laura Kammin, IISG pollution prevention specialist, "many species of fish and other aquatic wildlife living in the contaminated waters have shown impaired development, behavior and reproduction."
The brochure is available for free download at: http://www.iisgcp.org/catalog/gros/grosAVMA.html
August 8, 2012 Medical assistants learning about pharmaceutical stewardship
Whether pills, patches, or liquids, managing pharmaceutical waste isn't just a matter of disposing of expired or unwanted medication properly. Even more attention has to be focused on reducing the hundreds of tons of medicine that go unused each year in the United States. Healthcare providers need to be at the forefront of the solution, because they have the means to help ensure that large quantities of unwanted medicines stay out of the water and out of the wrong hands.
Illinois-Indiana Sea Grant is doing our part to spread the word about pharmaceutical stewardship to healthcare providers. IISG's Laura Kammin was recently interviewed for an article published in the latest edition of CMA Today (subscription required) titled "Medicine Cabinet Crackdown". CMA Today is published six times a year by the American Association of Medical Assistants (AAMA).
The article, written by Fred Donini-Lenhoff, outlines the scope of the unwanted medicine problem, covering medication abuse/misuse, accidental poisonings, current legislation, medicine take-back programs and environmental impacts. It also provides practical disposal tips and resources for medical assistants to share with patients.
While the article provides guidance on disposal, the real take-home message is the need to reduce waste on the front end. Donini-Lenhoff writes:
One key is to change health professions education to ensure that students and practitioners are cognizant of the systemic side effects of overprescribing, and to look beyond an individual patient to see the larger population's health consequences. ..."Physicians should be mindful of the quantity of medication prescribed," adds Kammin. "Try a sample first to see if it will work for the patient. Do not unnecessarily push samples provided by pharmaceutical reps. Be aware of the consequences of having pharmaceuticals present in the environment. And educate patients on how they can responsibly dispose of any unused medications."
(Image and excerpts: Copyright American Association of Medical Assistants. Reprinted from July/August 2012 CMA Today with permission).
July 31, 2012 PPCPs: What are the big questions?
Since time and money are limiting factors, key research questions must be identified. That was the recent goal of an international group from academia, government and industry. They identified a "top 20" list of questions that still need to be answered in order to better manage PPCPs in the environment. Their findings were published recently in Environmental Health Perspectives.
Their "Top 20" list:
1. What approaches should be used to prioritize PPCPs for research on environmental and human health exposure and effects?
2. What are the environmental exposure pathways for organisms (including humans) to PPCPs in the environment and are any of these missed in current risk assessment approaches?
3. How can the uptake of ionizable PPCPs into aquatic and terrestrial organisms and through food chains be predicted?
4. What is the bioavailability of non-extractable residues of PPCPs?
5. How can pharmaceutical preclinical and clinical information be used to assess the potential for adverse environmental impacts of pharmaceuticals?
6. What can be learned about the evolutionary conservation of PPCP targets across species and life stages in the context of potential adverse outcomes and effects?
7. How can ecotoxicological responses, such as histological and molecular-level responses, observed for PPCPs, be translated to traditional ecologically important endpoints such as survival, growth and reproduction of a species?
8. How can ecotoxicity test methods, which reflect the different modes of actions of active PPCPs, be developed and implemented in customized risk assessment strategies?
9. How can effects from long-term exposure to low concentrations of PPCP mixtures on non-target organisms be assessed?
10. Can non-animal testing methods be developed that will provide equivalent or better hazard data compared to current in vivo methods?
11. How can regions where PPCPs pose the greatest risk to environmental and human health, either now or in the future, be identified?
12. How important are PPCPs relative to other chemicals and non-chemical stressors in terms of biological impacts in the natural environment?
13. Do PPCPs pose a risk to wildlife such as mammals, birds, reptiles and amphibians?
14. How can the environmental risks of metabolites and environmental transformation products of PPCPs be assessed?
15. How can data on the occurrence of PPCPs in the environment and on quality of ecosystems exposed to PPCPs be used to determine whether current regulatory risk assessment schemes are effective?
16. Does environmental exposure to PPCP residues result in the selection of antimicrobial resistant micro-organisms and is this important in terms of human health outcomes?
17. How can the risks to human health, arising from antibiotic resistance selection by PPCPs in the natural environment, be assessed?
18. If a PPCP has an adverse environmental risk profile what can be done to manage and mitigate the risks?
19. What effluent treatment methods are effective in reducing the effects of PPCPs in the environment while at the same time not increasing the toxicity of whole effluents?
20. How can the efficacy of risk management approaches be assessed?
Today the Alameda County Board of Supervisors voted unanimously to pass the Alameda County Safe Medication Disposal Ordinance. This makes Alameda County the first in the U.S. to require pharmaceutical producers to pay for the collection, transportation and disposal of unused or expired medications from residential sources. The ordinance is based on a producer responsibility model. Requirements would be similar to successful medicine collection programs in Canada, France and Australia.
After July 1, 2013, the following changes will take place:
- Producers must submit a product stewardship plan, or be partnered with an existing approved plan, within 180 days of selling their products in Alameda County.
- Producers must offer medicine collection program(s) at permanent collection sites and/or at locations where envelopes for a mail-back program are available.
- The companies are not allowed to charge consumers a visible fee for the medicine collection service.
- Producers must have an outreach and promotion campaign so that consumers are aware of the medicine disposal program.
- Controlled substances (medications that have strong potential for abuse or addiction) are excluded from the ordinance for now, pending new regulations on the disposal of controlled substances to be provided by the Drug Enforcement Administration.
June 14, 2012 unwantedmeds.org goes mobile
As part of the Great Lakes Pharmaceutical Initiative, the Product Stewardship Institute will be hosting a summit with the University of Wisconsin-Extension and the Midwest Product Stewardship Council to build a strategy for expanding pharmaceutical collection in the Great Lakes region to reduce pharmaceutical pollution and prescription drug abuse.
The Great Lakes Pharmaceutical Stewardship Summit will be held next week in Chicago on June 7th and 8th. Additional logistical information, the draft agenda and registration can be found here. The cost of registration is $30 and space is still available for those interested in participating.
The meeting will provide opportunities for discussion among a diverse group of experts and policymakers from around the region about potential models for creating a regional pharmaceutical collection program. The Summit will be focused on a high-level discussion of policies and practices being tested or developed to address the public health and environmental impacts of the disposal of unused and expired medications.
For more information on the Great Lakes Pharmaceuticals Initiative, please see: http://www.takebacknetwork.com/great_lakes_initiative.html. For questions about the summit please email email@example.com.
May 17, 2012 Stewardship project contest deadline is May 24th
Pharmaceuticals and personal-care products can impact the environment and can end up in local water sources if they are disposed of incorrectly, such as flushing medicine down the toilet. In fact, a 2008 Associated Press investigation found pharmaceuticals in the drinking water supplies of at least 46 million Americans. Proper disposal of unwanted medicine is one method of keeping these chemicals out of the environment.
To be eligible for the contest, students must be in 5th to 12th grade in Illinois, Indiana, Ohio, Pennsylvania or New York.
On the entry form, teachers should explain how the students chose, researched, planned, implemented and evaluated their project.
Each project will be judged on organization, scientific accuracy, concise messaging, sources, originality and proper grammar and spelling. The 20 winners will be selected and announced by June 8, with a prize of a $100 education resource gift certificate.
All entries must be submitted electronically no later than May 24th to Goettel at firstname.lastname@example.org. Visit here for more details on how to submit a project (click on Stewardship Project Contest).
The service is free and anonymous. Items accepted include prescription and over-the-counter medicines. Both human and veterinary medications will be accepted from residential sources; no business waste will be accepted. Sharps/ needles, thermometers, and medical waste will not be accepted.
Currently there are more than 178 drop-off sites registered in Illinois and 95 in Indiana. Law enforcement agencies interested in operating one or more collection sites on April 28th can still register with the DEA.
IISG will be helping the City of Maroa Police Department with a DEA take-back event that day at 506 S. Wood St. in Maroa, IL. Maroa currently has the only permanent medicine collection program capable of taking controlled substances in Macon County.
In Central Illinois, Walgreen's is hosting multiple take-back sites including:
Bourbonnais (501 N. Convent)
Champaign (841 Bloomington Road)
Charleston (411 W. Lincoln Ave.)
Danville (400 W. Fairchild)
Effingham (1200 W. Fayette Ave.)
Kankakee (1050 N. Kennedy Drive)
Mahomet (104 N. Lomard)
Mattoon (212 S. Logan)
Monticello (108 N. Market St.)
Pana (108 South Poplar St.)
Rantoul (220 S Century Blvd.)
Taylorville (315 N. Webster St.)
Urbana (302 E. University)
If you don't see your community listed on the DEA's website, call your local police department to see if they are participating. Not all of the communities that will be participating in the April event are listed yet on the DEA website.
March 28, 2012 Don't Flush, Don't Trash - Proper Medication Disposal
video about proper disposal of expired and unwanted medicine. Check it out,
and share the message with family and friends: "Don't Flush or Trash Unwanted Medicines".
Has your child ever asked you where the water goes after it goes down the sink or toilet? The MWRD has also developed a video that teaches children about wastewater treatment.
In August 2011, Governor Pat Quinn signed two new bills into law making it easier for communities to dispose of unwanted medicines. The Household Pharmaceutical Disposal Fund (Public Act 97-0545) and Public Act 97-0546, which amended the Illinois Safe Pharmaceutical Disposal Act, went into effect on January 1, 2012.
The Household Pharmaceutical Disposal Fund authorizes the Illinois Criminal Justice Information Authority (ICJIA) to provide local law enforcement agencies grants to cover the costs of collection, transportation, and incineration of pharmaceuticals from residential sources. The funding comes from a $20 fine charged to those who commit drug offenses (i.e., possession of marijuana or controlled substances).
The Illinois Safe Pharmaceutical Act allows city halls or police departments to provide locked and secure medicine collection boxes on-site that residents can use to dispose of their unused medications.