Rx for Action

Beginning May 24, residents will have 24/7 access to safely dispose of their unwanted or expired medications, including controlled substances. IISG is happy to announce that the C-U Area Medicine Take-back Program will collect and properly dispose of pharmaceuticals to help reduce accidental poisonings of children and pets, prevent drug diversion and abuse, and limit environmental impacts.

Residents can drop off their medications in the collection boxes in the lobbies at:

• Urbana Police Department, 400 South Vine St., Urbana
• Champaign Police Department, 82 E. University Ave., Champaign
• University of Illinois Police Department, 1110 W. Springfield Ave., Urbana

Both prescription and over-the-counter medicines, as well as veterinary pharmaceuticals will be accepted. Illicit drugs, syringes, needles, or thermometers will not be accepted. The program will take medications from residential sources only. No personal information remaining on the containers will be used; privacy of any personal information will be strictly maintained. The collected drugs will be incinerated, which is the environmentally-preferred disposal method.

The new take-back program is a partnership between Illinois-Indiana Sea Grant, Urbana Police Department, Champaign Police Department, University of Illinois Police, Champaign County Sheriff's Office, the International Prescription Pill and Drug Disposal Program (P2D2), City of Champaign, City of Urbana, Illinois American Water, University of Illinois Student Sustainability Committee, UI Illinois Sustainable Technology Center, Champaign County Regional Planning Commission, Champaign-Urbana Public Health District, WCIA 3 News, and Prairie Rivers Network.

Illinois American Water, the P2D2 Program, and Carle Rx (now Walgreens) started a program in C-U in 2009, but due to current federal regulations, the two locations may not accept controlled substances. The C-U Area Medicine Take-back Program is the first in Champaign County to be able to collect controlled substances, but it is not the only one in central Illinois. IISG helped the Maroa Police Department start a program in Macon County in 2011. And there are several P2D2 drop-boxes in Effingham County. As word of these programs spread, hopefully more communities will soon join in to safely dispose of their unused medicines.

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/

The U.S. Drug Enforcement Administration (DEA) has announced that they collected 371 tons (742,497 pounds) of unwanted medications at the sixth National Prescription Drug Take-Back Day held on April 27. More than 5,829 locations around the country participated in the event. So far the DEA has collected 1,409 tons (2.8 million pounds) of medication. For past events, the DEA has reported:

• September 2010: 121 tons
• April 2011: 188 tons
• October 2011: 188.5 tons
• April 2012: 276 tons
• October 2012: 244 tons

As people become more aware of the issues surrounding improper storage and disposal of medication, the need for medicine collection programs will grow. While the DEA take-back events have been successful, they are not intended to serve as a long-term national solution to the unwanted medicine disposal problem. Once the DEA releases the new regulations on disposal of controlled substances, communities will once again be on their own to fund single-day take-back events or permanent medicine collection programs. Police departments or other organizations looking to start a permanent medicine collection program can contact IISG for assistance.

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.

How do you know which products are safe to buy for your family if you don't even know what's in them? The Safe Chemicals Act of 2013 introduced in April aims to help consumers answer that question, and many others. The bill calls for increased safety standards used in consumer products, including personal care products. It would modernize the Toxic Substances Control Act, which hasn't seen substantial updates since the 1970s. In a nutshell, the proposed bill would:

• include a new safety standard of "reasonable certainty of no harm"
• increase testing requirements for products
• improve product labeling
• require the Environmental Protection Agency to create new safety standards and prioritize chemicals of high concern, and
• develop new research programs for green chemistry and biomonitoring

Personal care products, such as fragrances or sunscreen, are among the most frequently detected substances in water bodies around the world. Despite their widespread use, we know little about their long-term effects. Given the huge quantities produced and the minimal safety testing, there is growing concern that personal care products may have unintended consequences for people and the environment. The new bill would increase public access to product information so they can make informed decisions about which products they want to buy.

The bill was originally introduced in December 2012 by Senator Frank Lautenberg (NJ), Senator Kristen Gillibrand (NY), and numerous co-sponsors. But it failed to make it out of Senate Environment and Public Works committee. According to the National Law Review, an alternative version of a chemical safety bill is expected to be introduced by Senator David Vitter (LA) sometime this spring.

The uncertainties surrounding the prospects for either bill haven't slowed down efforts at the state level. Several states have also introduced similar personal care production legislation this year. Massachusetts and New York lawmakers are working on safe cosmetics bills, while Minnesota and Oregon want to require manufactures to maintain lists of high priority, or potentially toxic, chemicals used in children's products.

Written by Corrie Layfield and Laura Kammin

Residents in Illinois and Indiana once again took full advantage of a national prescription drug take back event last Saturday, bringing unwanted pharmaceuticals to one of hundreds of collection locations set up throughout the region for the one-day event. And IISG staffers were again at two of the locations at Walgreens stores in Champaign and Urbana to talk about the risks pharmaceuticals pose to aquatic environments and answer questions about how to safely dispose of medicine between take back days.

By the end of the 4-hour event, officials in Champaign and Urbana had collected 12 large boxes of unused prescription and over-the-counter medication. These and other boxes collected throughout the country will be properly incinerated by the Drug Enforcement Administration (DEA). A final tally for how many pounds of pharmaceuticals were collected during the sixth National Take-Back Day will be announced by the DEA in the coming weeks. Last September, Illinois residents brought in over 21,000 pounds of unwanted medicine for proper disposal, followed closely by Indiana's 18,560 pounds. More than 2 million pounds of medicine have been disposed of nation-wide since the take-back days began in 2010.

IISG volunteers were also onsite to tell residents of the two cities about a new year-round collection program launching May 24. Like last year, many who brought in pharmaceuticals–often by the bagful–said they had been holding onto their medications for months, waiting for the next collection day. Permanent collection boxes at the Champaign, Urbana, and University of Illinois police departments means residents will no longer have to wait for single-day events like these to rid their homes of unwanted pharmaceuticals.

The permanent program comes at the same time officials at DEA are considering ending its national events in favor of more localized programs. In December 2012, DEA proposed regulations that would make it easier for manufacturers and retail pharmacies to set up permanent collection programs. DEA has said it will end National Take-Back Days once the regulations are approved, making last week's one of the last.

To learn more about permanent programs operating in your area, or for information on how to dispose of medicine where collections are not available, visit www.unwantedmeds.org.

Pharmaceutical pollution is the focus of a new investigative series launched this week by the Wisconsin Center for Investigative Journalism. Part of the group's Water Watch Wisconsin project, the eight stories published so far have covered everything from the impact pharmaceuticals on fish to what Great Lakes states are doing to keep these chemicals from entering waterways.

The stories focus on the impacts of endocrine disruptors, chemicals that interfere with hormonal processes in humans and animals. These chemicals have been linked to a range of reproductive problems in fathead minnows, including decreased sperm counts and infertility.

Among the prevention strategies discussed in the series is a recent executive order in Minnesota that prevents state agencies from buying products containing the antibacterial triclosan. The decision–the first of its kind in the country–comes in the wake of growing evidence that the chemical commonly used in soaps, cleaners, and plastics poses a threat to aquatic fish and wildlife.

To read the stories published so far and to follow the ongoing series, visit www.wisconsinwatch.org/projects/hormones.

Guest post by: Christine Grossman, Michigan Department of Environmental Quality

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.

For more information, visit Michigan's webpage at www.michigan.gov/deqhealthcare and see the Waste Health Care Resources link or contact Christine Grossman at 517-373-0590.

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.

Thanks,

Hazardous Waste Pharmaceuticals Wiki Team
http://hwpharms.wikispaces.com
HWPharmsWiki@epa.gov
US EPA

Communities across central Illinois will have an opportunity to safely dispose of unwanted medications this month. Another National Prescription Drug Take-Back Day will take place on Saturday, April 27 from 10 a.m. to 2 p.m. Local police departments will anonymously collect both prescription and over-the-counter medications–including pet medications. No sharps or syringes please.

Residents can drop off their unused medications free of charge at participating Walgreens stores in:

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 Dr.

Mahomet: 104 N. Lombard St.

Mattoon: 212 Logan Ave.

Monticello: 108 N. Market

Pana: 108 S. Poplar St.

Rantoul: 220 S. Century Blvd.

Taylorville: 315 N. Webster St.

Urbana: 302 E. University Avenue

This is the sixth DEA-led pharmaceutical collection day held since 2010. In that time, more than 2 million pounds of medication have been collected by law enforcement agencies and community partners nationwide.

To find a participating location near you, visit www.deadiversion.usdoj.gov/drug_disposal/takeback.

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

Thanks to a new treatment technique, wastewater treatment plants may soon be able to remove more pharmaceutical chemicals found in wastewater. The technology–known as membrane distillation–is the first of its kind capable of treating large amounts of water.

The process works by heating wastewater and then using a filter to separate pharmaceutical compounds from the water vapor. During test runs conducted by the KTH Royal Institute of Technology in Stockholm, membrane distillation was able to remove as much as 100 percent of some pharmaceuticals, compared to the 70-85 percent success rate of more conventional methods. One of those chemicals is Oxazepam, an antianxiety medication that has recently been linked to behavioral changes in wild perch.

So far, researchers have mostly investigated whether the technology can remove pharmaceuticals at concentrations found in the effluent of a Swedish treatment plant. It is still unknown whether membrane distillation is effective at higher concentrations.

Read more at:www.sciencedaily.com/releases/2013/02/130226081157.htm

Image courtesy of KTH The Royal Institute of Technology

March 22 is recognized as World Water Day. A day for communities across the world to celebrate freshwater and to promote ways that people can help protect our water resources. So on World Water Day, IISG urges people to reduce pharmaceutical waste by:
1. Buying only as much medicine as you will use
2. Don't accept medication samples if you know you won't use them
3. Store medicine as indicated on the label

If you do end up with medicine that you don't need:
1. Take it to a local medicine take-back program, or
2. Take your medications to the next DEA National Drug Take-Back Day to be held on April 27th.

IISG is proud to help protect water on World Water Day, and we understand the importance of protecting water everyday. We've been protecting Lake Michigan and other waterways in Illinois and Indiana for 30 years. One of our focus areas is on preventing pharmaceuticals and personal care products from contaminating waterways and drinking water, but IISG has a team of talented specialists and educators who help protect water from multiple risks. Check out the IISG website to learn more about how we can help you protect the water that you care about.

A man-made wetland outside of Waco, Texas could be the key to uncovering natural ways to prevent pharmaceuticals from entering the rivers and lakes near wastewater treatment plants. The planned 12-acre wetland is part of a 5-year project designed to give researchers a closer look at whether aquatic plants and micro-organisms common in wetlands can safely break down pharmaceutical chemicals that survive the wastewater treatment process. The results of the study could help communities across the country improve water quality without the high cost of additional wastewater treatment equipment.

The wetland will serve as an outdoor laboratory for researchers at Baylor University. Treated water from the Waco Metropolitan Area Regional Sewer System–with small concentrations of pharmaceuticals added to it–will be funneled into the contained area and allowed to filter through it for several days. After researchers have tested for remaining pharmaceutical compounds, the water will be sent back to the treatment plant and then released into the Brazos River.

The project is backed by the U.S. Geological Service and the Bureau of Reclamation, a branch of the Department of the Interior. Construction of the wetland is slated to begin later this year, as soon as federal officials have secured the $1.5 million needed for the project.

Wetlands like the one planned for Waco are already being used by some communities as an efficient and cost-saving method for removing pharmaceuticals and other pollutants from wastewater effluent. In Minoa, a village in western New York, small wetlands near the treatment plant have been shown to remove up to 60 percent of ibuprofen from the village's wastewater before it is discharged into a nearby stream.

Click here to learn more about the Waco project. And, for a behind-the-scenes look at research into how pharmaceuticals breakdown during the wastewater treatment process, read UpClose with Timothy Strathmann.

While sewage treatment lagoons are typically infective at removing nutrients, a new study indicates that they do a fairly good job of removing many (though not all) pharmaceuticals--at least when temperatures are warm. Why is this important? Because in the United States, many rural communities use these lagoons to treat their wastewater rather than the more expensive three-stage sewage treatment plants found in many larger municipalities. Since the water treated by these lagoons is released directly into nearby rivers, we need to understand how effective they are at removing pharmaceuticals and personal care products (PPCPs).

The researchers found that the lagoons were less able to remove pharmaceuticals in November than in September. They suggested that the colder temperatures may have reduced the activity of microorganisms responsible for breaking down the chemicals. Despite being effective in removing some pharmaceuticals, the authors point out that their results indicate that the discharge from the lagoons may increase the occurrence and concentration of PPCPs in surrounding waterways, which could impact the local aquatic environment.

Read more about the article here. Or check out the Illinois Sustainable Technology Center for more information on research in this area.

The study can be accessed at:
Xiaolin, L., W. Zheng, and W. R. Kelly. 2013. Occurrence and removal of pharmaceutical and hormone contaminants in rural wastewater treatment lagoons. Science of the Total Environment 445-446:22-28.

Last month, Baylee Ritter and two other students from Pontiac Township High School traveled to Nairobi, Kenya for the United Nations Environment Programme (UNEP) Tunza International Youth Conference. The main theme of the conference was the links between human health and environmental degradation. The Pontiac High School students presented the P2D2 Program and Operation Endangered Species project, both of which are highlighted models in the Geo 5 for Youth at this year's conference. They were part of a delegate of 250 youth from over 100 countries who went to the conference to showcase ways that young people can work together to tackle today's most pressing environmental issues.

At the conference, UNEP experts held workshops, panel discussions and other events with young people to present the latest science on health impacts of environmental degradation. Other sessions covered water, sustainable consumption, green entrepreneurship, and new international targets that are set to succeed the Millennium Development Goals from 2015.

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

The Drug Enforcement Administration (DEA) has announced that it will once again partner with local police departments and pharmacies on April 27 to collect and safely dispose of unused pharmaceuticals. The event will be the sixth National Take-Back Day in two years, but it is unclear if there will be a seventh as the federal government continues to take steps to return collection responsibilities to local officials and private organizations.

In December 2012, the DEA proposed regulations that would remove some of the legal barriers that make it more difficult for communities to implement local pharmaceutical collection programs. If approved, the new regulations would allow authorized manufacturers, distributors, and retail pharmacies to set up collection boxes at their facilities or launch a mail-back program. The proposal is still several stages away from being law–the public comment period ended on Feb. 19, 2013–but the DEA has indicated that if the regulations are approved it will end its national events in favor of more localized programs.

Communities throughout the country began implementing permanent collection programs even before the DEA introduced National Take-Back Days. And these efforts continue as more and more launch their own programs. Permanent collection boxes are now available in nearly every state, although the number, coverage area, and accepted medicines vary quite a bit across states. Some programs are run as state, county, or municipal programs, while others are headed by private organizations. For example, pharmacies in Kansas accept uncontrolled medicines, vitamins, and pet medications year-round. In Utah, though, residents can take all unwanted medications to regularly scheduled state-wide take back events and to permanent collection boxes in local police and sheriff departments throughout the state.

In the Great Lakes region, organizations like the National Prescription Pill and Drug Disposal Program (P2D2) and the Yellow Jug Old Drugs Program continue to help communities set up collection programs that residents can use year-round. To learn what programs are operating in your area, visit web.extension.illinois.edu/unusedmeds/disposal/.

The DEA's sixth National Take-Back Day will run from 10:00am to 2:00pm on April 27, 2013. For more information, visit www.deadiversion.usdoj.gov/drug_disposal/takeback. Details on specific collection locations will be available starting April 1 at the same website.

Written by: Anjanette Riley, IISG Science Writer

Half-way through a controversial pharmaceutical disposal pilot program, officials in San Francisco have dubbed the effort a success. But the future of take-back programs in the city is much less clear.

When it was launched in April of 2012, the program served as a compromise between lawmakers trying to push through legislation that would require drug manufactures to fund and operate a permanent program and the opposition who ultimately defeated the bill. Since then, more than 10,000 pounds of pharmaceuticals have been collected for disposal by the 13 pharmacies and 10 police stations participating in the program.

To fund the pilot, drug companies gave a one-time financial contribution totaling $110,000. That money is set to run out when the program sunsets in June. And it is unclear whether the city will be able to collect enough money to keep the program going, and where that money would come from.

Part of the uncertainty stems from a legal battle being fought to the south of the city in Alameda County. After it became the first legal body to pass a law requiring drug manufacturers to pay for take-back programs in 2012, the county was sued by several organizations representing drug companies. If the court finds in their favor, programs like the one required in Alameda County and proposed in San Francisco would be unconstitutional.

This latest pilot program is one in a series of initiatives San Francisco has passed since 1990 in an attempt to prevent pharmaceutical contaminants from entering the soil and groundwater. An early program that allowed residents to drop-off pharmaceuticals at facilities operated by a trash hauling company was also cut short over legal concerns. Two others ended when the costs proved too much for the city to take on long-term.

For more information on San Francisco's pilot program, read this article.

Written by: Anjanette Riley, IISG Science Writer

A new study shows that medicine designed to help humans suffering from anxiety disorders and insomnia also changes the behavior of wild perch, but outcomes for the fish appear to be far less positive. For them, exposure to the generic drug Oxazepam causes hyperactivity, increased appetites, and anti-social behavior. Taken together, these new behaviors put perch in greater danger of being eaten by predators that can more easily hunt lone fish that chose to forgo the safety of a school.

Swedish researchers discovered changes in the behavior of wild European perch after exposing them to different concentrations of the medicine over a period of seven days. At the lowest concentration–three times higher than what has been reported in surface waters in both the U.S. and Europe–the fish moved more, ate more aggressively, and ventured alone into unfamiliar places. And the effects were even more noticeable at concentrations up to 1,500 times higher than existing levels.

Behaviors like these that change a species' ability to catch food or avoid being eating can also have long-term consequences for other organisms living in the same habitat. In the case of the perch, aggressive feeding could cause a dip in the population of zooplankton, a staple of their diet. Because zooplankton feed on algae and keep it from blanketing lakes and rivers, hungrier perch could mean less oxygen and sunlight for other aquatic life.

In addition, researchers found that Oxazepam builds up in the perch. Fish living in the Fyris River in central Sweden had more than six times the natural concentrations in their muscle tissue when they were tested at the start of the study. It is unclear what impact this has on predators that feed on the perch.

It is also unclear what these results mean for fish living in waters with lower concentrations of Oxazepam, but for longer periods of time than the study's seven days. These results, though, join a growing number of studies that suggest that pharmaceuticals in waterways can affect the biology and behaviors of aquatic animals.

Brodin, T., Flick, J., Jonsson, M., and Klaminder, J. Dilute concentrations of a psychiatric drug alter behavior of fish from natural populations. Science. Vol. 339 no. 6121. DOI: 10.1126/science.1226850. Publication date: 15 February 2013.

Written by: Anjanette Riley, IISG Science Writer

From the Journal Sentinel:

In a monumental pushback against America's narcotic painkiller epidemic, a U.S. Food and Drug Administration advisory panel recommended Friday that stricter controls be placed on popular narcotic painkillers such as Vicodin.

The 19-10 vote will be used by the FDA to decide if drugs containing the opioid hydrocodone should have the same restrictions as morphine and OxyContin, which contains oxycodone.

Ever since coming on the market 40 years ago, hydrocodone drugs have had fewer restrictions. However, as overdose deaths and addiction rates soared over the past decade, hydrocodone as been at the center of a fight to reform the use of opioids and deal with America's epidemic of painkiller abuse.

The vote recommends that hydrocodone products be moved from the more relaxed controls of Schedule III to Schedule II under the Controlled Substances Act.

Read the full article at: http://www.jsonline.com/features/health/fda-panel-votes-to-place-tighter-controls-on-narcotics-like-vicodin-k28h6hl-188396901.html

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

On December 20, the Drug Enforcement Administration (DEA) released proposed regulations that would make it easier for people to responsibly dispose of their expired or unwanted medications. The public comment period is open until February 19, 2013.

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.

The country's first law requiring that pharmaceutical producers pay for medicine take-back programs may be repealed before ever taking effect if a lawsuit filed last week is successful. The Alameda County Safe Medication Disposal Ordinance passed in July of this year would require drug companies to submit plans for the collection, transportation, and disposal of unused or expired medications from residential sources in Alameda County, California by July 2013.

Drugmakers, though, say the law violates the Commerce Clause by shifting the costs of a local program directly onto interstate commerce and out-of-county consumers.The Pharmaceutical Research and Manufacturers of America (PhRMA), which represents brand-name drug companies, the Generic Pharmaceutical Association, and the Biotechnology Industry Organization joined together to file a lawsuit on Friday, hoping to have the law struck down.

Read more about it in The New York Times.

On September 29, the Drug Enforcement Administration (DEA) sponsored the 5th National Prescription Drug Take-Back Day. State, local, and tribal law enforcement partners worked at more than 5,260 locations around the country and collected 488,395 pounds (244 tons) of prescription and over-the-counter medications. In Illinois residents brought in over 21,000 pounds of unwanted medicines for proper disposal and Indiana followed closely with 18,560 pounds collected. In total, the five DEA Take-Back events have collected more than 2 million pounds (1,018 tons) of unwanted medicine.

Shortly after DEA's first Take-Back Day event two years ago, Congress passed the Secure and Responsible Drug Disposal Act of 2010, which amended the Controlled Substances Act (CSA). This allowed the DEA the authority to develop new regulations regarding permanent, ongoing and responsible methods for medicine disposal. For two years the DEA has been in the process of drafting regulations that would make medicine collection easier for communities, but no funding for collection programs was established, and the new regulations have yet to be released.

The DEA has stated that they will continue to hold the Take-Back Days until they issue the new regulations. After that, it will fall again solely to communities to support collection efforts. Fortunately in the Great Lakes states, much work has been done to set up permanent medicine collection programs that residents can access year-round. Examples include the National Prescription Pill and Drug Disposal Program (P2D2) and the Yellow Jug Old Drugs Program. And many communities and counties have set up similar programs for their residents.

Click here to see if your community offers a program. If not, contact IISG to see how a new program might be established in your hometown.

Earlier this month, several Sea Grant programs were recognized for their outstanding work and collaboration on informing people about the dangers of unwanted medicines.

Undo the Great Lakes Chemical Brew: Proper PPCP Disposal was funded by a Great Lakes Restoration Initiative (GLRI) grant from the U.S. EPA. By combining outreach and educational efforts, the project helps Great Lakes basin residents understand the correct use and proper disposal of unwanted medications and personal care products.

The project was awarded the 2012 Great Lakes Outstanding Outreach Programming Award, which is presented by the Great Lakes Sea Grant Network to recognize multi-program initiatives that have helped solve a problem of major importance in the Great Lakes basin. It recognizes exceptional leadership, teamwork, and accomplishments by Great Lakes Sea Grant personnel, and is the highest award the Great Lakes Sea Grant Network bestows.

Sea Grant staff provided research-based information to policy makers addressing this issue, as well as assistance in hosting community medicine collection events. Working together, the Undo the Chemical Brew team has collected almost 2.7 million pills and informed over 1,075,000 anglers, educators, students, 4-H youth, medical professionals, and community members.

Congratulations to these Undo the Chemical Brew team members who made this successful program possible:

Pennsylvania Sea Grant

Marti Martz (principal investigator), Coastal Outreach Specialist

Anna McCartney, Communications and Education Specialist

Illinois-Indiana Sea Grant

Robin Goettel, Associate Director for Education

Terri Hallesy, Education Specialist

Laura Kammin, Pollution Prevention Program Specialist

New York Sea Grant

Helen Domske, Senior Extension Specialist, NY Sea Grant; Associate Director, Great Lakes Program

Ohio Sea Grant

David Kelch, Associate Professor and Extension Specialist (retired)

Frank Lichtkoppler, Sea Grant and Extension Specialist

Unwanted medication that comes from households is not regulated as hazardous waste under the Resource Conservation and Recovery Act (RCRA). The exemption from RCRA applies even when the medications are collected at a single-day take-back event, such as the recent DEA sponsored event, or at a permanent medicine collection program. However, the collected medications still need to be disposed of responsibly.
The U.S. EPA has historically recommended that pharmaceuticals collected from households should be incinerated as hazardous waste. Their recently released recommendations reaffirm the EPA's position that collected medication be incinerated to address both environmental and diversion concerns.
EPA recommends that take-back events/programs destroy the medications at a:

• RCRA-permitted hazardous waste incinerator
• RCRA-permitted cement kiln

When using a RCRA-permitted facility is not feasible, they recommend incineration at a:

• Large municipal waste combustor
• Small municipal waste combustor

They do not recommend the following types of incineration:

• Other Solid Waste Incinerators (OSWI). Medicine collected at take-back events/programs are not considered by the U.S. EPA to be "contraband or prohibited goods" and so no exclusion from OSWI regulations applies.
• Crematoriums. These units are not regulated under Clean Air Act regulations and are not recommended.

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

Thousands of residents in Illinois and Indiana came out last Saturday with the goal of ridding their homes of unwanted pharmaceuticals as part of the Drug Enforcement Administration's (DEA) 5^th annual National Prescription Drug Take-Back Day. From 10 a.m. to 2 p.m. police officers and volunteers in more than 200 locations in Illinois and 70 in Indiana collected bottles, boxes, and sometimes even garbage bags full of prescription and over-the-counter human and veterinary medications. Everything collected will be properly incinerated by the DEA.

IISG staffers were at two of these locations at Walgreens stores in Champaign and Urbana, joining local police officers and Walgreens representatives to collect medication, answer questions the about the environmental effects of throwing away or flushing pharmaceuticals, and provide information on how to safely dispose of medications when collection events are not available.

At both locations, people began lining up to hand over their medicine even before the event began. IISG volunteers at both locations heard from several people that they had been saving medications in anticipation of Saturday's event. Take-back event regulars brought medications accumulated just since April's DEA-sponsored event, but some brought pharmaceuticals with much older time stamps. One woman disposed of medicine she had been storing in her cabinet since 2005, and another brought in medication that was almost 20 years old. Exact figures on how many pounds of pharmaceuticals were collected during the 4-hour event won't be announced by the DEA for several weeks, but police officers involved in the event described the day as on track to exceed previous take-back days.

(Guest post by Anjanette Riley, IISG Science Writer)

If you use an antibacterial soap or bodywash it probably contains triclosan. Lots of products these days contain the antibacterial chemical. It is found in toothpastes, cosmetics, clothing, kitchenware, carpeting, furniture and even toys. Such widespread use of triclosan is attracting the attention of a growing number of researchers. In fact, the Food and Drug Administration is currently conducting an ongoing scientific and regulatory review of this ingredient. And recently published research in the Proceedings of the National Academy of Sciences of the United States of America is raising more questions about the effects of our ubiquitous use of triclosan.

"Triclosan is found in virtually everyone's home and is pervasive in the environment," said Isaac Pessah, professor and chair of the Department of Molecular Biosciences in the UC Davis School of Veterinary Medicine and principal investigator of the study. "These findings provide strong evidence that the chemical is of concern to both human and environmental health."

The investigators performed several experiments to evaluate the effects of triclosan on muscle activity, using doses similar to those that people and animals may be exposed to during everyday life.

The researchers found that triclosan:

...hinders muscle contractions at a cellular level, slows swimming in fish and reduces muscular strength in mice... The UC Davis research team has previously linked triclosan to other potentially harmful health effects, including disruption of reproductive hormone activity and of cell signaling in the brain.

Read more about the study here.

Each fall Marsh Pharmacies and their partners provide Indiana communities a safe and environmentally responsible way to dispose of expired and unused medications. This year is no exception.

Do you have old and leftover medicine? Not sure what to do with it? Don't flush it down the toilet or sink. Marsh Pharmacy along with its partners at the Indiana Department of Environmental Management, the Indiana Poison Center, Inmar, Rexam, IU Health and Indiana Association for Home & Hospice Care know that our groundwater, lakes and streams need to be protected as well as our homes from accidental poisonings.

Marsh Pharmacies will be collecting and qualifying unwanted medications for FREE disposal.

Friday, September 21st, 9am – 7pm
Saturday, September 22nd, 9am – 5pm
Sunday, September 23rd, 11am – 5pm
Monday, September 24th, 9am – 7pm

at all Marsh Pharmacy locations

What kinds of medicine can I bring?

• Pills, capsules and liquids (no aerosols, inhalers, Nitroglycerin or alcohol containing products).
• Medicine must be in original container with original label intact.
• Medicines that have the words ''toxic'', ''corrosive", ''reactive'', ''ignitable'', ''flammable'' or ''poison'' will not be accepted.
• Only one type of medication can be in a single container, no mixtures.
• No pill organizers will be accepted.
• No controlled or illegal substances (check with your regular pharmacist if you're not sure whether a medicine is controlled).

This program is for individuals only. Nothing will be accepted from health centers, clinics, doctor's offices or other organizations. Pharmacist's decision to accept or reject any medication or container is final.

For more information, call 317-594-2408.

Medications that cannot be returned at the Marsh Pharmacies collection event can be accepted at the National Prescription Drug Take-Back event on Saturday, September 29th. Click here to find the location nearest you.

The Drug Enforcement Administration (DEA) will host another nationwide medicine take-back on Saturday, September 29th. This will be the fifth collection event the DEA has sponsored since fall of 2010. More than 1.5 million pounds (774 tons) of medication were collected nationwide during previous events.

For this fall's take-back event, residents will be able to drop-off unwanted pharmaceuticals at more than 200 locations in Illinois and 70 in Indiana. Check out the DEA's website to find an event in your community. Law enforcement agencies interested in operating one or more collection sites on September 29th can still register with the DEA.

Expired and unused medications can be dropped off from 10 a.m. to 2 p.m. at participating locations. The service is free and anonymous. Items accepted include prescription and over-the-counter medicines, both human and veterinary medications. Sharps/needles, thermometers, and medical waste will not be accepted. Medications should be from residential sources only; no business waste will be accepted. All materials collected will be properly incinerated by the DEA.

In Central Illinois, Walgreens 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 here or on the DEA's website, call your local police department to ask if they are participating. Not all of the communities that will be participating in the event are listed yet on the DEA website.

Flushing medications down the toilet or throwing them in the trash can threaten the safety and health of humans, pets and the environment. Recent studies have found a wide-range of pharmaceutical chemicals in rivers, groundwater and drinking water throughout the United States. These chemicals can kill bacteria needed to break down waste in sewage plants and harm fish and other wildlife. Storing unneeded medicines in the home is also the cause of thousands of accidental poisonings in children and pets each year.

Pharmaceutical stewardship is based on proper use, storage and disposal of medications. Single-day medicine take-back events like this one are a great way to prevent accidental poisonings, reduce drug abuse and diversion and limit negative impacts to wildlife and local waterways. So if you've been looking for a place to dispose of your expired or unused medications, be sure not to miss the take-back event on September 29th.

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).

Seventh-grade teacher Kimiko Pettis participated in this year's Windy City Earth Force project in partnership with Illinois-Indiana Sea Grant and the Calumet Environmental Education Program at The Field Museum, where she learned about the GLRI-funded Stewardship Project Contest (PDF). Ms. Pettis was selected as one of three award-winning teachers, and her students at Thomas Hoyne Elementary in Chicago helped educate their local community about the importance of properly using and disposing of pharmaceuticals and personal care products (PPCP).

The class' first step was to research the subject of PPCPs, how to dispose of them, and what effects they can have if they're allowed into the water. The class invited IISG staffers and representatives from the Peggy Notebaert Nature Museum to provide hands-on activities teaching them about water quality. They also requested educational resources and feedback on this issue from Karol Media, and used the Great Lakes Sea Grant Network publication "It's what you can't see..." (PDF) to learn more about PPCPs.

Then they put what they had learned into action by making posters and flyers that they posted in local churches, businesses, and shops. They also conducted a school-wide survey about water quality to find out what their fellow students knew about the issues, and wrote letters to legislators and environmental agencies detailing what they had learned about threats to water safety.

At the end, the students produced a great video skit to share with their fellow students at the school, and they participated in the Ford Environmental Leadership Summit at the Field Museum on May 8, 2012, where they were able to display the posters and flyers they had made and engage with the attendees to talk about proper disposal of PPCPs.

Ms. Pettis and two teachers in Pennsylvania will each receive a $100 gift certificate to use for education resources as an award for their excellence in fostering student engagement and stewardship.
The contest, sponsored by Sea Grant Programs in Pennsylvania, Illinois-Indiana, and New York will continue throughout the 2012-13 school year, and complete details are included in the PDF linked above.

The Illinois EPA will conduct a free, one-day household hazardous waste (HHW) collection in Champaign-Urbana on Saturday, September 29, from 8 a.m. to 3 p.m. If you have been accumulating unwanted medicine, paint, florescent light bulbs, batteries or other HHW, you can drop it off at the News-Gazette Distribution Center on Apollo Drive in Champaign on September 29th.

List of accepted items:
Old medicines and pharmaceuticals
Oil-based paint (Latex paint not accepted; see below)
Household batteries
Paint thinner
Used motor oil
Herbicides
Drain cleaners
Insecticides
Lawn chemicals
Pesticides
Solvents
Old gasoline
Antifreeze
Pool chemicals
Hobby chemicals
Cleaning products
Aerosol paint
Mercury-containing devices
Fluorescent lamp bulbs
Double-bagged & wetted asbestos
Propane tanks
Lead acid batteries

Latex-based paint will not be accepted at the collection event. Call the recycling coordinator at (217) 384-2302 for latex paint disposal options, or visit the Illinois EPA at http://www.epa.state.il.us./land/hazardous-waste/household-haz-waste/used-paint-disposal-alternatives.html for recommendations on how to use remaining latex-based paint.

Urbana Recycling Coordinator, Courtney Rushforth, says, "I am very happy that our community was selected for a household hazardous waste collection event this year. There has not been a hazardous waste collection event in the Champaign-Urbana area since 2006, and a large response is anticipated. Residents are encouraged to carpool and combine loads, use alternative modes of transportation, and be prepared for wait times."

The event is sponsored by the Illinois EPA. Co-sponsors include City of Urbana, City of Champaign, Village of Savoy, Champaign County, Champaign County Probation and Court Services, Champaign County Regional Planning Commission, Prairie Rivers Network, Sierra Club Prairie Group and MTD. The News-Gazette will host the event. Hick's Gas and Interstate Batteries are local onsite vendors, and will be present to collect propane tanks and lead acid batteries respectively.

For more information about this event visit www.ccrpc.org or contact:
Courtney Rushforth
Recycling Coordinator, City of Urbana
Phone: (217) 384-2302
Fax: (217) 384-2400
E-mail: crrushforth@urbanaillinois.us

By now, most people have heard about pharmaceuticals and personal care products (PPCPs) finding their way into the environment and into our drinking water supplies. With over 4,000 pharmaceuticals currently in use, and a myriad of chemicals used to make personal care products, it's no wonder that scientists haven't yet figured out how all these chemicals might react with one another or what the long-term effects on people might be. But they are diligently working on it.

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.

On June 7th and 8th, a diverse group of people met in Chicago to discuss how to better manage pharmaceutical waste. Representatives from the Sea Grant Programs in Illinois-Indiana, Oregon and Pennsylvania attended to share their knowledge and to build new partnerships. The summit was hosted by the University of Wisconsin-Extension and the Product Stewardship Institute. Presentations from the summit are available.

One of the major hurdles to hosting successful medicine take-back programs is the lack of sustainable funding. Pennsylvania recently introduced HB 2466 which seeks to address that hurdle. If the bill passes, come January 1, 2014, any pharmaceutical manufacturers that wish to sell their product in Pennsylvania must operate or participate in an approved pharmaceutical take-back program. This would include providing at least one collection site in each county and in every municipality with a population over 50,000 as well as providing mail-back envelopes at the collection sites and participating pharmacies. In addition to the collection sites, the bill would provide funding for an education and outreach program that would assist people in using the take-back programs. This is one to watch.

Now you can check out the How to Dispose of Unwanted Medicine and Personal Care Products website on your phone:
http://m.extension.illinois.edu/unusedmeds/

P2D2 students are not just spreading the word about proper medicine disposal in the United States. Their message has now gone global. P2D2 students recently returned from Gothenburg, Sweden where they competed in the Volvo Adventure Award competition. Despite the stiff competition, the P2D2 brought home the third prize, a $4,000 check and international recognition of their work.

Students from 45 countries submitted projects to the Volvo Adventure competition this year. Twelve were selected to travel to Sweden to compete in June. The P2D2 students had the opportunity to meet students from Brazil, Paraguay, UK, China, Croatia, Egypt, Fiji, Russia, Tanzania, Turkey and Macedonia. Students from Paraguay and Brazil took first and second place, respectively.

The Prescription Pill and Drug Disposal (P2D2) Program is a collaborative effort between communities, local pharmacies, police departments, hospitals, city officials, students and more. The purpose of the program is to educate the public about the harm done to the environment as well as the misuse and abuse of pharmaceuticals due to the current prescription and non-prescription drug disposal practices worldwide. The mission of the program is to provide communities with a proper method of pharmaceutical disposal that effectively reduces the misuse and abuse of pharmaceuticals and ensures the quality of water and wildlife for future generations.

The purpose of Volvo Adventure is to increase environmental awareness among young people worldwide and encourage them to develop projects that will make a positive difference in the environment in which they live.

Illinois EPA announces 2012 household hazardous waste collection schedule

The Illinois EPA announced that six household hazardous waste collection events will be held in central and southern Illinois in 2012. The events will be held from 8 a.m. to 3 p.m. at the following locations and will accept unwanted pharmaceuticals:

Carbondale on June 2

Quincy on June 23

Peoria on September 8

Swansea on September 15

Springfield on September 22

Champaign-Urbana on September 29

In addition to the six downstate single-day events, the Illinois EPA continues to support long-term HHW facilities in Naperville, Rockford, Chicago and Lake County. The program, which began in 1989, has served nearly 417,000 households. Since the program's inception, 465 one-day events have been held and over 81,000 fifty-five gallon drums of toxic materials have been collected from Illinois citizens. The collections give citizens the opportunity to safely dispose of unused or leftover household products commonly found in their homes, basements and garages. The materials are handled in an environmentally sound manner, diverting them from local area landfills.

Paints, thinners, chemical cleaners, unwanted pharmaceuticals, mercury and mercury-containing items, antifreeze, motor oil, gasoline, kerosene, weed killers, insecticides, pesticides, adhesives, hobby chemicals, household batteries and similar products will be accepted. Fluorescent and other high-intensity discharge lamps may also be brought to the collections. Medical waste, sharps and controlled substances will not be accepted. As of January 1, 2012, unwanted electronics must be recycled, so no electronics or related devices will be accepted.

In April 2012, Rep. Michelle Mussman introduced HB 6155. This bill would amend the Safe Pharmaceutical Disposal Act by allowing any licensed pharmacy in Illinois to display a locked and secure container suitable for use as a collection receptacle for expired or unwanted medicines. The Department of Financial and Professional Regulation would be required to adopt rules to facilitate the receipt of medication and prescription drugs under these provisions. If passed, the bill would go into effect on July 1, 2013. It is currently assigned to the Rules Committee.

The student developed National "P2D2" Pharmaceutical Disposal Program will soon head to Sweden to compete in the Volvo Adventure Award competition--an international environmental problem-solving program created by Volvo Car Corporation in partnership with the United Nations. Students from Pontiac Township High School in Pontiac, Illinois, and Reedsburg Area High School in Reedsburg, Wisconsin, will represent the United States in Sweden this June.

Students aged 13 to 16 years must plan and execute environmental protection efforts in their local community, with one team from each participating country awarded an all-expenses-paid trip to Sweden to present their project. The team members will depart for Göteborg, Sweden in June for a six day adventure to present their project, "The National Prescription Pill and Drug Disposal Program (P2D2)," to a panel of environmental judges, including representatives from the United Nations Environmental Program, World Wildlife Fund, World Scouting Organization, UNESCO, Volvo Car Corporation, and AB Volvo.

The P2D2 Program was chosen as one of 11 teams from over 240 teams from 45 countries. The judges will award the top three teams with prizes of $10,000, $6,000 and $4,000 respectively. The P2D2 Team will be accompanied by program P2D2 Program director Paul Ritter and Wisconsin P2D2 Program director Krystal Schara.

The Prescription Pill and Drug Disposal program was created in 2007 as a collaborative effort between adult mentors, students, police departments, municipalities, civic groups, lawmakers, volunteers, and pharmacies that now spans across the country into over 18 states. P2D2's goal is to educate the world about the environmental harm done when consumers improperly dispose of prescription and over-the-counter (OTC) drugs. The mission of the program is to provide communities with a proper method of pharmaceutical disposal that effectively reduces the misuse and abuse of pharmaceuticals, as well as, ensures the quality of our water and wildlife for future generations.

Volvo Adventure is a global environmental competition for young people, aged 10 to 16. The purpose of Volvo Adventure is to increase environmental awareness among young people worldwide, as well as encourage young people to take on practical projects that will demonstrate they can make a difference to the environment in which they live. Volvo Adventure is a joint project between AB Volvo and Volvo Cars. More information about Volvo Adventure is available at www.volvoadventure.org. Information about P2D2 can be found at www.p2d2program.org

The DEA announced yesterday that the April 28th nationwide medicine take-back collected 552,161 pounds (276 tons) of unwanted  medications for safe and proper disposal. In all, 5,659 take-back sites participated in the event. The four DEA take-back events that have been held since fall of 2010 have collected over 1.5 million pounds (774 tons) of medication.

Antibiotics have been documented in the environment and concerns about antibiotic resistance are growing. But there are still many questions. Researchers at the University of Wisconsin Parkside hope to answer some of those questions as they try to better understand how antibiotics react with soil microbes. Does clay provide a platform for antibiotics to alter microbial life? Or could clay help neutralize the antibiotics? To learn more about what the researchers have found, read Tracking Antibiotics in Soil in the latest issue of University of Wisconsin's Aquatic Sciences Chronicle. 

On April 19, 2012, Mary Perkins received the Youth Service Governor's Volunteer Service Award. The award recognizes individual volunteers for their community service in the State of Illinois.

Mary is a junior at Effingham High School, and has been involved in 4-H for nine years. Along with John Loy, Effingham County Chief Deputy, Michelle Loy, Effingham County 4-H Ambassador's leader, and fellow 4-H Ambassadors, Mary started the P2D2 program for the Effingham community. P2D2 stands for Prescription Pill and Drug Disposal, which is a national program that properly disposes of expired and unwanted pharmaceuticals. The P2D2 program helps prevent medications from being used inappropriately within households and also from harming the environment. Mary has volunteered numerous hours to start and sustain the P2D2 program in Effingham County.

Congratulations Mary!

Don't forget to dispose of your unwanted medicines at the DEA's next take-back event to be held tomorrow from 10a.m. to 2p.m.

What do irritability, shyness, tremors, changes in vision or hearing, memory problems, depression, and numbness and tingling all have in common? They are all signs of mercury poisoning. If you have been using personal care products that work as skin lighteners or anti-aging treatments, you should check the product label. The U.S. Food and Drug Administration reports that skin creams, beauty and antiseptic soaps, and lotions that contain mercury are being sold illegally in the United State. They are urging people to stop using the products immediately.

The U.S. Food and Drug Administration issued a consumer advisory on Wednesday, reminding people to properly store, use, apply, and dispose of fentanyl patches. Young children, particularly those under two years of age, can be seriously harmed or killed if they come into contact with the patches, even ones that have already been used.

The upcoming DEA Drug Take-Back on April 28th would be a good way to get unneeded fentanyl patches out of the house. The FDA's advisory serves as an important reminder that all medications, both human and veterinary, should be properly used, stored, and disposed of to prevent harm to people, animals, and the environment.

Check out the FDA's video "Lock It Up: Medicine Safety in Your Home".

It's that time of year again...get ready to clean out your medicine cabinet. The Drug Enforcement Administration (DEA) will host another nationwide medicine take-back on Saturday, April 28th. You can drop off your expired or unwanted medications from 10 a.m. to 2 p.m. at the nearest collection location.

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.

The U.S. Food and Drug Administration (FDA) has announced new guidance regarding the use of antibiotics in livestock. The FDA recommends that farmers and ranchers phase out the use of antibiotics to promote growth; using antibiotics instead to prevent or treat disease.

The FDA is asking drug companies to voluntarily revise their product labels to focus on disease prevention and treatment rather than promoting faster weight gain or improving feed efficiency. They are also asking for increased veterinary oversight or consultation. Currently, many antimicrobial drugs approved for use in livestock feed or water are available over-the-counter. Requiring veterinary prescriptions could reduce the amount of antibiotics being fed to food-producing animals. The FDA has invited public comment on these recommendations. They are also inviting public comment on Veterinary Feed Directive regulation that outlines ways that veterinarians can authorize the use of antibiotics in animal feed.

In 1977, the FDA concluded that it was unsafe to give antibiotics to food-producing animals for non-medical reasons (i.e., to promote growth and to prevent disease in animals housed in overcrowded, unsanitary conditions). They warned that these practices could promote the development of antibiotic-resistant bacteria and announced plans to withdraw approval of some antibiotics used in livestock feed. However, approval for using antibiotics for these purposes was never withdrawn.

Since then, medical evidence has shown that treating livestock with antibiotics increases risks to human health. Using antibiotics for reasons other than treating disease continuously exposes bacteria to low doses of drugs, providing an ideal environment for them to develop antibiotic-resistance. The concern is that formerly useful drugs will become ineffective against resistance microbes, negatively affecting the health and safety of both people and animals.

In March 2012, a judge ruled that the FDA must take action by withdrawing approval for most non-therapeutic uses of antibiotics in animal feed, unless industry can prove in public hearings that those drug uses are safe.
The FDA's April 11^th announcement has been met with mixed reactions.

Covanta Energy Corporation recently announced the indefinite continuation of their Prescription for Safety Program (Rx4Safety) which provides safe disposal of medications collected at community drug take-back programs. Covanta has been providing communities with free disposal of pharmaceuticals since 2010. Click here to learn more about their program.

The Solid Waste Agency of Lake County (SWALCO) is hosting a Household Chemical Waste Event on Monday, March 26, 2012 1311 N. Estes Street Gurnee, IL 60031

APPOINTMENTS ARE REQUIRED for this Household Chemical Waste Event. This collection is for residential waste only. No business waste will be accepted. All SWALCO HCW Collection Events are FREE for Illinois residents ONLY. The next collections will be on Saturday, April 14, 2012 and Monday, April 23, 2012. Items you can bring to a collection include: CFL bulbs, unwanted prescription and over-the-counter medicines and supplements (people and pet), household cleaners, gasoline, garden chemicals, pesticides, oil-based paints (no latex) and varnishes, as well as other household chemicals.For a more detailed list visit SWALCO's HCW Website www.swalco.org

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.

What can teachers and students do to help prevent pharmaceuticals and personal care products (PPCPs) from getting into our rivers, lakes, and drinking water? There are lots of ways to get involved. Sea Grant has developed curricula and service-learning projects to get teachers and teens excited about raising community awareness. What is your class doing about PPCPs in the environment? Let us know and your class could win $100 and your project will be featured on this website!