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RE: Pharmaceuticals

Let's start with why these drugs are becoming surplus:
1. Could be due to improper storage.  Are they being held in a dry, cool, and dark area? Are they kept in their sealed containers until needed?
2. Are they being purchased in bulk to get a good price break rather than being purchased according to need?
3. Are doctors too quick to jump on the band wagon for every new drug that comes out rather than using up existing stock?  This reminds me of the "free" sample effect.  You get a gallon of new cleaner for free, use a little bit to find out that it doesn't work, and then spend big $$ to get rid of it as waste.
4. Are they using first in, first out storage to make sure that drug stocks are not being pushed to the back of the cabinet and forgotten until they expire.
Other thoughts:
1. Can the expired drugs be extended for use?  Most drugs remain active for a long time provided they are stored properly.  The resale of expired drugs is likely to be very difficult given FDA regulations but donation for free might be possible.  One approach might be the application of Good Samaritan laws that protect people who donate food.  People didn't want to donate surplus food to shelters under the fear of lawsuit should someone get sick.  The law is designed to protect donors provided they follow some common sense measures to maintain food safety.
2. Can the hospice arrange with one or more pharmacy's a just-in-time delivery system?  This would eliminate or reduce the need for on-site storage.
3. Certain surplus drugs should be segregated and managed as hazardous waste to keep them out of the POTW or sanitary landfill.  This would include compounds that are bioaccumulative, persistent, or toxic. 
Good luck, you've got quite a challenge.
Mike Callahan, PE
Jacobs Engineering
1111 S. Arroyo Parkway
Pasadena CA 91105
Business: (626) 568-7005
Fax: (626) 578-3550
-----Original Message-----
From: owner-p2tech@great-lakes.net [mailto:owner-p2tech@great-lakes.net]On Behalf Of Thomas Vinson-Peng
Sent: Thursday, May 13, 2004 9:07 AM
To: P2tech
Subject: Pharmaceuticals

Well, I am in my new home at the University of Texas, and am finally putting my head above the mass of administrative issues to get back to P2.
I got one of my first calls and it is a big issue. 
The caller coordinates a series of hospice operations.  He has been getting an increasing number of calls from people who want to know what to do with pharmaceuticals that are left over.    I am sure we all know this is an emerging issue. After a lot of research he came my way.  To date the best solution he has heard is to water down the chemicals, pour them over kitty litter and trash them...GASP!  Others are flushing them into the POTW system.So far H2E list serve is telling me that there isn't really a good strategy yet...so I know this crowd of creative thinkers will come up with something.   A series of local programs are attempting to address it with take back and disposal programs. They all remind me of control or remediation.  Even these programs are challenged because you are dealing with controlled substances that also pose a hazard to the environment.    
I spoke with some POTW people and they are also vexed. Not only is disposal an issue, but much of the chemical finds it's way into the toliet as urine.
Anybody got a good idea? 
I will get ahead of some of the more philosophical people and say the ultimate source reduction is not to get sick.  Barring that, what should be done with left over pharmaceuticals from home health care/hospice?
Thomas Vinson-Peng
Southwest Network for Zero Waste
University of Texas
10100 Burnet Rd.  CEER-R 7100
Austin, TX 78758
Phone: 512/232-7149
Fax: 512/471-1720

The Southwest Zero Waste Network is a proud member of the National Prevention Resource Exchange http://www.p2rx.org


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