We had a web conference on Pharmaceutical Waste Reduction in February and a compendium of the presentations is available on our website at:
You already keyed on “preventative medicine” message. As you mentioned, a major part of the problem is medications that our bodies do not take-up are being excreted through human waste to the POTWs and in many cases on to receiving waters. For some background data on the extent to which pharmaceuticals, hormones and other organic chemicals are showing up in waterways, take a look at the 2002 USGS study that found these substances in 80% of the waterways tested. (http://toxics.usgs.gov/pubs/OFR-02-94/index.html) Going up the pipe on this issue means promoting healthy, active life styles and healthy eating habits. For links on these issues visit an archived copy of the no-longer-available EPA page “Environmental Stewardship of PPCPs: The Green Pharmacy”.
The site contains links on nutrition,
holistic medicine, and some articles by forward thinkers on how to reverse some
of the negative health trends in the
Charlotte Smith (csmith@ pharmecology.com, 262-814-2635) is the President of PharmEcology and provides environmental consultation to the healthcare industry. She presented a virtual wealth of information on our web conference and really seems to have a handle on the myriad of issues related to pharmaceutical waste.
Some other resources you can forward to the hospice folks:
The Pharmacy section of Hospitals for a Healthy Environment’s (H2E) Chemical Minimization Plan:
In the appendix of H2E’s Chemical Minimization Plan there is an in-depth prioritization of hazardous pharmaceuticals:
The issue of take back was raised – a
number of pharmaceuticals are P- and U-listed wastes under RCRA and need to be
handled accordingly. P-listed
wastes have a very low threshold (2.2 pounds/month) before a facility is
considered a large quantity generator and the waste rules that large quantity
generators must abide by are significant.
Other pharmaceuticals are hazardous by characteristic (ignitable,
reactive, corrosive, or toxic) and also need to be handled as hazardous. So, although take-back makes a lot of
sense, there are some regulatory barriers that prevent this from happen in many
cases. I believe
Northeast Waste Management Officials' Association (NEWMOA)
129 Portland Street, Sixth Floor
Boston, MA 02114
617-367-8558 ext. 306
NEWMOA is a proud member of P2Rx - a national network of regional P2 information centers.
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?
The Southwest Zero Waste Network is a proud member of the National Prevention Resource Exchange http://www.p2rx.org