Sensible Disposal of Unwanted Medicines - New York Sea Grant

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36Appendix D. Background InformationFrom Illinois-Indiana Sea Grant website,http://www.iisgcp.org/unwantedmeds,Chapter 1.IntroductionUnwanted medicine disposal is a rapidly emergingconcern that spans a broad range of issues includinghuman and environmental health, water quality,solid waste management, law enforcement, andthe health care industry. Substances of concern includeboth prescription and non-prescription medicines,and this category is sometimes expanded toinclude cleansing agents, cosmetics, nutritionalsupplements, and skin care products. The terms“medicine,” “medication” and “pharmaceutical”are used interchangeably throughout the documentsthat follow to refer to substances used intreating disease or illness. Another common termis PPCPs, which is an acronym for Pharmaceuticalsand Personal Care Products. There are thousandsof products that fall into this classification; all ofthese substances are specifically designed to interactwith biological processes and are widely usedaround the world. They can enter the environmentwhen people dispose of medicines via trash or toilet,or after use when they are excreted in theiroriginal or metabolized form or rinsed off the skinin the case of topical applications.The IssueMedicines are produced and prescribed in increasingvolumes every year (Figure 1). In the UnitedStates, sales of over-the-counter medicines haveincreased by 60% since the 1990s. 1 In 2006, the U.S.prescription volume rose to 3.7 billion prescriptions.2 With these increases comes concern aboutthe fate and effects of these compounds in the environment.Recent studies have identified a widerange of pharmaceutical chemicals in rivers andstreams nationwide, 3 and it has also been shownthat some of these compounds are potentiallyPercent of Persons Reporting Prescription Drug Use in the Past Month by AgeAll ages1988-19941999-2002Under18 years1988-19941999-2002One or two prescribed drugsThree or more prescribed drugs18-44years1988-19941999-200245-64years1988-19941999-200265 yearsand over1988-19941999-20020 10 20 30 40 50 60 70 80 90 100Figure 1. Prescription Drug Use. Source: National Health and Nutrition Examination Survey, 1999-2002. Center for DiseaseControl and Prevention. National Center for Health Statistics. Available at http://www.cdc.gov/nchs/nhanes.htm.1Ann Pistell, Maine Department of Environmental Protection. Presentation at Northeast Water Science Forum, August 9, 2007.2“IMS Intelligence.360: Global Pharmaceutical Perspectives 2006”, IMS Health Report, February 22, 2007.http://www.imshealth.com/ims/portal/front/articleC/0,2777,6599_40183881_81567488,00.html3Kolpin, Dana W., et al. “Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in U.S. Streams, 1999-2000: A National Reconnaissance.” Environ. Science and Technology.Vol. 36 no. 6 (2002): pp. 1202-1211.
Appendix D. Background Information 37harmful to aquatic organisms, affecting reproductionand development even at low concentrations. 4The fate of pharmaceutical chemicals in sewagesludge is also of concern, as sludge from wastewatertreatment is often applied to agriculturalland as a fertilizer. The long-term impacts of medicinedisposal on our health and the health of theenvironment are not fully known. However, unlessaction is taken, the quantity of these chemicalsreaching our waterways will continue to increaseas pharmaceutical usage increases. Thus, Illinois-Indiana Sea Grant recommends a precautionaryapproach to this issue.So what can be done? The issues surroundingmedicine disposal are complex. Improper disposalof unwanted medicines can pose a risk tochildren and pets. For example, medicines placedin the trash without taking precautions to securethe container, make the medication unpalatable,or disguise the content are often accessible to childrenand pets, sometimes resulting in unintentionalpoisonings. And medicines disposed withtheir original labels intact can result in identitytheft and drug theft. This is an especially importantissue for the elderly, who are thebiggest consumersof prescribed medicines.In early 2007, both the American Pharmacists Association5 and the Office of National Drug ControlPolicy 6 issued guidelines for medicine disposal,following on the heels of several states providingadvice to their citizens. The two main componentsof both sets of national guidelines are:1. Don’t flush medications down the toilet andinstead,2. Remove labeling from packaging and dissolvesolid medications, mix with unpalatableitems (kitty litter, coffee grounds, etc.)and seal in a bag before placing in the trash.Disposal to trash is considered by some organizationsto be an interim solution because medicinesplaced in landfills may ultimately reach wastewatertreatment plants and local streams andrivers. Illinois-Indiana Sea Grant believes thatcurrently, the best disposal solution is incinerationof medications in a regulated incinerator. There is,however, a very long list of hurdles to overcomebefore a national disposal plan can be implementedthat is protective of humans, pets and ourenvironment. These hurdles include identifyingsafe and convenient medicine collection pathwaysand determining who will pay for this service.This resource kit was created to help communitiesdesign, establish and implement safe and propercollection programs. Included in the kit are severalexamples of pamphlets, fact sheets and educationmaterials that have been developed bycommunities and states as they wrestle with thiscomplicated issue. The recommendations and advicevary because jurisdictions are finding differentways to deal with the fact that only interimsolutions are available currently.The good news about this issue is that it touchesupon so many different aspects of our lives thatthere is no end of partners to join with to educateand reach out to the public. This issue impacts theelderly through drug and identity theft issues, accidentalpoisoning, and health care costs. It mattersto the police because prescription drug abuseby teenagers is on the rise. Concerns for the safetyof children and pets also can drive behavioralchange. And for all of us, our health depends onthe health of our environment, including riversand streams and the creatures that live in them.BackgroundDisposal of Unwanted MedicinesFor many reasons, medicines are not always entirelyused and therefore remain and may eventuallyexpire in the hands of consumers or healthcare facilities. Some reasons for this include:4For example, see Nash, Jon P., et al. “Long-Term Exposure to Environmental Concentrations of the PharmaceuticalEthynylestradiol Causes Reproductive Failure in Fish.” Environmental Health Perspectives. 112.17 (2004): pp. 1725-1733.5These guidelines were issued in cooperation with the U. S. Fish and Wildlife Service and can be found online athttp://www.aphanet.org/AM/Template.cfm?Section=News_Releases1&CONTENTID=7481& TEMPLATE=/CM/ContentDisplay.cfm6Available online at http://www.ondcp.gov/news/press07/022007.html
Page 1: A curriculum developed tohelp youth
Page 4 and 5: 2AuthorsNatalie CarrollPurdue Unive
Page 6 and 7: 4> Note to the InstructorThank you
Page 8 and 9: 6So, what’s the big deal?Crop Pro
Page 10 and 11: 8So, what’s the big deal?Soil Abs
Page 12 and 13: 10So, what’s the big deal?> Instr
Page 14: 12So, what’s the big deal?• Did
Page 17 and 18: What are the issues? 15• Youth ma
Page 19 and 20: What should I be concerned about?17
Page 21 and 22: What should I be concerned about? 1
Page 23 and 24: What are my options?21General Objec
Page 25 and 26: What are my options?23ences we want
Page 27 and 28: How can I let others know about the
Page 29 and 30: Appendix B. Unwanted Medications:A
Page 31 and 32: Appendix C. Science Standards29Nati
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Page 35 and 36: Appendix C. Science Standards 33Ill
Page 37: Appendix C. Science Standards35Indi
Page 41 and 42: Appendix D. Background Information
Page 47 and 48: Appendix E. Poster and ExhibitGuide
Page 49 and 50: Appendix E. Poster and Exhibit Guid
Page 51 and 52: The Medicine ChestA collection of s

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