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Safe Drug Disposal Act

Published (2/11/2010)
By Sue Hegarty
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Leftover pills stowed in medicine cabinets and under bathroom sinks are an accident waiting to happen and a target for thieves or experimenting teens.

But getting rid of this stash can be a problem. According to state and federal drug recommendations, most state health care facilities are required to flush medicines after a patient or resident is discharged or dies. But environmentalists fear drugs entering our sewage system are contributing to deformities in fish.

“Our wastewater treatment system is not completely breaking down those compounds,” said Rep. Paul Gardner (DFL-Shoreview), who sponsors HF1217, known as the “Minnesota Safe Drug Disposal Act of 2010.”

“We think the concept of minimizing medications in the sewer systems and in the landfills is a good and laudable goal. We just don’t want to be caught in the middle of conflicting regulations,” said Doug Beardsley, vice-president of member services for Care Providers.

Hoping to rectify these issues, HF1217 seeks to reduce waste when medications are prescribed and to safely destroy any that are left over. The House Environment Policy and Oversight Committee approved the bill Feb. 9 and referred it to the House Health Care and Human Services Finance Division. An amendment to remove veterinary medications was offered by Rep. Al Juhnke (DFL-Willmar) and approved. Companion file, SF1568, sponsored by Sen. John Doll (DFL-Burnsville) awaits action by the Senate Environment and Natural Resources Committee.

To flush or not to flush

Bill supporters link pharmaceuticals in wastewater to possible reasons why male fish in Minnesota lakes and rivers are exhibiting female sex characteristics, a problem known as endocrine disruption. Improving wastewater filtering systems would cost millions more than the projected $1 million to operate the product stewardship program, Gardner said.

Pharmaceutical representatives debunked the argument that eliminating excess medications from the wastewater stream would significantly impact water quality. Drugs in wastewater are primarily what people taking the drugs excrete naturally.

“Perhaps 95 percent is through the regular taking of medicine to keep us and our livestock healthy. So when you think that perhaps you will be affecting somewhere between five and 10 percent … you are going to have an extremely marginal, and perhaps meaningless impact on the situation,” said Patrick Moore of Greenspirit Strategies and an advisor to Pharmaceutical Research and Manufacturers of America, known as PhRMA.

Drug companies don’t deny there are endocrine disruptors in water, but peer review articles report other culprits, such as sunscreens, fertilizers and DEET, an oil used in insect repellants, said Marjorie Powell, senior assistant general counsel for PhRMA, a consortium of 48 member drug companies.

PhRMA, the U.S. Fish & Wildlife Service and the American Pharmacists Association organized a “SMARxT” disposal education campaign that recommends putting drugs into a sealable bag and mixing them with kitty litter, sawdust or coffee grounds so they’re less appealing to animals or children.

“Right now we see that as the preferable method,” said Tim Scherkenbach, deputy commissioner of the Minnesota Pollution Control Agency. The issue boils down to two questions: what are acceptable amounts of contaminants and how does one find the source so the agency can allocate responsibility, Scherkenbach said.

Pharmaceutical companies that would foot the bill for the disposal programs oppose the bill. Drug producers or their collective organizations would be required to pay all administrative and operational costs associated with collecting, transporting and disposing of the drugs and would be prohibited from charging a fee to cover their costs, either at the purchase counter or at the time of collection.

State-of-the-art dispensing machines potentially could save millions of Medicare and Medicaid spending through more efficient dispensing methods. Local governments could voluntarily have community-wide collections, such as a pilot project conducted in Chisago County last year.

The county’s solid waste administrator Lisa Thibodeau explained that through the program, 1,400 pounds of drugs were collected at a cost of $5,000 to Chisago County taxpayers. She said drugs must be destroyed at a licensed hazardous waste facility, with the closest being in Illinois. Although Minnesota has several incinerators, they are not licensed to handle controlled substances.

Rep. Denny McNamara (R-Hastings) said state bureaucracy would be less effective and more costly than leaving it up to local government. “It seemed to me in Chisago County it’s working,” he said.

Crime

The drugs collected in Chisago County last year would have had a street value of $1 million, Chisago County Sgt. Karl Schreck said.

“When younger people are coming in and doing burglaries, they’re not taking your TV or your guns. They’re not taking your jewelry. They’re taking your drugs,” Schreck said.

He said teens are hosting “pharming parties,” or mixing cold medicines with energy drinks for a “short high.”

Realtors told the bill’s sponsor that people posing as buyers at an open house steal drugs from medicine cabinets.

Opponents of the bill fear that a central collection site for drugs could become a target for vandals or that controlled substance drugs might be diverted in transit.

“The federal drug enforcement administration has been a little hesitant to open the flood gates to letting stuff be collected where it might be a target, but the risk of having it in your house now exceeds the risk than if you have it in a secure collection program,” Gardner said.

U.S. poison centers answered 4.3 million calls in 2008, according to the American Association of Poison Control Centers (AAPCC).

Painkillers are the leading cause of poisonings, according to an AAPCC report. Sedatives, topical ointments, antidepressants, cough and cold medications, and cardiovascular pills are among the top 10. Children under 6 accounted for half of all poisonings in 2008.

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