Drug-Free Water

Do you agree that our county government should link up our county's Health Department, Office for the Aging, Sheriff, local police departments, and local nursing homes to set up the same type of recycling and/or permanent drop-off centers for pharmaceuticals reported in the December 2006 "County News" article below in San Mateo and Marin counties in California and Tulsa County in Oklahoma-- so these medications don't end up in our drinking water?

Sign on to this petition-- and pass it along to all you know.

Letters helpful as well-- to [email protected] and [email protected]

Let's make it happen here in 2007.

Joel Tyner
County Legislator
Clinton/Rhinebeck
324 Browns Pond Road
Staatsburg, NY 12580
[email protected]
RealMajorityProject.blogspot.com
(845) 876-2488

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Two more of interest:

Pharmaceuticals in Waterways Raise Concern Effect on Wildlife, Humans Questioned"
by Juliet Eilperin
[Washington Post 6/23/05]
WashingtonPost.com/wpdyn/content/article/2005/06/22/AR2005062201988.html

"Our Environment: Eat, Drink and Be Wary: Chemicals Often Linger in Water After Treatment"
by Brian Buckley
[Poughkeepsie Journal 1/18/04]
DCEMC.org/fishkill/media/PoJo_01_18_04.htm

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"Counties Protect Environment by Collecting Unwanted Medication"
by Dan Miller
[County News 12/06]
NACO.org/Template.cfm?Section=Publications&template=/ContentManagement/ContentDisplay.cfm&ContentID=21878

(For more information on Christian Daughton's research on this right on EPA
website see EPA.gov/nerlesd1/chemistry/pharma/.]

The long-standing advice for expired or unneeded medications has been simple: flush them. However, due to environmental concerns, counties across the country are launching programs that aim to encourage residents to safely dispose of the medicine.

A 2002 study by the U.S. Geological Survey (USGS), the first national-scale examination of pharmaceutical wastewater contaminants, found pharmaceutical and personal care products (PPCP) in 80 percent of the 139 streams that it sampled in 30 states. Furthermore, a 2003 study by the San Francisco Estuary Institute found acetaminophen, a pain reliever, in the San Francisco Bay.

Much is yet to be learned about the impact of these chemicals in humans, but the results are already evident in fish. Western mosquitofish exposed to Fluoxetine, a generic version of the antidepressant Prozac, experience delayed development of their young, according to the EPA. Masculinization of fish has been associated with pharmaceuticals off the coast of Orange County, Calif., and USGS also found intersex characteristics in bass in the Potomac River in Washington, D.C.

In addition to mutations in fish, EPA said, the presence of antibiotics can lead to the release of resistant pathogens and their natural selection in the wild.

Christian Daughton, researcher with the EPA, said these are only two of a large number of potential problems that the pharmaceuticals can cause.

"The pertinent environmental issues could be as varied and diverse as the number of chemical classes in use," he said in a report.

In an effort to prevent these chemicals from entering the environment, several counties have started programs to collect the drugs before they can cause harm.

San Mateo County launches permanent disposal program

In its first five weeks of operation, San Mateo County, Calif.'s permanent pharmaceutical disposal program has collected approximately 68 pounds of expired and unwanted medications. The program has established four permanent drop-off sites for the medicine-- police departments in Daly City, Pacifica and San Bruno as well as the Sheriff's Office in Redwood City-- to accept legal pharmaceuticals.

"Actually, there was a bit of overflow and so at least one of the departments
and the Sheriff's Office had to hold some items for November's pick-up,"
said County Supervisor Adrienne J. Tissier, who created the program.

Law enforcement agencies were selected as drop-off points so that all medicines, including those classified as controlled substances could be accepted.

In addition to improving the environment, the program also aims to help seniors avoid dangerous medication errors and prevent recreational pharmaceutical use.

"Seniors have all these pills in their medicine cabinets and could easily take the wrong one by mistake," Tissier said. "And the law enforcement community already knows that drug abusers are raiding household cabinets looking for pills. This program is an effort to address all three issues - a win-win-win."

Tissier was inspired to create the program after her father died in the spring of 2004, leaving behind a large quantity of prescription drugs. After taking office in January 2005, she headed the county's first effort to divert pharmaceuticals from landfills and wastewater streams during that year's Earth Week celebration. That week, the county collected about 235 pounds of various medicines.

The new program exists so that citizens can turn in medications year-round.

Marin County participates in regional collection

Marin County, Calif. participated in a far-reaching medication disposal event organized by the Bay Area Pollution Prevention Group. Billed as a first-of-its-kind regional collection event, the San Francisco Bay Area's Safe Medicine Disposal Days set up 39 locations for citizens to bring in their unneeded meds.

The pilot program worked with numerous agencies to coordinate event details, including city governments and Walgreens pharmacies.

More than 1,500 people disposed of 3,634 pounds of pharmaceutical waste. A survey given to participants found that one-quarter of participants had previously flushed their medications down the toilet while nearly half disposed of them in the trash.

Tulsa County recycles old medicine

Tulsa County, Okla. has taken a completely different approach to unneeded medications: using them.

In January 2005, Tulsa County Social Services and the Tulsa Medical Society began recycling medications from eight nursing homes around the county and delivering them to indigent citizens, local nonprofits as well as victims of Hurricane Katrina.

Since the start of the Recycled Medication Program, 6,114 prescriptions have been filled at an estimated value of $1.3 million.

This program operates by having the director of nursing at county nursing homes collect extra medications and giving them to the county for testing, repackaging and free distribution to members of the community who are not otherwise able to afford them.

The NACo Acts of Caring Award-winning program was able to fill 190 prescriptions for Family and Children's Services, as well as provide over-the-counter medications to most indigent health care clinics, homeless shelters and mental health agencies in the county. Katrina survivors at Tulsa's Camp Gruber also received free medications.

According to the University of Oklahoma, Tulsa County nursing homes destroy up to $7 million in medications annually.

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[text here below of resolution Tyner submitted months earlier on this]

REQUESTING THAT OUR COUNTY HEALTH DEPARTMENT HELP COORDINATE PHARMACEUTICAL TAKE-BACK PROGRAM IN DUTCHESS COUNTY TO PROTECT GROUNDWATER

WHEREAS, over the last few years, there have been a number of attempts to try to determine the occurrence of pharmaceuticals in the environment; a major study was conducted by the US Geological Survey in 2002; this survey used five newly developed analytical methods to measure concentrations of 95 OWC (organic waste water contaminants) in water samples from a network of 29 streams across the US during 1999 and 2000, and

WHEREAS, the selection of sampling sites was biased towards streams susceptible to contamination (i.e downstream of intense urbanization and livestock production); in 80\% of the samples analyzed, one or more of the pharmaceuticals were detected; regarding the compounds, 82 of the 95 OWCs were found during this study, and

WHEREAS, only targeted compounds were reported with no attempt to report data on not targeted compounds; many compounds however do not have such guidelines established; the detection of multiple OWC was common for this study; 75 percent of the streams had more than one, 50 percent had 7 or more, and 34 percent had 10 or more, with as many 38 OWCs being detected in a given water sample; little is known about the potential interactive effects that may occur from complex mixtures of OWCs in the environment, and

WHEREAS, examples of pharmaceuticals found include acetaminophen found in 24\% of samples analyzed, steroids and hormones commonly found, with 17 -ethynyl estradiol (a hormone used in birth control pills) found in 16\% of samples analyzed, and Diltiazem (blood pressure medication) found in over 13\% of samples analyzed, Codeine found in 11 percent of samples analyzed, and antibiotics and antimicrobials were found in over 10 percent of samples analyzed, and

WHEREAS, in an ideal situation, all the pharmaceuticals that are prescribed for a patient or bought by a person to treat a common illness (such as colds, etc) would totally be consumed, however this is not always the case; with a very few exceptions, countries do not have clear and consistent guidelines on how to properly dispose unwanted pharmaceuticals, especially when it comes to the general public, and

WHEREAS, medical centers and pharmacies usually send unused or expired pharmaceuticals back to the manufacturer; in other cases they use a reverse distribution company which disposes of the products that are non returnable; in the US, this often contradictory guidance varies from state to state in both formal and informal ways, and

WHEREAS, as an example, this is a statement found on the Wisconsin Department of Natural Resources Web Page "If your waste is not a hazardous waste and it is a dispensed narcotic or other medication, first consider donating the medication, or if possible, return the medication to the supplier or send it to a firm specializing in accepting these wastes. This is called "reverse distribution". If you can not use reverse distribution or donation, you may flush the medications down the drain or dispose them in the trash. Do not flush medications into a septic system. Before flushing large amounts, contact your local wastewater treatment plant operator.
Store dispensed narcotic medications securely before disposal," and

WHEREAS, King County in Washington State performed a survey on 60 drug waste generators (primary doctor's offices, health care centers, hospitals); the survey identified that Chemotherapy wastes were being disposed primarily through hazardous waste vendors, although some went to biohazardous waste containers; the "mixed" and "narcotic" wastes (DEA controlled) going to the hazardous waste vendor were reported by one reverse distributor; otherwise, most drug wastes went into the sewer system, garbage and biohazardous waste containers, and

WHEREAS, in the King County survey, it was clear that with the exception of large institutions as hospitals and pharmacies, health care centers are not aware of their responsibility to meet hazardous waste regulation; lacking and understanding of proper disposal options has made these facilities come up with different methods to manage pharmaceutical waste, such as disposal down the drain or in the garbage, and

WHEREAS, if we follow the precautionary principle which implies that "when
an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established scientifically", there are a number of proactive measures that could be taken to reduce the amount of pharmaceuticals that is introduced to the environment due to the actions of the general public, and

WHEREAS, Take Back Programs provide the legal framework and the logistic resources required to allow health care facilities, patients and public in general to returned expired and unwanted pharmaceuticals so that they can be either reused or disposed safely in waste to energy or incineration facilities, and

WHEREAS, Clark County, Washington has been taking back consumer drugs for about 12 years at three household hazardous waste facilities; the City of Palo Alto (California) hosts take back programs at Senior Centers; collected 75 lbs of pharmaceuticals during 3 day event (only advertised at Senior Centers); Los Angeles County takes back all consumer medications except controlled substances at household hazardous waste facilities, and

WHEREAS, the State of Maine initiated a pharmacy-based take back program in 2003; all non-controlled drugs can be dropped off at participating pharmacies; shipped FedEx to a hazardous waste firm; all controlled substances can be dropped off at designated sheriff's offices; stored in evidence rooms until disposed, and

WHEREAS, the Northeast Recycling Council (NERC) received a grant from the EPA to pilot consumer take-back programs; this project is developing and implementing a replicable pilot for collecting unwanted medications at HHW collections or in other rural settings; project to focus on Massachusetts, Maine, New Hampshire and Vermont, and

WHEREAS, the Washington Department of Ecology is coordinating a recently formed informal agency working group to address residential pharmaceutical waste management; the group includes state and local government representatives from Washington, Idaho, and Oregon; the group plans to explore options for effective collection of pharmaceuticals, including the option of returning unwanted residential pharmaceuticals to pharmacies, and

WHEREAS, the Office of Fiscal Analysis in Connecticut estimates that recycling unused prescription drugs could save Medicaid and private insurers in the state $7 million a year, and

WHEREAS, in British Columbia in Canada, the pharmaceutical industry voluntarily established the Medications Return Program in November 1996; for the period April, 2000 to December, 2000, industry reports that over 550 retail pharmacy outlets, representing over 75 percent of all pharmacies in British Columbia, accepted unused and expired medications from consumers; for the nine month period April, 2000 to December, 2000, the program reports the collection of 4490.1 kg for a four year program total of 32,776 kg, and

WHEREAS, eleven European Union member nations have pharmaceutical take-back systems, all of which allow residents to drop unwanted pharmaceuticals at pharmacies; more than half of the European nation systems are operated by the pharmaceutical industry or by pharmacies; the rest are paid for municipalities, and

WHEREAS, Australia has a Return Unwanted Medicines (RUM) Project, providing for unwanted and out-of-date medicines to be collected by community pharmacies; Commonwealth funds currently cover these costs, due to outstanding support from the pharmaceutical industry; community pharmacies collect these medicines at no cost, and pharmaceutical wholesalers have agreed to a dramatic discount in charges for delivery and collection
of containers to pharmacies; the program has established protocols on how to manage the waste; it also includes consumer awareness campaigns and media releases; the program collects around 300 ton of unwanted pharmaceuticals annually; it had a budget of 5 million Australian dollars to operate from 2001 to 2006, and

WHEREAS, between July 2004 and June 2005, Australia collected 315,810 kg of unwanted pharmaceuticals; Australia has a population of 20,090,437 and and the United States has a population of 293.655.404 according to the US Census Bureau; so, using population as the extrapolation factor, it could be estimated that in the US there are around 4,616,089 kg (5,000 short tons) of
unwanted pharmaceuticals that are either kept at people's homes representing
a hazard for children or disposed in an improper manner by the public, now, therefore, be it

RESOLVED, that the Dutchess County Legislature hereby requests that our county's Health Department help coordinate a pharmaceutical Take Back program here in Dutchess County similar to what other communities have successfully done to protect their groundwater, as noted above, and, be it further

RESOLVED, that a copy of this resolution be sent to County Executive William Steinhaus and our county's Health Commissioner Dr. Michael Caldwell.