Monday, January 28, 2008

Drugs Flushed Weekly-Billon$ Wasted

(Author's note: This story was published Feb. 3, 2006 in the Register Citizen and is still relevant.)

TORRINGTON, CT -- Hundreds of unexpired prescription drugs are literally going down the drain, wasting billions of dollars and possibly contaminating drinking water, officials say.

Federal and state regulations are forcing nursing homes in the United States to flush hundreds of unused blister packs of prescription drugs down the drain each week due to patient deaths and prescription changes.

"The money we are wasting is incredible," Registered Nurse Shari Yard, the director of nursing services at Valerie Manor said. "I’ve had to flush an entire 30-day supply (of medicines) down the toilet."

Valerie Manor is a 151-bed nursing home on 1360 Torringford St. in the city.

"It is sad that many medicines can’t be re-used and have to be destroyed," Administrator Denise Quarles said.

Medicines are distributed to these patients monthly in blister packs, which have to be destroyed if the patient dies or has their medication or dosage changed, Greg Hamley, the administrator for Wolcott Hall for Special Care on Forest Street said.

"They can’t be recycled," Hamley said. "The pharmacy can’t take them back."

Quarles and Yard disposed of hundreds of pills at the home Wednesday night.

Two of the prescriptions alone cost $1,200, Yard said.

A registered nurse and a supervisor must be present as the pills are popped out of the blister packs into a container, which is then flushed down the toilet, Yard said.

"I couldn’t make an educated guess how much is flushed," Yard said. "It is still good medicine."

Various federal agencies denied direct jurisdiction in the issue, but said interagency policies leave the homes little choice in disposing the medicines.

"There is no direct U.S. Environmental Protection Agency regulation," EPA spokesman Suzanne Ackerman said. "It is a complicated issue."

Various regulations prohibit the drugs from being thrown in the trash or given to another individual, severely limiting what can be done with them.

"It leaves the nursing homes in a quandary," Ackerman said.

Ackerman said the U.S. Drug Enforcement Administration, however, provided "guidance" to nursing home facilities by approving flushing the medicines.

DEA officials did not respond to questions by press time.

Using the amount flushed this week at Valerie Manor, the home will destroy a minimum of $5,200 per month in medicines, or $62,400 a year.

There were 18,000 nursing homes with 1.9 million beds in the United States as of 1999, according to a Center for Disease Control report.

If all the homes destroy a similar amount to the Valerie Manor total, the national total would reach more than $1.2 billion annually.

"There is no excuse for flushing it down," former presidential candidate and consumer advocate Ralph Nader said Thursday night. "There are ways of getting rid of things using proper procedures."

Hospitals, like Charlotte Hungerford in Torrington, do not deal with these issues because they have a pharmacy on site, Hungerford spokesman Tim LeBouthillier said.

"We have our own medicines (to distribute to patients)," LeBouthillier said. "They are dispensed internally."

The hospitals have their own stringent policies regarding drug monitoring and only destroy drugs after they expire, LeBouthillier said.

Some states, including New York and Oklahoma, have passed laws to allow the drugs to be re-used.

State Sen. Chris Murphy, D-16, said Thursday the state passed a law three years ago allowing the top 50 medicines at nursing facilities to be re-packaged and re-used.

"It saved the state about $3.8 million," Murphy said. "It is a serious issue."

Murphy, who chairs the state Senate public health committee, said he hopes to add to the list of medicines this year.

The money lost is not the only concern. Recent studies and reports are showing traces of these pharmaceuticals and other personal care chemicals showing up in water supplies throughout the nation, including drinking water supplies, Ackerman said.

"These chemicals are being found in rivers and lakes, which can serve as sources of drinking water," Ackerman said. "The EPA is examining data from the U.S. Geological Survey to determine which emerging contaminants are occurring in public water systems."

Ackerman said the agency would study the issue to see if the "incredibly small" amounts of these chemicals will impact the environment.

"We don’t know if it is a hazard," Ackerman said. "The EPA is funding research into this issue."

Nader said he was concerned that the practice is being allowed.

"These(chemicals) are toxic," Nader said. "This is contributing to the toxicity of the ground."

Several pharmaceutical companies contacted did not return calls seeking comment.

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