Beyond the Drug Store~ What do Riverbanks, Medicine Cabinets, Toilets and City Streets Have in Common?

Erin Johnson MPH, MSN, RN
Assistant Clinical Professor
College of Nursing & Health Professions
Drexel University
Philadelphia, PA

Andrew M. Peterson, PharmD, PhD
John Wyeth Dean
Mayes College of Healthcare Business and Policy
University of the Sciences
Philadelphia, PA 19104

Background:

Erin Johnson is an environmentalist and a nurse. Interested in the intersection between human and environmental health, Erin Johnson has worked with a variety of organizations focused on these areas. Erin is currently an Assistant Clinical Professor teaching community and global health courses at Drexel’s College of Nursing and Health Professions.
Erin serves as an at-large member of the Pennsylvania State Nurses Association Environmental Health Committee, volunteers as an RN at Puentes de Salud community health clinic, and is on the board of the local chapter of Physicians for Social Responsibility.
Previously, Erin directed the environmental sustainability programs department of a Philadelphia nonprofit. Along with work on other environmental committees, she co-chaired the Urban Sustainability Forum Steering Committee, a group of more than 15 regional organizations working to advance the sustainability of the Philadelphia region. Previously, Erin also worked for the Montana Conservation Corps, for an educational farm in New York, and at an organic apiary in Germany.
For Erin’s Master’s of Public Health capstone project, she researched the environmental health assessment practices of home health care nurses in Chester, PA, a regional “environmental justice community.” Erin Johnson holds BSN (2009), MSN and MPH (2011) degrees from the University of Pennsylvania. She earned a BA in Environmental Studies from Washington University in St. Louis, Missouri (1997).

Andrew Peterson PharmD, PhD, is the John Wyeth Dean of the Mayes College and Professor of Clinical Pharmacy and Health Policy at University of the Science in Philadelphia and was formerly the Chair of the Department of Pharmacy Practice/Pharmacy Administration. Before joining USciences in 1996, he was an Assistant Director of pharmacy and clinical services at Thomas Jefferson University Hospital and an Associate Director of pharmacy, drug information, and clinical services at Crozer-Chester Medical Center.

Highly regarded in the fields of Pharmacy Management and Health Policy, Dr. Peterson has more than 20 years research experience in pharmacy management, managed care pharmacy, medications compliance, and more recently, medications in the environment. His accomplishments are wide ranging: he has produced a large body of research and scholarly work, created innovative programming, and secured significant grand dollars.

Known for his commitment to mentoring others and fostering success, recognitions include several awards for excellence in teaching and for learning innovation.

Dr. Peterson speaks at conferences around the world on issues related to pharmacy and health policy. He is co-author of an authoritative text for mid-level practitioners: Advanced Pharmacotherapeutics: A Practical Approach published in 2013, editor of the book Managing Pharmacy Practice: Principles, Systems and Strategies, and a contributor to numerous peer publications. His journal reviews include the American Journal of Hospital/Health System Pharmacy, Journal of the American Pharmaceutical Association, Journal of the American Medical Association, and Lancet.

Active in the academic and research communities, Dr. Peterson has served on the boards of many professional organizations. He is also a member of Rho Chi Pharmacy Honor Society and Phi Lamda Sigma Pharmacy Leadership Society.

Dr. Peterson earned his PharmD from Virginia Commonwealth University and his PhD in Health Policy at USciences. He also completed an Advanced Residency in Hospital Pharmacy Administration at Jefferson Medical College of Thomas Jefferson University and a Residency in Hospital Pharmacy Practice from Rush-Presbyterian St. Luke’s Medical Center.

Overview:

• Since 2010, Drug Enforcement Administration’s (DEA) National Prescription Drug Take-Back Day initiative has collected a total of 4.1 million pounds (2,123 tons) of unneeded medications, helping to prevent diversion, misuse, and abuse of the drugs.
• The public has embraced the opportunity these Take-Back Day events provide to prevent pill abuse and theft by ridding their homes of potentially dangerous expired, unused, or unwanted prescription drugs.  Last October Americans turned in 324 tons (over 647,000 pounds) of prescription drugs.
• Unused medications in homes create a public health and safety concern, because they are highly susceptible to accidental ingestion, theft, misuse, and abuse.  Almost twice as many Americans (6.8 million) currently abuse prescription drugs than the number of those using cocaine, hallucinogens, heroin, and inhalants combined, according to the 2012 National Survey on Drug Use and Health.  And more Americans died in 2010 from overdoses of prescription medications (22,134, including 16,651 from narcotic painkillers) than from motor vehicle accidents, says the Centers for Disease Control and Prevention.  Surveys of users have found that the majority of abused prescription drugs are obtained from family and friends, including from the home medicine cabinet.

This is a complex issue because each and every one of us is a part of this problem. Basically, what we are talking about here keeping contaminants out of the environment as much as possible. We are also talking about keeping kids and family members safe.

The environment: water and air pollution result from our current medication use and disposal practices (active pharmaceuticals ingredients), including the excretion of our medication, disposing of it down the drain or in bulk quantities, and incinerating it.

Safety: Keeping the possibility of having too many available drugs in the medicine cabinet to avoid accidental overdoses or abuse of medications.

The majority of the pharmaceuticals come into the water from:

• our excretion
• from Concentrated Animal Feedlot Operations
  (CAFOs) & animal waste
• overprescribing
• flushing unwanted or unused meds

Action Steps

• 1) Educateyourself and others about proper disposal methods, and about some of the existing resource to learn more.
• a) Philadelphia Water Department: 2013 Drinking Water Quality Report
• b) Philadelphia Water Department’s approach to pharmaceuticals in the drinking water http://www.phila.gov/water
• c) PSRPhila (Environmental health):    Video and flyer posted there – share it!
• P5: Philadelphia Partnership for Pharmaceutical Pollution Prevention
• 2) Properly dispose of medications if there is no community drug collection event
• a) protect your info by removing the labels or crossing out your info; b) put pills or liquid in a another container such as a plastic bag and add coffee grounds or kitty litter – something undesirable – to the bag; c) dispose of in the household trash
• 3) Tell others about and participate in the next annual Drug Take back event (September 27, 2014 10 am – 2pm). To find out about future take-back events, visit the Drug Enforcement Agency’s website at www.dea.gov or call 215-238-5172. Only pills and other solids, like patches, can be brought to the collection sites–liquids and needles or other sharps will not be accepted.
• 4) If you are a healthcare provider or work in a healthcare facility, Practice Green Health also offers solutions for you: https://practicegreenhealth.org/

Other Resources:

• Physicians for Social Responsibility (PSR) Philadelphia: 
• Physicians for Social Responsibility (PSR) Philadelphia/P5 (Philadelphia Partnership for Pharmaceutical Pollution Prevention): 
• United States Drug Enforcement Administration, Take Back Initiative: 
• Philadelphia Water Department (PWD) 2013 Annual Drinking Water Quality Report: 
• United States Environmental Protection Agency (EPA), Pharmaceuticals and Personal Care Products, FAQs: 

3 Key Points:

1. We all have a responsibility to the environment and being actively mindful about medication disposal is a contribution that everyone can make and tips are shared on how to do this properly.
2. Consumer drug diversion-which is defined as taking drugs not prescribedand it is a behavior that we needs to change in order to both protect our health and the health of others.
3. Ask your primary care provider to only prescribe the amount of medication you actually need so there is less likelihood of excess medications that need to be thrown away.

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