January 27, 2013

New rules could hurt Maine drug takeback programs

Federal and state proposals could erode health-care savings and pave the way for less ecologically sound disposal methods.

By Colin Woodard cwoodard@pressherald.com
Staff Writer

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Lewiston Police Sgt. David St. Pierre and Officer Craig Johnson crate unused prescription drugs at the U.S. Drug Enforcement Administration’s Portland office April 28, 2012, during National Prescription Drug Take-Back Day.

Maine Sunday Telegram file photo/John Patriquin

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Unused prescription drugs collected during a 2008 Sagadahoc County drug disposal effort are sorted at Mid Coast Hospital in Brunswick. A U.S. DEA proposal would ban authorities from gathering data on what drugs are being returned during drug takeback programs and in what quantities. Such data has been used to cut the cost of MaineCare by imposing 15-day limits on the initial prescriptions of often-wasted drugs.

Maine Sunday Telegram file photo/Shawn Patrick Ouellette

DEA will sponsor another takeback day -- possibly its last -- on April 27.


DEA drug-disposal funding is widely expected to end later this year, shifting disposal costs back on local and state authorities. In expectation, Gov. Paul LePage last year created a prescription drug abuse task force whose duties include developing disposal solutions.

According to Greg Couture, assistant to the commissioner for public safety, the task force is entirely funded by a $60,000 grant from the Pharmaceutical Research and Manufacturers of America. PhRMA successfully opposed a 2010 bill that would have required its member drug companies to fund Maine's drug takeback programs.

State Environmental Protection Commissioner Patricia Aho, who chairs the task force's disposal subcommittee, has reinterpreted disposal rules to allow collected drugs to be treated as household waste rather than hazardous waste. The shift paves the way for the drugs to be burned at municipal waste incinerators in Portland, Auburn and Orrington, rather than being sent out of state for disposal in more permissive locales or by hazardous waste combustors.

In a January 2012 memo, Aho wrote that because the collected materials "would amount to less than 5 percent of a load" at the municipal waste plants, "we do not expect incineration of medications to have a measurable effect on emissions or ash characteristics" at the facilities. She also said the plants "achieve a 99.99 percent destruction efficiency of combustion by-products."

This represents a shift from the Department of Environmental Protection's previous interpretation of the rules, which was articulated in an August 2011 memo written by Maine Assistant Attorney General Nancy Macirowski. Medications, she noted, can contain hazardous substances and therefore are "deemed to be a hazardous waste." Drugs disposed of by households are specifically exempted, but not when "collected in an 'unusual quantity' such as at a collection event."

"As things now stand, there is not any solid waste disposal facility in Maine approved by the DEP to accept unsorted pharmaceutical waste," Macirowski wrote.

Michael Wardrop, the head agent at the DEA's Portland office, said the old interpretation "put the wall up" against in-state incineration of unsorted drugs.

The new interpretation holds that loads of several hundred pounds of drugs do not constitute an "unusual quantity" under the rules, on the grounds that they represent a tiny percentage of the municipal waste plant's hourly burn load. As a result, they can be categorized as household waste.


A review of hundreds of pages of department files and interviews with a dozen sources involved in the issue suggested there is a difference in opinion between air quality experts (whose data supports the changes) and solid and hazardous waste specialists (who remain concerned about whether the substances will be fully destroyed).

Marc Cone, director of the DEP's Bureau of Air Quality, notes that air emission tests for dioxin and other relevant substances recently conducted at the ecoMaine incinerator in Portland suggest that any drugs presently in the household waste stream are being cleanly burned. The department hasn't been able to test the effect of several hundred pounds being burned but plans to do so with some of the drugs collected during the DEA's April 27 takeback event.

"It's very evident that the combustion that occurs in these units is very good," Cone said. "I can't imagine the tests in April will result in anything different."

Solid waste experts at the DEP appear to have had reservations about the proposed shift, according to internal emails obtained through a public records request.

"My understanding is that the significant difference between hazardous waste incineration and solid waste incineration is not in the emissions control technology, but in the incineration technology, the control of the feed rate for different materials, and the burn temperature monitoring and control," Carole Cifrino, manager of product management programs, wrote a colleague in the air bureau in November 2010. "If the pharmaceutical companies think that solid waste incineration is achieving the desired results, why aren't they stepping up to do the testing and demonstrate it's safe?"

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