COUNCIL OF THE CITY OF PHILADELPHIA2 COMMITTEE ON PUBLIC HEALTH AND3 HUMAN SERVICES4 5 6 Room 400, City Hall7 Philadelphia, Pennsylvania Wednesday, November 10, 20108 1:25 p.m. 9 10 PRESENT: COUNCILWOMAN MARIAN B. TASCO, CHAIR11 COUNCILMAN W. WILSON GOODE, JR. COUNCILWOMAN DONNA REED MILLER12 COUNCILWOMAN BLONDELL REYNOLDS BROWN 13 RESOLUTION 100516 - Resolution authorizing the14 Committee on Public Health and Human Services to hold hearings to investigate the National15 and Local emergence of the improper use and disposal of Prescription Drugs and the need16 for a Prescription Drug Disposal Program in Philadelphia, PA.17 18 - - -19 20 21 22 23 24 25 2 1
Good2 afternoon. The Council Committee on3 Public Health and Human Services will4 come to order. We note that we have a5 quorum in the presence of Councilwoman6 Donna Reed Miller, Councilman Goode,7 Councilwoman Blondell Reynolds Brown and8 myself. I'm Councilwoman Marian Tasco.9 We ask the Clerk to please read10 the resolution.11
Resolution 100516,12 resolution authorizing the Committee on13 Public Health and Human Services to hold14 hearings to investigate the National and15 Local emergence of the improper use and16 disposal of Prescription Drugs and the17 need for a Prescription Drug Disposal18 Program in Philadelphia, Pennsylvania.19
Thank you20 very much.21 We will have opening remarks by22 Councilwoman Blondell Reynolds Brown.23
Thank you,24 Chairwoman Tasco.25 3 11/10/10 - PUBLIC HEALTH - RES. 1005161 Good afternoon. On June 17th,2 2010, I introduced this resolution3 calling for hearings for a Prescription4 Drug Disposal Program thanks principally5 and solely to our citizen, activist6 Bernie Strain, who is with us today, who7 very sadly lost his son to the improper8 disposal of drugs.9 And so the question is, Madam10 Chair and Council colleagues, if we can11 dispose of cans and bottles properly, if12 government has made it a priority to13 instruct us and educate us on why we14 should dispose of cans and bottles15 properly, we should be able to do better16 when it comes to the disposal of17 prescription drugs, particularly when18 lives are at and have been at stake.19 And for that, I'd like to first20 thank our activist citizen Bernie Strain21 for putting this on the radar screen in a22 magnificent way, both at the local level23 and at the federal level. Today, we will24 hear testimony that will help us to25 4 11/10/10 - PUBLIC HEALTH - RES. 1005161 determine what it will take to develop2 and execute a strategic plan that will3 create an ongoing prescription pill and4 drug disposal program right here in5 Philadelphia.6 I want to say a huge, special7 thank-you to Dr. Gressitt for flying in8 from Maine. We appreciate your9 willingness to provide testimony on this10 effort very much, and to all of those who11 will speak on behalf of this resolution.12 Thank you, Madam Chairwoman.13
Thank you,14 Councilwoman. And we certainly15 appreciate your leadership and bringing16 forth this issue to the City Council's17 Committee on Public Health and Human18 Services, and we certainly welcome all of19 you to this Council Chamber today and20 particularly our out-of-town guest, who21 has chosen to come at his own expense to22 testify. So we appreciate that. He sees23 the importance of this issue.24 We will now have our first25 5 11/10/10 - PUBLIC HEALTH - RES. 1005161 witness and we call Bernie A. Strain,2 lifelong Philadelphian and the father of3 Timmy Strain.4 (Witness approached witness5 table.)6
Would you7 please identify yourself for the record8 and proceed with your testimony.9
Good afternoon,10 Councilwoman Madam Chairman. 13 Good afternoon, Chairwoman14 Tasco, members of the Public Health and15 Human Services Committee of our16 Philadelphia City Council. My name is17 Bernie Strain. I'm a 53-year-old18 lifelong Philadelphian. 23 We had three wonderful sons24 together: Brian, 27, who is serving our25 6 11/10/10 - PUBLIC HEALTH - RES. 1005161 country as a Sergeant in the United2 States Air Force. He has served several3 tours overseas and one in the sands of4 Iraq. 7 Our third son, Timothy Michael8 Strain, was 18 years old at the time of9 his untimely and tragic death. Tim was10 soon to attend college. 14 He was treated by a doctor and then seen15 at Saint Christopher's Hospital in the16 Philadelphia Burn Unit. 25 7 11/10/10 - PUBLIC HEALTH - RES. 6 Months passed and a news7 article was published in the Philadelphia8 Daily News. The article was about the9 tragic way that my son Timmy died. After10 reading that newspaper article, Beverly11 and I wondered how medications are12 routinely disposed of -- excuse the13 sniffles -- as well as the incidence of14 misuse of prescription drugs. 23 The same news article caught24 the attention of an environmental25 8 11/10/10 - PUBLIC HEALTH - RES. 1005161 educator in Illinois, Paul Ritter. In my2 opinion, Paul is the teacher of the3 century. Paul and his students developed4 the P2D2 program. This is a prescription5 drug give-back program. Paul called my6 wife and me on one of our darkest days7 following the funeral for our youngest8 son. We never thought this could happen9 to us. "14 Paul had the answer to all of15 our questions. He has since become a16 dear friend. Following that night, he17 called us and offered us sympathy. One18 phone call initiated a new direction in19 our lives, to try to turn lemons into20 lemonade. With his experience and21 knowledge, he introduced us to Gail and22 David Katz. They too lost their son to23 prescription drug medication. Gail and24 David started the Save a Star Foundation25 9 11/10/10 - PUBLIC HEALTH - RES. 1005161 in honor of their son Daniel. 5 Chairman Tasco, you might not6 be aware that on May 24th, our Timothy's7 birthday, a resolution was passed in the8 United States Senate calling on all 509 states to start thinking about the issue10 regarding how we can properly dispose of11 unused medications. Last summer, this12 Philadelphia City Council passed a13 resolution that called on our City of the14 First Class to start a drug give-back15 program. Councilwoman Brown introduced16 the resolution that was co-sponsored by17 Councilmembers Tasco, Green and Jones. 25 10 11/10/10 - PUBLIC HEALTH - RES. 1005161 This program would be paid for by the2 $787 billion stimulus plan for green3 initiatives. With funds from this4 stimulus plan, we can develop a drug5 give-back program to clean our water that6 we drink and rid our water systems of7 dangerous pollutants. We can develop a8 drug give-back program where our citizens9 can properly dispose of medication and10 not dump them into the water system,11 which is a common practice, or simply12 throw them into the trash. According to13 the Philadelphia Water Department, there14 are 50-plus pharmaceuticals in every15 glass of water that we drink. 18 More people die in the United19 States from legal prescription drugs than20 from illegal drug use. It is our intent21 to save a life. It may be a member of22 your family. If this legislation is23 passed, I respectfully ask that you24 consider naming this "Timmy's Law" in25 11 11/10/10 - PUBLIC HEALTH - RES. 2 In closing, I would ask that3 all of the members of this Committee tell4 your children and family members that you5 love them before you leave each day to6 serve our great city. As I left that7 fateful day to serve the citizens of8 Pennsylvania, I received that devastating9 phone call on my way to work, that Timmy10 was dead. 11 My wife and I are most sincere12 and dedicated to this cause. 21
Thank you22 very much for your testimony, and we23 certainly share our sympathy with you24 over the loss of a son. You know, we25 12 11/10/10 - PUBLIC HEALTH - RES. 1005161 don't want to bury our children. We want2 our children to bury us. So it's very,3 very sad. And under the circumstances,4 I'm not sure that we are to give anyone5 medicine out of our medicine cabinet,6 that we are taught that and we're told7 that, don't give anyone else prescription8 drugs, because you never know the9 interaction and the problems that could10 cause, such as with your son. Maybe an11 aspirin, over-the-counter thing that we12 take or Tylenol, but --13
Councilwoman, I14 was advised by the District Attorney, who15 is prosecuting this case, to not discuss16 this in a legal matter, but I appreciate17 your sympathy.18
It is quite public25 13 11/10/10 - PUBLIC HEALTH - RES. 1005161 information, yes.2
Good16 afternoon. Let me first acknowledge as17 well your sister, Beth Strain Berry, who18 walked this road with you and for you. I19 wanted to do that. And please tell us,20 who co-sponsored, who sponsored the21 resolution in the United States Senate?22
And can25 14 11/10/10 - PUBLIC HEALTH - RES. 1005161 you simply give us an update on where2 that is at that level of government?3
May 24th the4 United States passed -- United States5 Senate passed a resolution calling on all6 50 states to start a conversation about7 how all 50 states are going to come up8 with or start the conversation on how we9 as a nation can come up with a plan.10 There's various plans, and you'll hear11 from some other people that are here12 today about some existing plans. But on13 May 24th, the Senate passed the bill14 unanimously.15 And, Councilwoman Brown, while16 I have you here, I'd just like to thank17 you personally for your friendship, as18 well as your being there for our family19 and your leadership on this issue. It's20 a twofold problem. It's a drug problem,21 and if you're not interested or anyone22 listening is not interested on the drug23 side of it, they might be interested in24 it from the environmental side.25 15 11/10/10 - PUBLIC HEALTH - RES. 1005161
And I2 would amend that to also include3 ultimately its impact on children and4 youth as well, who, quite frankly, they5 are children and youth because they still6 need adults to give them proper and7 adequate supervision around this issue.8 So it's a threefold problem ultimately.9 Again, we want to make a difference in10 the lives of our city's children as well.11
Councilwoman, you12 are known as the children's Councilwoman,13 and I applaud your effort and all the14 things that you do for our youth.15
You're16 welcome. We still have work to do.17 I thank you, Madam Chair.18
Thank you19 very much.20 Any other questions, comments?21 (No response.)22
We'll23 listen to the testimony. You plan to24 stay in case we want to call you back and25 16 11/10/10 - PUBLIC HEALTH - RES. 1005161 ask --2
Thank you5 for your commitment. Certainly it takes6 strong commitment and perseverance to7 move an agenda of this nature. It's8 complex, and it's going to take a lot of9 work, but you've begun already, and we10 appreciate your tenacity and know that at11 the end of the day, someone, whether it's12 a young person or an elderly person, can13 be saved by your efforts. So we14 appreciate your advocacy for change.15
Thank you,16 Councilwoman, and thank you for your17 effort on behalf of the citizens of18 Philadelphia serving on this fine19 Committee --20
Thank you.24 We're going to call up now25 17 11/10/10 - PUBLIC HEALTH - RES. 1005161 Inspector Robert Snyder from the2 Narcotics Division and Mr. Jeremiah Daley3 from the Camden HIDTA.4 (Witnesses approached witness5 table.)6
Good7 afternoon.8 (Good afternoon, Madam9 Chairman.)10
Thank you11 for coming. 14 INSPECTOR SNYDER: Yes. My15 name is H. Robert Snyder. 24 The dangers of prescription25 18 11/10/10 - PUBLIC HEALTH - RES. 1005161 drug abuse and misuse are quite evident,2 but we're not fully aware of the total3 amount of misuse and abuse by children4 here in the City of Philadelphia, because5 oftentimes this activity is conducted6 behind closed doors at unsupervised7 parties and other activities. 20 While the Philadelphia21 Narcotics Division has not witnessed a22 remarkable increase in arrests or23 confiscations of prescription drugs from24 individuals under the age of 18, we have,25 19 11/10/10 - PUBLIC HEALTH - RES. 1005161 however, seen a drastic increase in the2 overall amount of confiscated3 prescription pills. In 2009, the4 Philadelphia Police Department Narcotics5 Field Division confiscated over 44,0006 pills with a street value of over7 $280,000. 22 This report indicates that23 benzodiazepines represent the highest24 drug reported in toxicology results25 20 11/10/10 - PUBLIC HEALTH - RES. 3 Benzodiazepines are4 legitimately used to produce sedation,5 induce sleep and relieve anxiety. 10 Another common prescription11 pill that we see on the streets of12 Philadelphia is a synthetic opioid used13 for severe pain management called14 oxycodone. 19 The misuse and abuse of20 prescription drugs nationwide has been21 researched and reported by the DEA and22 contained in the 2010 National Drug23 Threat Assessment. It displays alarming24 rates that have led to overdose,25 21 11/10/10 - PUBLIC HEALTH - RES. 6 With the potential prescription7 drug dangers being prevalent within the8 City of Philadelphia, the Philadelphia9 Police Department partnered with the DEA10 on Saturday, September 25th, 2010 in a11 coordinated effort with the DEA National12 Take Back Day Initiative. It provided a13 unique one-day nationwide opportunity for14 the public to surrender for destruction15 any expired, unwanted or unused16 pharmaceutical substances. 20 As an aid to DEA, the21 Philadelphia Police Department utilized22 its patrol districts throughout the City23 of Philadelphia to be utilized as24 drop-off points for the collection of25 22 11/10/10 - PUBLIC HEALTH - RES. 8 For patient confidentiality9 purposes, the participants were to remove10 the pills and capsules from their11 containers and place the pills directly12 into the disposal box and then take the13 original pill container with them. 23 And for obvious security reasons, the24 disposal boxes were constantly under25 23 11/10/10 - PUBLIC HEALTH - RES. m. 17 In summary, there were 2118 Philadelphia Police Department collection19 sites that collected a total of 22320 pounds of pills that day. 23 Although at first blush the24 program would seem simple to accomplish,25 24 11/10/10 - PUBLIC HEALTH - RES. 7 Through the limited experience8 I have with the recent DEA Take Back9 Initiative, the following recommendations10 are offered for consideration if the City11 of Philadelphia were to establish its own12 program:13 First, develop a working14 partnership with Drug Enforcement15 Administration and the Pennsylvania16 Department of Environmental Protection17 concerning the collection and the18 destruction of the discarded pills;19 relocate the collection sites away from20 the Philadelphia Police Department patrol21 districts and identify one City health22 center located within each Philadelphia23 police patrol district as a designated24 collection site; utilize the community25 25 11/10/10 - PUBLIC HEALTH - RES. S. Senators Amy Klobuchar, a democrat25 26 11/10/10 - PUBLIC HEALTH - RES. 1005161 from Minnesota, and John Cornyn, a2 republican of Texas, introduced a bill3 titled, "The Secure and Responsible Drug4 Disposal Act of 2010," which was just5 recently signed into law by President6 Obama. The Senators recognized that7 consumers currently seeking to reduce the8 amount of expired or otherwise unwanted9 prescriptions in their homes have few10 disposal options.
The Act is designed to11 permit individuals and long-term care12 facilities to deliver dangerous13 prescription drugs to law enforcement14 officials and other authorized15 individuals for safe disposal. 23
We'll come24 back for questions. We'll let everybody25 27 11/10/10 - PUBLIC HEALTH - RES. 1005161 testify.2
Good afternoon,3 Madam Chairwoman and members of the4 Committee. My name is Jeremiah Daley and5 I am the Director of the Philadelphia6 Camden High Intensity Drug Trafficking7 Area, or HIDTA as we call it for short,8 and we are a program out of the office of9 National Drug Control Policy that was10 created in 1988, and we are one of 2811 HIDTAs around the country. Prior to me12 taking this position, I was a13 Philadelphia Police Inspector, who had14 the same job that the gentleman to my15 right in uniform has, Commanding Officer16 of the Narcotics Division, and I was with17 the Department for 25 years. I'm also a18 lifelong resident of the City.19 Our HIDTA coordinates the20 activities of more than 25 federal, state21 and local law enforcement agencies, and22 we have over 200 law enforcement officers23 and agents participating every day. We24 cover the areas of Philadelphia, Chester,25 28 11/10/10 - PUBLIC HEALTH - RES. 1005161 Delaware Counties in Pennsylvania and2 Camden County in New Jersey.3 Just from a high-level4 overview -- and I don't want to repeat5 the same things that Inspector Snyder has6 already testified to. I'll try to give7 you some highlights from some of the data8 that we would like to present to you in9 regards to this issue.10 First of all, every year we do11 a threat assessment for the region here12 as far as drug abuse and drug trafficking13 is concerned, and in our most recent14 threat assessment looking forward to next15 year, we see a significant threat being16 posed by prescription drug abuse in the17 region. It is a problem that is not just18 unique to us; it is around the country.19 Reducing prescription drug abuse is one20 of the key initiatives in President21 Obama's National Drug Control Strategy22 this year and will be for future years.23 According to the National24 Survey on Drug Use and Health in 2009,25 29 11/10/10 - PUBLIC HEALTH - RES. 1005161 seven million Americans used prescription2 drugs for non-medical purposes that year.3 That's an increase of 800,000 people over4 2008, according to that survey, making5 prescription drug abuse the fastest6 growing drug problem in the country.7 Nearly one-third of the people8 aged 12 or older who used drugs for the9 first time in 2009 began by using a10 prescription drug for non-medical11 reasons. Among 12- and 13-year-olds,12 prescription drugs were the most commonly13 abused drugs. So it's affecting young14 people and initiating them --15
What does16 that mean, "non-medical reasons"? They17 are just taking them?18
For some19 non-therapeutic reason, for recreational20 purposes, if you want to call it that, to21 get that euphoric high or buzz, or22 whatever you want to call it. They're23 not under a doctor's supervision.24 They're taking it on their own.25 30 11/10/10 - PUBLIC HEALTH - RES. 1005161 And additionally --2
They are obtaining5 them illegally. 8 Beyond the use of it, we're9 also seeing that the perceptions about10 prescription drugs among young people are11 such that they feel that they are safer12 somehow than the street drugs - heroin,13 cocaine, marijuana, things like that -14 they're safer to use because they are a15 prescription. 18 As Inspector Snyder testified19 to, the toxicology data out of the20 Medical Examiner's Office, our analysis21 of that showed that the most commonly22 abused prescription drugs -23 benzodiazepines, fentanyl, hydrocodone,24 methadone and oxycodone - were present in25 31 11/10/10 - PUBLIC HEALTH - RES. 1005161 almost 20 percent of all decedents that2 were tested at the Medical Examiner's3 Office, and in 90 percent of anyone who4 tested positive for any controlled5 substance, prescription drugs were there,6 too. 8 From 2004 to 2008 across the9 country, the number of emergency10 department visits linked to non-medical11 use of prescription pain relievers more12 than doubled, while the number of visits13 for illicit drugs like heroin and cocaine14 remained constant. 18 Treatment programs are also19 being overwhelmed. 24 The Centers for Disease Control25 32 11/10/10 - PUBLIC HEALTH - RES. 7 And Mr. 9 As I said, two unique issues10 surrounding the prescription drug abuse11 problem, it's the public perception of12 risk and the relative accessibility of13 the prescription drugs. Recent studies14 found that the teens perceived15 prescription medication abuse as safer16 and less addictive and less risky than17 using illegal drugs from the street, and18 that the drugs obtained from a medicine19 cabinet or pharmacy were not the same as20 drugs obtained from a drug dealer. Quite21 frankly, that's often not true. The22 addiction potential for oxycodones is23 every bit as great as heroin. The24 addiction problems associated with25 33 11/10/10 - PUBLIC HEALTH - RES. 1005161 benzodiazepine, your Xanax, your Valium,2 your tranquilizer class, antianxiety3 medications, are very severe physical4 effects. 10 Data from that National Survey11 on Drug Use found that over 70 percent of12 people who abused prescription pain13 relievers got them from relatives or14 friends, while only five percent of them15 got them from a drug dealer or off the16 Internet. This goes to the issue of17 accessibility. They're getting these18 drugs at home and they're using them19 themselves or they're sharing them with20 friends from homes. These are not large21 drug trafficking organizations that22 typically organizations like mine and the23 agencies that we have deal with. These24 are kids raiding mom and dad's or25 34 11/10/10 - PUBLIC HEALTH - RES. 1005161 grand-mom and grand-pop's medicine2 cabinets, or maybe themselves have had3 for some therapeutic reason been4 prescribed a prescription pain medication5 that are now no longer needed. 12 These are not necessarily bad things per13 se. 25 35 11/10/10 - PUBLIC HEALTH - RES. 1005161 Right now the current2 limitations of law of regulations that3 are in place make it challenging for the4 public to dispose of medications in a5 simple, legal and environmentally6 responsible manner. 18 Right now the federal19 government advises people to dispose of20 prescription drugs in one of three ways:21 Throw them in the trash, after they're22 taking proper precautions to deter abuse,23 things like mixing them with coffee24 grinds or other substances that keep25 36 11/10/10 - PUBLIC HEALTH - RES. 1005161 someone from dumpster diving to get pills2 out of it; to flush them down the toilet,3 and we heard earlier what the problem is4 with that, it then gets into the water5 supply for communities and contaminates6 it, and even if you throw them in the7 trash and they go out, they're going to8 end up getting in the ground water. So9 those are not really good long-term10 solutions. But the third one is11 participation in community take-back12 programs.
There's three types of13 take-back programs broadly: First,14 permanent sites where unused medications15 are collected and received; one-day16 events, like was hosted earlier this year17 by Drug Enforcement Administration and18 law enforcement agencies throughout the19 country; and then mail or ship-back20 programs where patients can send their21 unused drugs to a central location for22 destruction. All three of these types of23 programs make sense, but all of them24 still require to be done under the25 37 11/10/10 - PUBLIC HEALTH - RES. 3 So in conclusion, all4 indicators lead one to conclude that5 prescription drug abuse is a problem of6 great magnitude and one that's not going7 to go away any time soon, and we should8 take steps now, through whatever means we9 can, to find ways of keeping these drugs10 from reaching young people's hands. A11 regularly occurring or permanent12 environmentally responsible and easily13 accessible prescription drug take-back14 program can be an essential part of a15 comprehensive strategy to reduce16 prescription drug abuse and its related17 consequences in our community. The18 development of such a program would be a19 welcomed step, provided that such program20 conforms to the yet-to-be-formulated21 regulations from experts at Drug22 Enforcement Administration. For this23 reason, I would urge the Committee and24 the City Council to delay taking action25 38 11/10/10 - PUBLIC HEALTH - RES. 4
Is this5 gentleman going to testify?6 LIEUTENANT HEALY: No.7 Actually, Councilwoman -- Lieutenant8 Healy, Special Advisor to Police9 Commissioner Ramsey, and on his behalf,10 he wanted to thank the City Council for11 allowing us to voice our opinion on this12 important resolution. I'm here basically13 as back-up to the Inspector today.14
Thank you17 all very, very much for your informative,18 deeply informative, testimony and for19 guiding us. You were actually reading my20 script here, because my question was21 going to be would it behoove us to push22 the pause button and wait until DEA and23 the feds have stipulated the regulations24 for The Secure and Responsible Drug25 39 11/10/10 - PUBLIC HEALTH - RES. 1005161 Disposal Act, and your concluding2 statement was that you would advise us to3 delay any action until those regulations4 are in place. Is that a fair --5
That is fair,6 Councilwoman Brown. I think the best7 intentions are certainly being expressed8 by this Committee and the City Council to9 put something in place. The status quo10 is not good and we need to take some11 proactive steps, and I think this is an12 excellent proactive measure that can be13 taken, but timing is everything.14
And it would be16 unfortunate if the Council went through17 the troubles of passing an ordinance and18 putting some citywide prescription drug19 take-back plan in place to find out that20 they were, for one reason or another, in21 contravention to the regulations that22 were coming out of the federal government23 which would require you to reopen the24 matter and have an amended ordinance25 40 11/10/10 - PUBLIC HEALTH - RES. 1005161 passed.2
Well,3 thank you for that instruction.4 My second question is -- I5 don't believe your testimony revealed6 it -- would it be accurate to say that7 the abuse of prescription drugs is now8 matching the abuse of illegal drugs in9 America? Are we headed that way?10
Across the country,11 after marijuana, prescription drug abuse12 is now the second highest form of drug13 abuse in the country. There are more14 people abusing prescription drugs than15 there are abusing heroin, cocaine,16 methamphetamine and all those other17 so-called street drugs. Marijuana18 ubiquitously around the country still is19 the number one controlled substance20 that's being abused, and, of course,21 alcohol is the number one substance of22 all but is not a controlled substance.23
Amazing.24 Then, lastly, do you know right25 41 11/10/10 - PUBLIC HEALTH - RES. 1005161 now as you sit here if there are roles2 for school districts in The Secure and3 Responsible Drug Disposal Act? Do you4 know just based on your own memory or5 knowledge base?6
From my reading of7 the Act, there was nothing specific to8 school districts in there. Certainly,9 again, talking about a comprehensive10 strategy, education programs in schools,11 be it in health classes or with special12 assemblies or things like that, to get13 young people to recognize the dangers14 that prescription drug abuse poses to15 them, that's part of a holistic strategy16 that needs to be included in this.17 More broadly, I think school18 districts have done a good job in19 promoting drug prevention, drug abuse20 prevention messages, but this issue has21 become so prominent that I think we may22 have been focused so much on the street23 drug side that we need to emphasize this24 in programs.25 42 11/10/10 - PUBLIC HEALTH - RES. 1005161
Before you6 go, we have questions. This is her7 resolution, and protocol requires me to8 let her go first on the questions. I9 have a number of them.10 The new regulations -- and11 Councilwoman Brown asked. Part of the12 question is about -- this Act solely13 deals with the disposal of prescription14 drugs? Is that what the Act does?15 INSPECTOR SNYDER: That's my16 understanding of the Act. I'm not real17 familiar with it.18
So there's19 nothing in there about an education20 component, which is very important?21
Not to my22 knowledge, ma'am, no. And I would also23 just call to the Committee's attention,24 present in the room is Mr. John25 43 11/10/10 - PUBLIC HEALTH - RES. 1005161 Bryfonski, the Special Agent in charge of2 the Drug Enforcement Administration in3 Philadelphia, who may be better4 positioned to answer those questions5 about the Act and the regulatory process6 than either Inspector Snyder or I.7
So,8 Inspector, when you talked about the9 disposal program that was held in10 Philadelphia, you gave recommendations to11 how to pursue it in the future, but you12 wouldn't be able to do that -- you're not13 going to take any action on doing that14 until the regulations are done by the15 feds --16 INSPECTOR SNYDER: That's17 correct.18
-- and the19 DEA?20 INSPECTOR SNYDER: That's21 correct. It's my understanding also that22 DEA is going to take another one of these23 one-day initiatives sometime in April.24 So we'll be participating with them25 44 11/10/10 - PUBLIC HEALTH - RES. 1005161 again. But working and talking to DEA,2 we expected to get more than 225 pounds3 of pills, and that's why I mentioned4 about taking them out of the police5 districts, because some people may be6 hesitant or apprehensive about going to a7 police district to turn it in. So I8 think it was because I'm involved in9 narcotics, they had me set it up, but I10 think it would be more suited in the11 health field somewhere. They seem to12 have the best response on community13 groups that might have a fair that people14 can come by. The best date they tell me15 is when they have these drive-by, they16 can just drive by, dump it in and be on17 their way. They get a good result from18 that. We would certainly have to have a19 role in that, because there's the pills,20 the danger of crime. So we would21 certainly have to assign someone, and22 that's why I mentioned maybe if we had23 one health facility in one of our -- each24 one of our police districts, that would25 45 11/10/10 - PUBLIC HEALTH - RES. 1005161 be something that we'd be able to manage.2 We wouldn't be able to man a vast amount3 of them throughout the City. We just4 don't have the personnel strength to do5 that, but I think just from -- if we had6 one in each police district, we would be7 able to do that, to man that for a few --8 a four-hour program. It won't be any9 problem.10
Well, if11 you had a steamroller, you could crush12 them right there.13 INSPECTOR SNYDER: That's true.14
At that15 time. I mean, it's a lot to dispose of,16 and I'd be curious as to where they do17 dispose of them.18 INSPECTOR SNYDER: Well, you19 know, that was something that -- once20 again, I didn't get involved in that part21 of it, but I did find out that -- well,22 there's two issues. One, with the23 Philadelphia Police Department, I asked24 our Forensic Science Bureau could they25 46 11/10/10 - PUBLIC HEALTH - RES. 1005161 store the pills that we collect until DEA2 was able to come and destroy them, and3 they said they don't have the storage4 capacity to do that.5 The other issue was if they6 even had the storage capacity, they now7 are accredited. They have worked for a8 couple years to get accreditation, and9 they can only take things in that was10 documented.11 They have a bar code system,12 and anything that comes into our Forensic13 Science Lab now has to go through a14 certain process, and that would be labor15 intensive for us and it would be16 self-defeating to the program, because we17 want to be -- just to give you an18 example, just one pill bottle would take19 an officer probably close to an hour to20 do the paperwork that was necessary.21 That's not even counting taking it down22 and transporting it and putting it into23 the chem lab. So that would be too labor24 intensive.25 47 11/10/10 - PUBLIC HEALTH - RES. 1005161 And so we worked with DEA and2 we told them we want to participate, and3 they worked out a protocol where they4 would take it immediately, they would5 store it, and they would worry about6 destroying it. But I understand that7 they also had some issues with destroying8 it, because there's two types of9 narcotics that we're talking about now in10 prescriptions. One are controlled, like11 the Xanax, the Percocets, the Percodans.12 The other that we get a majority of13 actually are the antibiotics that people14 have in their medicine cabinets and the15 blood pressure medications. And the16 Pennsylvania Department of Environmental17 Protection oversees the destruction and18 collection when it comes to the19 non-controlled, the blood pressure, those20 types of things, the antibiotics, and21 they deem that as hazardous waste. And22 so then Pennsylvania state hazardous23 waste laws come into play and they have24 to -- anyone that collects them has to be25 48 11/10/10 - PUBLIC HEALTH - RES. 1005161 registered. So technically every one of2 our police districts would have had to3 have a registration. Anyone that hauls4 them has to have a special registration,5 and they have to be designated to a6 specific incinerator that has, I guess,7 special considerations to destroy this8 type of narcotics. So with the help of9 the DEA, we were able to get one10 registration for the whole City and then11 one registration for hauling it. And12 what I find out is that Pennsylvania does13 not have a qualified incinerator in the14 state, so they actually had to haul it to15 Ohio somewhere to have it destroyed.16 So there's a host of issues,17 and I think that's why at some point even18 with the federal laws we'll probably have19 to work with Pennsylvania Department of20 Environmental Protection to work along21 with us, how we can streamline this22 process and make it feasible.23
That's24 very complicated.25 49 11/10/10 - PUBLIC HEALTH - RES. 1005161
In your7 testimony, Mr. Daley, did you talk8 about -- I have down here census. You9 talked about the young people getting the10 drugs from home, their medicine cabinet.11 Is that more prevalent than getting the12 drugs on the street?13
Yes, at least for17 the initial phases of recreational drug18 use by young people. The survey data19 here from the National Survey on Drug Use20 and Health found that over 70 percent of21 people who abuse prescription pain22 relievers got them from friends or23 relatives, while only approximately five24 percent got them from a drug dealer or25 50 11/10/10 - PUBLIC HEALTH - RES. 1005161 via the Internet. So clearly the2 accessibility to drugs in the household3 poses a major risk for abuse, especially4 for young people.5
Okay.6 Well, thank all of you for coming this7 afternoon and presenting your testimony.8 It certainly is very interesting, and the9 whole issue of the disposal, disposing of10 these drugs, is really much more11 complicated than I would imagine or would12 have imagined. Thank you very much.13 INSPECTOR SNYDER: My pleasure.14
The Chair16 now calls on Dr. Stevan Gressitt and17 Dr. Julie Becker. If she's here, she can18 come up too at the same time.19 (Witnesses approached witness20 table.)21
We will22 recognize that testimony has been23 submitted for the record by Mr. Paul24 Ritter, science teacher from the Pontiac25 51 11/10/10 - PUBLIC HEALTH - RES. 1005161 Township High School in Pontiac,2 Illinois. He's the founder of the3 National Prescription Pill and Drug4 Disposal Program; testimony from Shawn M.5 Garvin, Regional Administrator, United6 States Environmental Protection Agency;7 and Mary Hendrickson, PharmD, MBA, RAC,8 Director of Quality and Regulatory9 Affairs, Capital Returns, Genco10 Pharmaceutical Services. That testimony11 will be entered into the record. And I12 have here testimony from the American13 Health Care Association, Bruce Yarwood,14 CEO and President, from Washington, DC.15 That testimony in its entirety -- all of16 these testimonies will be put in and17 added to the record for review by anyone18 who cares to read the testimony.19 Good afternoon, Doctor.20
24 Approximately two weeks before25 52 11/10/10 - PUBLIC HEALTH - RES. S. Senate hearing on S 3397 was the2 date that I understand this resolution3 was certified. Since that was passed, we4 now are in a different situation, as we5 are pending the Attorney General6 promulgating regulations. S. DEA10 held the first-ever National Drug Take11 Back Day at 4,094 separate sites in all12 50 states with 2,992 law enforcement13 agencies involved and over 121 tons of14 returned unused drugs. 18 It is very likely that a law19 passed or a regulation that this20 Committee could come up with might be21 overridden by a federal rule, but as I22 tried to tailor my testimony, I realized23 some of what I was hearing I'd like to24 offer another view on, and, that is,25 53 11/10/10 - PUBLIC HEALTH - RES. 1005161 rather than hitting the pause button,2 could we hit the shift button and shift3 up a bit. 8 Within 3397 are two references9 towards the end, and I have the language10 here. 15 Something that would be consistent with16 public health would certainly involve17 some sort of educational component, I18 would think. There's no funding attached19 to this federal rule. 22 What I'd like to say is that23 there's some history, and it's important24 to say this here, and I'm going to25 54 11/10/10 - PUBLIC HEALTH - RES. 1005161 salvage this from what I submitted. 5 Philadelphia was the first6 capital under the First Continental7 Congress from September 5th, 1774 to8 October 24th, 1774. The best estimate I9 have found of the total number of10 casualties for the entire Revolutionary11 War is approximately 25,000. 13 Unfortunately today, we have14 more deaths in a single year from15 inadvertent drug overdose or overdose,16 and that's a statistic that should at17 least raise this to some significant18 level of attention, and that is something19 this Committee could state, this Council20 could state. 23 My contribution to this hearing24 will not be a thorough review of national25 55 11/10/10 - PUBLIC HEALTH - RES. 1005161 or local rates, but I'll bring to your2 attention a mail-back program for which3 there is a sample mailer, precisely what4 is in use now, and I would point out that5 there are several ways that drugs can be6 returned. S. 22 The third is a permanent23 drop-off, as is done in San Mateo and24 other places where there's a drop box25 56 11/10/10 - PUBLIC HEALTH - RES. 1005161 within a law enforcement facility. 7 But there's a fourth. 12 And the reason is, it engages him with13 his community. 17 Now, paying attention to what18 specifically comes back can also drive19 policy. 25 57 11/10/10 - PUBLIC HEALTH - RES. 1005161 Meaning that when you get a first2 prescriptions of these, the state will3 only pay for 15 days. They will not pay4 for a first prescription for 90 days. If5 you have a good effect from that first 156 days, then a 90-day prescription can be7 paid. I'm not sure at what level a city8 can impact that. " One was to curtail childhood19 overdose; second, to curtail teenage20 theft; third, accumulation among the21 elderly. 23 The fifth was to address pharmacoeconomic24 waste, and the sixth was to curtail bad25 58 11/10/10 - PUBLIC HEALTH - RES. 1005161 international drug donations, which occur2 after every disaster; for instance, after3 the tsunami in Banda Aceh. 19
So this20 did not come from them as testimony; this21 is an exhibit?22
American24 Health Care Association information is an25 59 11/10/10 - PUBLIC HEALTH - RES. 1005161 exhibit?2
This was brought5 to my attention just two days ago. It6 was issued two days ago, and I finally7 got to read it on the plane.8
And so I would11 just point out that this represents the12 organization that represents all of the13 long-term care facilities, both14 non-profit and profit. And after I15 weighted through it, I find that there16 are two recommendations that they make to17 the U.S. EPA:18 Recognize the barriers that19 make it difficult for long-term care20 facilities to comply, and the previous21 nine pages go through all the22 difficulties they have with these23 regulations. These are only the EPA24 regulations. There will probably be one25 60 11/10/10 - PUBLIC HEALTH - RES. 1005161 just as long when the DEA has their2 regulations for some of the identical3 reasons, because of, in part, the4 inconsistency between current5 recommendations of federal governments,6 state governments and where they can be7 harmonized. But I ran across the final8 recommendation, and I'd just like to read9 part of it.10
It's the final13 page.14 As we note, meaning the15 American Home Care Association, many16 recommended disposal practices such as17 take-back programs have serious18 limitations due to regulatory barriers --19 and some of those the Inspector referred20 to earlier -- cost, complexity or21 perceptions that the programs are not22 safe. In contrast, the Maine Mail Back23 program for unused pharmaceuticals was24 highly successful because it was simple,25 61 11/10/10 - PUBLIC HEALTH - RES. 1005161 inexpensive and addressed all unused2 pharmaceuticals in the same manner.3 Importantly, it did not require consumers4 to undertake a sophisticated analysis of5 their unused medications or to sort drugs6 into different classes for different7 disposal techniques. Also, the Maine8 program offers safe disposal of newer9 medications where it is not yet known10 whether a P or a U hazard list is needed.11 Based upon conversations with the12 leadership of the Maine program, we13 hypothesize that the elements that led to14 success in Maine may be the keys to15 success for other programs as well. We16 call upon the EPA to provide additional17 funding to test an expanded version of18 the Maine program that would encompass19 long-term care facilities. And,20 alternatively, we urge EPA to partner21 with healthcare providers and other22 federal agencies to explore how we can23 replicate, expand and sustain such24 programs on a national scale.25 62 11/10/10 - PUBLIC HEALTH - RES. 1005161 It does not -- it's certainly2 an assessment from an outside group that3 refers to one of the programs, but I4 think it was the Inspector who referred5 to a coordinated series of approaches,6 meaning both drop-off, take-back events7 and mail harmonized together is probably8 the best way to go, taking into account9 urban-rural community engagement.10 And I appreciate your time. Be11 welcomed to answer any questions.12
Could I13 just ask a question? This testimony14 talks about prescription drugs, right?15
What about17 the disposal of non-prescription drugs,18 left over over-the-counter drugs?19
We accepted20 over-the-counter drugs. We accept openly21 controlled, non-controlled, because of22 our letter of agreement with the DEA,23 which probably I should give you some24 history to.25 63 11/10/10 - PUBLIC HEALTH - RES. 1005161 The first step was actually not2 setting up a program. It was to come to3 a representative body like this, our4 state legislature. And when we went to5 our state legislature, we defined the6 job, the role, of our state drug control7 agency as to facilitate the community,8 and that then met with this Controlled9 Substances Act definition of law10 enforcement "within the line of duty"11 being able to handle controlled drugs.12 We defined it as in the line of duty.13 Once that was defined, that made us14 eligible. And I think that has15 maintained the uniqueness of what there16 was in Maine simply because that was not17 in place anywhere else.18 So we took back controlled19 drugs, non-controlled drugs, over the20 counter. I actually personally am of a21 mind that illegal drugs could come back,22 because of the level of security we have23 in place. We never touch the drug. Once24 someone puts it in the mailer, if you25 64 11/10/10 - PUBLIC HEALTH - RES. 1005161 look at that mailer, the address is the2 MDEA. It goes to a post office box and3 then into the MDEA. We never touch it.4 The only time we touch it is when we5 count it to assess it, and there's some6 guys with guns in the room.7
What about8 security? I mean, what about theft of9 these mailers?10
We set up a11 redundant security system with a12 voluntary phone-in system to identify for13 us when certain mailers -- if you'll14 notice, there is a code number on that15 mailer, each one's serial. That code --16
Well, there's a19 redundancy here, because also the post20 office was identifying when these came21 into the system. And so when this number22 was called in, we had a list of numbers,23 not names, no names. We had numbers, and24 we could take that number set either with25 65 11/10/10 - PUBLIC HEALTH - RES. 1005161 the post office or with the MDEA.2 There's been no slippage. We would not3 keep up that after we've proved the4 pilot. We would not find it necessary.5 There are a number of savings even that6 can drive the cost down significantly.7 Remember, this was set up in such a way8 that for one year we didn't do anything9 except talk to lawyers. I mean, nothing.10 Talk to lawyers.11
Well, they12 did well.13 Okay. Don't go away.14 Councilwoman Brown.15
Thank you16 again for your testimony. And given your17 rich experience with this, whom do you18 believe, whom or what, should be the19 spoke in the wheel between DEA and EPA to20 have some uniformity in the execution of21 this new law?22
If I could, I'd23 like to suggest there's actually another24 complication. There's FDA and there's25 66 11/10/10 - PUBLIC HEALTH - RES. 1005161 EPA. So you have DEA promulgating regs,2 which will be the controlling agency or3 authority. The desire on DEA's part or4 FDA's part or EPA's part is not something5 I can read the tea leaves about, but6 going back to the use of the word "a7 public health message," we need -- and8 that's something this Council could also9 take a shift key on and recommend10 harmonization of federal guidelines for11 us poor citizens.12
The four,13 DEA, FDA, EPA and what was the fourth14 one?15
DEA, FDA, EPA,16 one can argue Fish and Wildlife and one17 could also argue the Office of National18 Drug Control Policy. It may very well be19 that ONDCP is best suited to be the20 coordinating function, but I'm not a21 wizard on federal agency mysteries.22
Lastly,23 the Athens Declaration, state again those24 six categories, and who came up with this25 67 11/10/10 - PUBLIC HEALTH - RES. 1005161 document?2
That came up at8 an environmental meeting held in 2007 in9 Athens with an international group from10 South America, North America, Europe,11 Asia, and at the end of it, based on12 presentations, it was put together and13 drafted and unanimously agreed to. I14 happen to be the person --15
So then24 was this sent to the 50 states, some25 68 11/10/10 - PUBLIC HEALTH - RES. 1005161 designated agency in the 50 states?2
No. We didn't3 do a very good job of publicizing it4 because we didn't have any support or5 infrastructure to send it around. We put6 it up on our web page.7
I see.8 Okay, then. Well, thank you again for9 the instruction and for the guidepost in10 what our action steps could be or should11 be following this hearing. Thank you12 very much for your contribution.13 Thank you, Madam Chairwoman.14
Thank you15 very much. We appreciate your coming16 down and appreciate your testimony.17 Never things seem to appear to be what18 they are, or whatever it is.19 Dr. Becker.20
My name is21 Dr. Julie Becker and I'm President and22 Founder of the Women's Health and23 Environmental Network. On behalf of24 WHEN, I would like to thank Councilwoman25 69 11/10/10 - PUBLIC HEALTH - RES. 12 While the vast majority of medications13 are eliminated as human waste, WHEN14 acknowledges that the disposal of15 unwanted, unused or expired medications16 present numerous challenges. A small17 pilot grant was submitted to EPA Region18 III and the Philadelphia Water Department19 to test a mail-in disposal process before20 Maine and Wisconsin began their21 large-scale, statewide programs. The22 objectives of this short, limited-scale23 pilot included educating consumers and24 health professionals about the potential25 70 11/10/10 - PUBLIC HEALTH - RES. 1005161 environmental impacts of improper2 disposal of medications; providing3 opportunities for safer disposal of4 unwanted pharmaceuticals through a5 mail-in system and reverse distribution;6 testing the feasibility of the model to7 be used on a larger scale; and testing8 educational materials that could be used9 to educate seniors about safer disposal10 options of unwanted or unused11 medications. 17 The results of the pilot proved18 that mail-in programs were feasible, the19 educational materials were helpful to the20 intended population and awareness of this21 issue was raised. 24 The types of pharmaceuticals that were25 71 11/10/10 - PUBLIC HEALTH - RES. 1005161 sent to the reverse distributor included2 antidepressants, anticonvulsants,3 cholesterol lowering drugs,4 over-the-counter analgesics, like aspirin5 or Tylenol, and cold medicines. 17 That's a mouthful. I spearheaded a18 qualitative research project to identify19 what four stakeholder groups knew about20 pharmaceutical disposal and to test21 reactions to disposal and pollution22 prevention strategies. The preliminary23 results from this multi-state study24 discovered that most medical25 72 11/10/10 - PUBLIC HEALTH - RES. 1005161 professionals, pharmacists, insurance2 companies and consumer advocacy groups do3 not know about the White House Office of4 National Drug Control Policy guidelines5 for home-based disposal practices, do not6 advise consumers on how to use these7 guidelines and would like better8 educational materials. The ONDCP9 guidelines describe how to dispose of10 unwanted or unused medications by mixing11 the medications with undesirable12 materials, such as coffee grounds or13 kitty litter, putting it in a leak-proof14 container and disposing in the household15 trash. 23 Working collaboratively with24 the Philadelphia Water Department, WHEN25 73 11/10/10 - PUBLIC HEALTH - RES. 5 We are testing its efficacy in6 a Pennsylvania Prescription Assistance7 Program pharmacy in Northeast8 Philadelphia. That's referred to as9 PACE. They do Medicare and Medicaid for10 senior citizens in the State of11 Pennsylvania. The goal of this pilot is12 to provide education about the ONDCP13 guidelines and increase awareness about14 safer disposal practices. Since this is15 a research project, it has received16 institutional review board approval at17 University of the Sciences. 19 Some key points from our pre-survey20 include: 74 percent of the participants21 use only this pharmacy and no other,22 indicating high level of consumer23 loyalty; 36 percent of the folks we asked24 disposed of medications in the last year,25 74 11/10/10 - PUBLIC HEALTH - RES. 4 Implementation of the logo on5 the stickers with the educational6 materials to increase knowledge of ONDCP7 guidelines begins this week and will8 continue for three months. We will9 conduct surveys of consumers in about six10 to eight weeks and one month11 post-intervention to assess the12 educational materials. We will have the13 results from this research project in14 spring 2011. 18 From our experiences, there are19 a number of challenges that impede20 pharmaceutical stewardship. These21 include what to do with controlled22 substances.
The Drug Enforcement Agency23 is responsible for implementing policy on24 this issue. These remain the largest25 75 11/10/10 - PUBLIC HEALTH - RES. 8 The need for ongoing funding to9 finance public take-backs or mail-in10 programs is essential. 16 Location matters for many people, and17 it's not clear if having law enforcement18 is the best possible place for19 take-backs. Additionally, with limited20 data collection on the types and amounts21 of drugs or the reasons for disposal from22 these events, it will be harder to move23 away from disposal to pollution24 prevention. The final disposition of the25 76 11/10/10 - PUBLIC HEALTH - RES. 11 State rules about the12 implementation of Resource Recovery and13 Recreation Act, RCRA, waste differ from14 federal laws. 25 77 11/10/10 - PUBLIC HEALTH - RES. 16 With the largest number of humans aging17 at one time, the potential for unused or18 unwanted drugs increases as well. 24 The collaboration between WHEN and the25 78 11/10/10 - PUBLIC HEALTH - RES. 1005161 Philadelphia Water Department highlight2 different low-cost approaches to3 providing informational materials on4 disposal to consumers and testing ways to5 implement these approaches. 15
That's16 very interesting.17 Now, will the Resource Recovery18 and Recreation Act come under the DEA19 rules and regulations that are being --20
So what happens24 right now -- and Pennsylvania is really a25 79 11/10/10 - PUBLIC HEALTH - RES. 1005161 unique place in many ways, but in this2 particular case, what happens is is that3 if we are to try to have a collection4 here in the state, if we collect the5 waste into one area, we collect the6 unused pharmaceuticals, it no longer7 becomes household waste. It becomes now8 hazardous waste. So, therefore, you need9 this special type of collection which10 classifies it as RCRA waste. You need a11 special hauler. And I believe the12 gentleman from the police force was13 talking about the importance of having14 that and how that needs to be set up. So15 when we initially did the mail-in here,16 we did not have a collection. We had a17 mail-back situation in order to test the18 proof of concept.19 COUNCILWOMAN TASCO:20 Councilwoman.21
Go ahead,24 Doctor.25 80 11/10/10 - PUBLIC HEALTH - RES. 1005161
Can I comment?2 There's something that Pennsylvania and3 Maine have in common. Our states have4 really tight, tight environmental rules.5
We are both7 unique. It makes it extremely more8 costly, extremely more cumbersome and far9 more burdensome on law enforcement.10 Actually, in some ways what is most11 restrictive and is chewing up a12 significant amount of the resources is13 the destruction costs.14
Well, there's not20 as many incinerators as there used to be,21 which really isn't a bad thing per se.22 Having incineration close by is not23 necessarily a good thing.24
One of the25 81 11/10/10 - PUBLIC HEALTH - RES. 1005161 issues is, the actual incidence of2 hazardous drugs and the total mix and in3 what we've counted coming back is very4 low. It's maybe 12 percent. We've got5 17 percent of what's coming back6 controlled drugs. So we think we're7 having an impact on controlled drugs, but8 then this very small percentage -- and9 for controlled hazardous drugs, the last10 time we did a count, we got one. And the11 whole thing was going to -- if we had not12 identified that, they would have required13 hazardous waste for the whole thing, and14 as a matter of fact, I think that's what15 ended up happening.16
How old is17 the Women's Health and Environmental18 Network?19
We've been around20 for 14 years. We just celebrated our21 14th anniversary.22
And what23 prompted the concept and ultimate24 creation of the organization?25 82 11/10/10 - PUBLIC HEALTH - RES. 1005161
We were birthed2 out of the breast cancer movement. So we3 initially come at this from looking at4 the nexus between environment and health,5 and myself and the other women who6 co-founded this had both served for a7 long time on breast cancer organizations.8
We wanted to10 address more of the root cause of why11 people get sick and not really focus on12 just treatment and diagnosis.13
Okay.14 Well, thank you for your testimony and15 your unique perspective.16 Thank you, Madam Chairwoman.17
Just a18 minute. When I first came into Council,19 there was this discussion about trash to20 steam. David Cohen was a strong opponent21 of incinerator trash. I have since been22 approached by individuals who it's now23 called waste to energy.24 Is there any way that if this25 83 11/10/10 - PUBLIC HEALTH - RES. 1005161 material is to be burned, it could be2 turned into energy?3
A number of the4 large waste folks that are doing5 incineration of different materials,6 including pharmaceuticals, are now7 calling this waste to energy. It's still8 incineration. The question is what's9 coming out of the smoke stacks. And also10 it is too an environmental justice issue,11 because most times where these places are12 located in terms of where the13 incinerators are located are located in14 low-income neighborhoods. And so for us,15 we would love to see something other than16 incineration being the final resting17 place for unused or unwanted18 pharmaceuticals. But we have an issue19 right now. We don't have the technology20 where we can thereby render21 pharmaceuticals both chemically and22 biologically inert, and that's sort of23 the DEA gold standard right now for24 saying where the final resting place25 84 11/10/10 - PUBLIC HEALTH - RES. 1005161 needs to go for pharmaceuticals.2
They go to8 incineration, that's it. So the waste to9 energy kind of component is still10 incineration.11
The difficulty12 is that there is a difference in13 temperature between the waste to energy14 and hazardous waste incineration. I15 believe both of our states are blessed16 with the same rule, that even though it's17 pretty hot, it might not be hot enough,18 but nobody has got any science that19 argues really one way or the other.20
In order for it to25 85 11/10/10 - PUBLIC HEALTH - RES. 1005161 be, quote, rendered biologically and2 chemically inert.3
So using the4 precautionary principle that something5 might have a risk, waste to energy is6 peremptorily dismissed and it must be7 hazardous waste, and we both get blessed8 with the taxi cab ride to Ohio.9
So if at10 the end of the day they burn it, what do11 they do with the ash? Is something --12
I believe each13 company may handle it differently, but14 what I know is it goes into landfills.15
It could, but19 theoretically it should be, because it's20 been burned at such a high temperature,21 it should be inert.22
And it would go23 into a hazardous waste landfill, which is24 also special, as opposed to a regular25 86 11/10/10 - PUBLIC HEALTH - RES. 1005161 landfill, all of which costs more.2
We hope to keep5 you optimistic, I think we both do,6 because we look forward to you being able7 to help us move forward on this. And I8 mean that.9
But what10 is gratifying is to know that you all are11 working on this.12
While we16 have a thousand other things to deal17 with, we appreciate your taking on this18 issue, but to the extent that we can be19 helpful and let us know what we can do to20 be helpful, certainly in this community,21 we would certainly be open to that.22
But thank25 87 11/10/10 - PUBLIC HEALTH - RES. 1005161 you so much for taking time.2 Dr. Gressitt, thank you so much3 for coming down. We appreciate it. You4 certainly have a great biography here and5 vitae, and we appreciate your expertise.6 Is there anyone else here to7 testify on this bill?8 (No response.)9
Certainly,10 Mr. Strain. Bernie. Is he still in the11 room? Would you have some closing12 comments you want to make or any13 recommendations right now?14 We will not adjourn this15 Committee. We will just recess it until16 the call of the Chair, so when we want to17 come back to further discuss the new18 developments or any other actions that19 we're asked to take, we would not have to20 introduce another resolution, unless21 we're going to do something totally22 different.23
Councilman Goode,24 thank you for your being here this25 88 11/10/10 - PUBLIC HEALTH - RES. 1005161 afternoon.2 Councilwoman Tasco, as always,3 it's good to see you.4 Councilwoman Brown, thank you5 for your effort in spearheading this6 cause. People sitting in this room,7 along with myself, are all rowing in the8 water at the same time. We just want to9 get all the oars in the water and all10 head in the same direction. You see that11 this is a very, very, very complex issue.12 You see there's federal guidelines, you13 see there's state guidelines.14 So I'd just like to thank the15 doctor for coming all the way from Maine16 and everyone in this room, who has a17 cause in this effort to try to save lives18 and to save our environment, and I'd just19 like to thank you and this Committee for20 meeting here today when there's other21 things that people could be doing on this22 beautiful day. And at that time, thank23 you very much.24
Well, we25 89 11/10/10 - PUBLIC HEALTH - RES. 1005161 appreciate your effort. We're sorry for2 your loss, but we thank you for taking3 this on. Certainly we will follow,4 through Councilwoman Brown, your5 direction and how we move forward to be6 helpful. During the course of the budget7 hearings during the spring when the Water8 Department testifies, you might want to9 come in and make further testimony just10 as an educational piece and11 conscious-raising. Other Councilmembers12 will know what's going on, what you've13 been doing, and it keeps us aware of --14 certainly we've had hearings on what is15 in the water, the Philadelphia water, I16 think a year or two ago. There was17 concern about contaminants in the water,18 so we had that discussion.19
Councilmembers,20 this isn't about me. This is about us,21 and this is about making Philadelphia the22 greenest city in America. Thank you for23 your cause.24
I think25 90 11/10/10 - PUBLIC HEALTH - RES. 1005161 you might want to talk to the Office of2 Sustainability if you have not. We3 should have had her here, Katherine -- I4 can never pronounce her last name --5 Gajewski. But she's very open to ideas,6 because her mission is to make7 Philadelphia green. So I suggest you8 schedule an appointment with her.9
Is there12 anyone else here to testify on this bill?13 (No response.)14
There15 being none, we will recess this Committee16 until the call of the Chair.17 Thank you very much.18
Thank you very19 much.20 (Committee on Public Health and21 Human Services adjourned at 3:55 p.m.)22 - - -23 24 25 91 1 CERTIFICATE2 I HEREBY CERTIFY that the3 proceedings, evidence and objections are4 contained fully and accurately in the5 stenographic notes taken by me upon the6 foregoing matter on November 10, 2010, and7 that this is a true and correct transcript of8 same.9 10 11 12 13 --------------------14 MICHELE L. MURPHY15 RPR-Notary Public16 17 18 19 (The foregoing certification of this20 transcript does not apply to any reproduction21 of the same by any means, unless under the22 direct control and/or supervision of the23 certifying reporter.)24 25