1. Thank you to our sponsors!
Platinum
Gold
National Association of Clean Water Agencies
Waste Treatment Division, King County, WA
San Francisco, CA – Department of the Environment
San Benito County Integrated Waste Management
Hazardous Waste Management Programs, King County, WA
Idaho Department of Environmental Quality
King County Solid Waste Division, WA
Los Angeles County Sanitation Districts, CA
Minnesota Pollution Control
California Integrated Waste Management Board
Silver
Santa Monica, CA
Snohomish County Solid Waste District, WA
City of Palo Alto, CA Environmental Compliance
City of Palo Alto, CA
Central Vermont Solid Waste Management
City of Santa Rosa, CA
Central Contra Costa Sanitary District, CA
Veolia ES MedServe

2. PSI National Dialogue on Pharmaceuticals
Sacramento, CA
June 19-20, 2008

3. What is the Product Stewardship Institute?
Non-profit, based in Boston, founded in 2000
Membership
44 State members
54 Local agency members
20 Adjunct Council members
Board of Directors: 7 states, 4 local agencies
Multi-stakeholder product stewardship network
Adjunct Council: businesses, environmental/other org’s

4. PSI Full and Affiliate State Members

5. Why was the Product Stewardship Institute Created?
Unified voice for State and Local governments
Fiscal relief for government on waste issues
Objective data for decision-making
Forum for collaboration with industry
Nationally coordinated systems/harmonized regulations

6. PSI Projects Pharmaceuticals Medical sharps Fluorescent lamps
Mercury thermostats
Paint
Electronics
Radioactive devices
Telephone books
Gas cylinders
Tires
Beverage containers
Packaging
Batteries
Motor oil

7. What is Product Stewardship?
“Product Stewardship" is a principle that directs all those involved in the life cycle of a product to take shared responsibility for reducing the health and environmental impacts that result from the production, use, and end-of-life management of the product.

8. PSI Role in Dialogue Research Facilitate/mediate dialogue meetings
Implement projects & initiatives
Evaluate projects

9. Process for Developing Action Plan
Draft Problem Statement and Goals
Issues/Strategies
Interviews/input from stakeholders
Input incorporated into Action Plan
Draft Action Plan distributed - June 30
Input & additions to draft – due July 31
NOT PSI’s Issue Statement and Goals

10. PSI’s “Agenda” Promote product stewardship solutions
Reduce product impacts
Forge partnerships that share responsibility
Product management
Sustainable financing
Emphasize producer responsibility
Get results – not just discussion

11. Meeting Objectives General agreement on: Confirm road map
Stakeholder roles/process
Issue statement
Dialogue focus
Dialogue goals
Confirm road map

12. Meeting Objectives Greater understanding of other perspectives
Explore shared interests and ways to move forward
Determine next steps
Meeting date/location
Stakeholder assessment

13. Stakeholder Roles
Authorized to represent company, agency, or organization.
Attend 4 meetings (or via phone).
Active participation in and between meetings.
Jointly develop agreement.
Ensure your interests/others’ interests are met.
Participation in dialogue does not preclude legislative activity, other initiatives.
Negotiate in good faith.
Trust the process.

14. Press Role Use information discussed at meeting for background only.
No direct quotes from meeting of any participant.
Opportunity for quotes from participants outside of meeting discussion (breaks or post-meeting).

15. Consensus
All participants can live with decision and no one will actively block or undermine decision.
The greater the stakeholder agreement, the greater the likelihood that the agreement will be sustainable.

16. Consensus Consensus is preferable for broad initiatives:
Technical standards
Policies
Legislation or regulatory changes
Consensus is NOT needed for pilot projects or individual initiatives.

17. Road Map START Workgroup Activity Dialogue Meeting MEETING 4
AGREEMENTS
2 Workgroups
Develop findings
Draft work plans
Finalize agreements
Develop Implementation Plan
MEETING 1
Refine draft agreements
START
MEETING 3
Present Workgroup findings/plans
Discuss additional strategies
Start to develop draft agreements
MEETING 2
Workgroup Activity
Refine Workgroups
Develop Findings
Draft work plans
Present Workgroup findings/plans
Discuss additional strategies
Dialogue Meeting
June Sep/Oct January March 2009

18. Possible Dialogue Outcomes
Joint research (“joint fact-finding”).
Pilot projects with measurable results (data).
Demonstration project to test comprehensive program.
Model state or national education campaign.

19. Possible Dialogue Outcomes
State or federal regulatory or policy changes.
Model state or federal legislation.
National sustainable financing system for the management of pharmaceuticals.

20. Possible Mechanisms for Agreements
Letter of agreement between those involved in pilot project.
Memorandum of understanding (MOU) between stakeholders stating intent to perform certain activities.

21. What do we want to avoid? Multiple state solutions.
Unilateral state or federal regulation.

22. Issue Statement – Pharmaceuticals
Save lives, improve quality of life.
Already wide use is increasing (and number of products).
Become waste as they expire or are no longer needed/wanted.
Enter the environment through a variety of pathways, primarily human/animal excretion.

23. Issue Statement – Pharmaceuticals
Growing concern over potential for misuse, abuse, poisonings, etc. of waste/unwanted medications.
Growing concern over presence of pharmaceuticals in waterways (potential for human health and environmental impacts).

24. Issue Statement – Pharmaceuticals
Currently, there is a lack of agreement as to whether waste pharmaceuticals should be collected in drug take-back programs for disposal.

25. Issue Statement – Pharmaceuticals
The debate over whether take backs are warranted has led to confusion over what message to provide the public regarding the safest way to dispose of waste pharmaceuticals.

26. Issue Statement – Some believe…
Current state of science does not warrant collection.
Question whether take backs have environmental or safety benefit since data show that most drugs entering waterways are derived through normal use and excretion.

27. Issue Statement – Some believe…
Question whether enough of the public would use take back systems, further nullifying any potential benefit.
Believe that people misuse drugs whether or not they are wastes, and that take backs would not reduce the incidence of drug abuse.

28. Issue Statement – Others believe…
Take backs are necessary to protect against unsafe storage practices that have resulted in accidental poisonings, overdoses, thefts, diversions, and deaths, and to reduce pharmaceuticals entering the environment.

29. Issue Statement – Others believe…
Industry take-back programs already exist in Canada and Europe, so why not the U.S.
While the science regarding environmental impact is uncertain, the potential scope of the problem could be immense, and therefore justifies invoking the “precautionary principle.”

30. Issue Statement – Others believe…
If they are convinced that a problem exists and they want their citizens and patients protected, regulations should be changed to allow programs for the collection of residential pharmaceuticals that are not unnecessarily inefficient, costly, or burdensome.

31. Issue Statement – Pharmaceuticals
While there is an emerging consensus that flushing unwanted pharmaceuticals down toilets is not recommended, there is disagreement over whether disposal in the garbage represents safe disposal.

32. Fundamental Questions
Why go through the trouble of educating consumers not to flush if there are no aquatic or human health impacts?
Is there a societal benefit to reduce the amount of waste/unwanted medications?
Is there a societal benefit to collect waste/unwanted medications once generated?
Can waste pharmaceuticals be safely disposed of in the home?

33. Dialogue Focus
This project will focus on unwanted or waste pharmaceutical products from residential sources (e.g., households, nursing homes, hospice care, long-term care facilities, schools, cruise ships, hotels, and pet care facilities).

34. Dialogue Focus
The project will specifically address the proper management of unused pharmaceuticals that typically enter the municipal solid waste stream, municipal wastewater, or residential septic systems. 

35. Dialogue Focus
The project will not focus on personal care products or non-pharmaceutical endocrine disruptors

36. Dialogue Focus
It will not focus on problems related to the use of pharmaceuticals, although the impacts of dispensing and use practices that are relevant to the generation of unwanted and waste pharmaceuticals will be explored.

37. Dialogue Goals
Evaluate the need for a nationally coordinated system for the management of unwanted/waste pharmaceuticals that allows for multiple solutions to reflect local/regional differences.
Increase the safe, legal, and environmentally-protective management of unwanted/waste pharmaceuticals through the development of best management practices.

38. Context for Collaboration
Some want more research to better understand the nature and scope of the problem.
Some are implementing take-back programs.
Some states are introducing legislation.
Given differences in opinions, are there areas of potential collaboration?

39. Potential Area of Collaboration: Joint research
Quantity and type of waste/unwanted medications.
Extent of accidental poisonings, overdoses, thefts, diversions, and deaths attributable to waste/unwanted medications in the home.
Percentage of pharmaceuticals in home storage attributable to normal use vs. waste/unwanted medications.

40. Potential Area of Collaboration: Joint research
Percentage of pharmaceuticals entering waterways attributable to excretion vs. other pathways.
Impact on aquatic species and potential impact on human health.
What are the reasons and attitudes behind household storage and disposal practices and preferences?