Recycling Unused Medicine

Across the country, nursing homes destroy thousands of dollars in medicine at each facility every day. The medicine is still good. But destroying the drugs has been the traditional way to keep prescription medication out of the wrong hands. A new federal directive might encourage more nursing homes to recycle unused medicines for the use of the poor. The GLRC’s Lisa Ann Pinkerton reports:

Transcript

Across the country, nursing homes destroy thousands of dollars in
medicine at each facility every day. The medicine is still good. But
destroying the drugs has been the traditional way to keep prescription
medication out of the wrong hands. A new federal directive might
encourage more nursing homes to recycle unused medicines for the use
of the poor. The GLRC’s Lisa Ann Pinkerton reports:


In her nursing home room, Genevieve Barns gazes out the window. A
black rosary is draped over her lap. She’s 94 and an oxygen
concentrator, bubbles behind her to help her breathe. She says even this
late in life she’s still abiding by her mother’s lessons.


“It’s a matter of how we were raised, you never wasted anything.”


Barns was on a common medication called Mucinex, to keep her
throat clear, but her doctor took her off of it. Normally, her unused
Mucinex would be sent back to the pharmacy for destruction, but Barns’
nursing home contributes it to a so-called ‘drug repository.’ Barns says it
was a simple choice to give medicine she can’t use to needy seniors.


“Well, everything is so expensive, and when you waste… you’re just
squandering things that should be used by someone.”


Four years ago, Ohio became the first state to recycle sealed, unused
medicine to seniors in need. Ever since, its two drug repositories have
struggled to get more participation. The drugs can’t be redistributed until
there’s enough of any one drug to make a 30 day supply. Then it’s made
available to seniors who otherwise couldn’t afford it.


At Genevieve Barns’ nursing home, the administrator, Denise Day,
collects the drugs in a blue plastic tote…


“We don’t have a huge cliental in this building at this time, but the
amount of medications that get sent back is still quite incredible.”


The bin in Day’s office is filled with pills and bottles sealed in their
packaging. She says what’s here comes from patients covered by
Medicaid; unused medicines covered by Medicare or private insurance
must to go back to the pharmacy for incineration before patients can get
their refund. Day says still, about 2-thousand dollars worth a month,
from just 34 patients, are recycled by the group called Serving Our
Seniors.


Its director, Susan Daugherty, says if every nursing home in her county
donated from just half their patients, the results would be astounding.


“Honestly we could meet and probably exceed the need of older adults
who’ve needed access to drugs that are common to the aging
populations. It could do a whole lot of good with a whole lot of waste.”


The drugs in this region are taken to Buderer Pharmacy. It’s become the
local drug repository. In the backroom shelves of medication go all the
way to the ceiling.


Matt Buderer is the pharmacist. He says the drugs are checked for their
expiration dates and whether they’re eligible for donation.


“And then what we want to do is take these drugs and poke them out of
this thing into a bottle. Making sure that what goes on the bottle is the
lot and expiration date.”


Seniors who’ve signed a waiver and received a card from Serving Our
Seniors can then buy any medication for a flat fee of 7 dollars and 40
cents.


“You can dispense one tablet. You can dispense 15. You can dispense a
billion for $7.40.”


Ohio’s not the only state with a drug repository program. At least
nineteen other states have mimicked the idea. Some states have had
more success than others.


In North Carolina the Board of Pharmacy says it recycles 5 to 6 million
dollars of drugs paid by tax payers every year. That’s a lot more than
Ohio’s program.


Buderer says his state could be matching those numbers, if only there
were more participation.


“There’s good public knowledge out there that large quantities are picked
up daily and incinerated that could be used. So I’m sure that a large
institutional pharmacy knowing that… certainly isn’t saying ‘well, we
don’t care.'”


Buderer says liability is often the reason given for not participating in
the drug repositories. The state’s largest nursing home corporation and
wholesale pharmacy. Both declined to comment for this story.


But now, there might be a bigger incentive. In April, the federal government
announced it will hold nursing home facilities financially accountable for
medicines going unused by patients. The states can still redistribute medicines,
as long as documents show the federal government isn’t paying for the same item
twice, and this acknowledgement of waste with in the system, might just be the
national push drug repositories need to move into the mainstream.


For the GLRC, I’m Lisa Ann Pinkerton.

Related Links

Upgrading Tired Hospital Food

  • Two gourmet chefs managing the kitchen at St. Luke's Hospital in Duluth are adding organic vegetables to the menu. (Photo by Stephanie Hemphill)

Some hospitals are trying to heal the food that they serve. The GLRC’s Stephanie Hemphill takes us to one hospital that’s making efforts to spice up their menu:

Transcript

Some hospitals are trying to heal the food that they serve. The GLRC’s
Stephanie Hemphill takes us to one hospital that making efforts to spice
up their menu:


(Sound of elevator)


St. Luke’s is the smaller of Duluth’s two hospitals. Their motto could be
“we try harder.” Several years ago, the hospital put two chefs in charge
of the housekeeping, laundry, and food.


In the kitchen, there’s the usual industrial stoves and dishwashers, and a
long assembly line where workers fill the trays for patients, based on
what they’ve ordered.


“The patient fills out the menu, I’ll have this entrée and that salad and this
beverage; then as the tray moves down the conveyor belt, they look at the
menu and put on the appropriate products.”


Mark Branovan was a gourmet chef at restaurants in California’s wine
country. In that part of the world, they take their fresh fruits and
vegetables very seriously.


“We did very little of our produce buying from the big distributors; we
had local guys that would grow lettuce for us, and herbs for us, and tomatoes…
anything we wanted. So that just kind of rolled over for us into, if
we can do it for a restaurant, why can’t we do it for a hospital?”


It’s harder to do in this part of the country, where you can grow lettuce
for about half the year and you’re lucky to get a tomato at all. But
Branovan and his colleague, LeeAnn Tomczyk, decided not to let that
stop them.


Tomczyk was a chef in a trendy restaurant in Wisconsin before she took
the job at the hospital. She says when she first came here, she was
appalled at some of the things on the menu.


“YOu know the patient was able to pick a jell-o salad and a piece of cake.
Well, to me jell-o is a dessert but to them it was their salad and that
was their vegetable, and that wasn’t right.”


Tomczyk and Branovan started to add more fruits and vegetables,
including organic items, to the menu, but they learned to pick their
battles.


“When I tried to change some of the casserole dishes, and some of the
traditional northern Minnesota fare, I was met with some serious
resistance from our customers and our patients who said, ‘Yeah, we have
tater tot hot dish on our menu because we like it.'”


One of the first items to change was the milk. Now the hospital serves
hormone-free milk to patients in the rooms and workers in the cafeteria.
Tomczyk says she’s convinced hormone-free milk and organic food are
healthier. She says an organization devoted to helping people heal, like a
hospital, needs to think about healing in broad terms, even globally. She
says buying local food avoids long-distance transportation, with its heavy
reliance on polluting fossil fuels.


“And the introduction of pesticides and herbicides, and that getting into
our water systems, it’s that whole cycle, and we’re using more and more
these days, and I think it’s just got out of hand.”


The hospital is also committed to reducing waste. It freezes unused
portions and gives them to soup kitchens and homeless shelters. It sends
its food waste to the city compost pile.


St. Luke’s is a member of a hospital buying group that negotiates prices
with big producers like Pillsbury. Each hospital is supposed to buy a
certain percentage of its food through the buying group. When Branovan
and Tomczyk asked the distributor for hormone-free milk, the distributor
didn’t carry it.


“We had to actually get a waiver that says they will allow us to buy off-
contract.”


Branovan got a similar waiver to buy organic fresh fruit, and greens for
the cafeteria salad bar. He hopes to add more organic and locally-grown
foods.


Branovan says St. Luke’s is the first hospital in the region to ask the
buying group to supply hormone-free milk and organic vegetables, but
hospitals and schools on the west coast and east coast are doing it on a larger
scale.


James Pond is editor of Food Service Director, a trade magazine.
He says the movement will grow.


“The pricing advantages will in some ways level out, where if it becomes
important enough to the clientele, the food service operators will respond
by providing products in this manner.”


Some hospitals organize a farmer’s market to serve their workers, as a
way to introduce them to organic and local foods. Then they add those
foods to the cafeteria and patient meals. At St. Luke’s, they feature
organic food at company parties.


For the GLRC, I’m Stephanie Hemphill.

Related Links

Kids Using More Prescription Drugs

Environmentalists and health officials often worry about the widespread use of antibiotics in cattle. But a recent report points to another concern: the rising use of such drugs in children. Researchers found a jump in the number of children taking prescription drugs. The Great Lakes Radio Consortium’s Mark Urycki reports:

Transcript

Environmentalists and health officials often worry about the widespread use of antibiotics in
cattle. But a recent report points to another concern: the rising use of such drugs in children.
Researchers found a jump in the number of children taking prescription drugs. The Great Lake
Radio Consortium’s Mark Urycki reports:


The survey was conducted by MEDCO, a pharmacy benefit management firm, and a division of
drug maker Merck. It found that prescription drug-use in children under 19 increased 85% over
the last five years. Although children still take fewer drugs than adults, MEDCO researchers say
it was the first time usage increased faster for kids than all other age groups.


The top drug use was antibiotics, with more than a third of the surveyed patients receiving such a
prescription each year. Health officials have expressed concern that the overuse of such drugs
could lead to drug-resistant bacteria.


A MEDCO researcher said the good news is that antibiotic use has at least flattened out. The
increased incidence of allergies, though, has not and the use of prescription allergy medicine
doubled from about 6% in 1997 to nearly 12% last year. Health officials suspect nearly twice as
many children today have allergies than 25 years ago.


For the Great Lakes Radio Consortium, I’m Mark Urycki.

Cooling the City With Green Rooftops

  • The City Hall in Chicago is topped with plants and trees to try to cool things down. The city is working to reduce the heat island effect caused by so many blacktop roofs and parking lots. Photo by Lester Graham

On the nightly TV news in large cities, the meteorologist sometimes talks about the heat island effect. That’s where all the blacktop roofs and asphalt parking lots soak up the heat and increase the temperature on a hot summer day. One major U.S. city is trying to do something to reduce that effect. To set an example, the mayor decided to start with City Hall. The Great Lakes Radio Consortium’s Lester Graham reports:

Transcript

On the nightly TV news in large cities, the meteorologist sometimes
talks about the heat island effect. That’s where all the blacktop roofs
and asphalt parking lots soak up the heat and increase the temperature
on a hot summer day. One major U.S. city is trying to do something to
reduce that effect. To set an example, the mayor decided to start with
City Hall. The Great Lakes Radio Consortium’s Lester Graham reports:


Standing on the roof, eleven stories up, isn’t really far enough to escape
the noise of the city below. But this rooftop is an escape. It’s a garden, a
big one. There are even trees. Not in pots, but actually planted on… or…
in the roof.


Marcia Jiminez is the Commissioner of the City of Chicago’s Department of Environment. She says Chicago wants building owners to
do what they can to cool the city down… and planting gardens on the
roof is one way to do it. So that’s what the city did on top of City Hall.


“Well, the garden on the rooftop is addressing what we call an urban heat
island problem. By putting the garden with light colored pavers and the
green plants on top of the roof, we’re actually helping to use less energy
inside the building and it actually helps to keep the building cooler.”


Cooling down the building is just the beginning of this garden. Despite
being eleven stories up in the middle of downtown, the roof is alive with
bugs and butterflies.


“Actually birds and all of the insects, many of them, have found their
way up here. We’ve actually put up birdhouses to study what kind of
birds are coming to the rooftop garden. This is a place of
respite as well as a place to feed.”


The whole rooftop has become something of a lab. Scientists research
what animals have made a home here… and they’re monitoring how the
plants are spreading.


Kimberly Worthington worked on the City Hall project to see it go from
the drawing board to rooftop. She says they chose plants for color, form
and for survivability.


“The design that we went with was low maintenance, was what we were
looking for in our plant selection. And the landscape architects that were part of the design team focused on plants that would require less water. And they also wanted to keep as many native plants as possible. So, there are a lot of prairie plants up here.”


The Chicago City Hall rooftop project also reduces rain water runoff. 75-percent of a one-inch rain will be soaked up right here in the garden. That’s good because too much rain overflows sewers into Lake Michigan. If enough buildings in the city had rooftop gardens, stormwater runoff problems would be curtailed a bit.


While the city is touting the environmental benefits of its rooftop garden, in another part of the city a planned rooftop garden is all about people.


Brenda Koverman is with the Schwab Rehabilitation Hospital in Chicago. We’re up on the roof where she’s showing me landscape renderings of how the surrounding area will look once the planting begins. Stone paths, fountains, flower gardens and shrubs.
It’ll look beautiful. And it’ll probably cool things down up here. But Koverman
says this is for the patients who are learning to be mobile after disabling injuries. The hospital hopes that patients in rehabilitation will find the rooftop garden more pleasant and helpful than institutional tile floors and plastic obstacles as they learn to
manuever…


“You know, so, are patients more able to maneuver their wheelchairs in the community? Are patients able to use their hands better so they can cook better at home? Are patients able to stay out of the nursing home and go to their home? So, if we can get any kind of
those outcomes, then it’s a huge success.”


It might be more interested in the patients, but the hospital will still be helping Chicago reduce its heat island effect.


There aren’t very many of these projects in the city, so it’s hard to say whether the rooftop gardens could cool things down all that much. But Environment Commissioner Marcia Jiminez says all you have to do is go up on the roof on a hot day. City Hall sits right next to the County Building. In fact they look like the same building. But not from the roof. Only one side is garden.


“In last summer in 2001 on the hottest day, while it was about a hundred degrees on the city hall side, it was 165 on the opposite end of the building where’s there’s a blacktop roof.”


Even if you’re not interested in planting a garden on your roof, the city still requires some effort to cool things down. City ordinance calls for light colored material when a roof is replaced. And parking lots have to plant some trees before they can get a permit to resurface. Rooftop gardens aren’t mandated… but city officials say they’re learning first
hand that it’s a much better use of space in the city.


For the Great Lakes Radio Consortium, this is Lester Graham.