Green Pharmacy The Opportunities for Minimizing the Environmental Load of PPCPs Nicholas D. Anastas, Ph.D., M.S. Poseidon’s Trident, LLC Triumvirate Conference November 20, 2008

Overview of the Talk History of PPCPs in the environment Lifecycle of PPCPs Greening each phase of the lifecycle Next steps

History of PPCPs in the environment

Lifecycle of PPCPs

Greening each phase of the lifecycle

Next steps

History of Environmental PPCPs Interest in environmental PPCPs has been a growing since the 1980s in Europe; more recently in U.S. (Daughton 2001). Federal, state and academic groups have contributed to these advancements. Daughton and others have been leading efforts in U.S. ( Toxicol. Lett ., 2002).

Interest in environmental PPCPs has been a growing since the 1980s in Europe; more recently in U.S. (Daughton 2001).

Federal, state and academic groups have contributed to these advancements.

Daughton and others have been leading efforts in U.S. ( Toxicol. Lett ., 2002).

Increased Awareness of Environmental PPCPs In the scientific literature Kolpin et al., 2002 Daughton, 2003 In the popular press AP five part series in March 2008 Response of federal and state regulatory agencies EPA States

In the scientific literature

Kolpin et al., 2002

Daughton, 2003

In the popular press

AP five part series in March 2008

Response of federal and state regulatory agencies

EPA

States

Environmental side effects of medication Non-target effects of medicines Human and veterinary Antibiotics Disposal influences soil microorganisms Potential changes to metabolism Anti-neoplastics Metabolism to more active products

Non-target effects of medicines

Human and veterinary

Antibiotics

Disposal influences soil microorganisms

Potential changes to metabolism

Anti-neoplastics

Metabolism to more active products

History of Green Pharmacy Green Medicine (Kreig, M., 1964) Ethnobotanical approach Green Pharmacy ( Duke, J., 1997) Herbal approach Green Pharmacy (Daughton, C., 2003) Environmental approach

Green Medicine (Kreig, M., 1964)

Ethnobotanical approach

Green Pharmacy ( Duke, J., 1997)

Herbal approach

Green Pharmacy (Daughton, C., 2003)

Environmental approach

Stages of PPCP Lifecycle Discovery and development Manufacturing Distribution Prescribing Disposal

Discovery and Development Opportunities for green pharmacy Green chemistry Green chemical design Improved selectivity (pharmacodynamics) Quick environmental degradation to innocuous products Improved potency Enhanced absorption ( e.g., “Rule of Five”)

Opportunities for green pharmacy

Green chemistry

Green chemical design

Improved selectivity (pharmacodynamics)

Quick environmental degradation to innocuous products

Improved potency

Enhanced absorption ( e.g., “Rule of Five”)

Manufacture and Distribution Use recycled materials when possible Design packaging for biodegradability and recycling

Use recycled materials when possible

Design packaging for biodegradability and recycling

Pill Economy Every pill manufactured using green design principles Every pill manufactured is prescribed Every pill prescribed is taken Unused/unwanted pills are recycled or completely destroyed

Every pill manufactured using green design principles

Every pill manufactured is prescribed

Every pill prescribed is taken

Unused/unwanted pills are recycled or completely destroyed

Prescribing Encourage judicious prescribing At the heart of pill economy Need to change the current approach in the medical profession Automated dispensing Pyxis system Prescribing prn

Encourage judicious prescribing

At the heart of pill economy

Need to change the current approach in the medical profession

Automated dispensing

Pyxis system

Prescribing prn

Disposal Flushing should be strongly discouraged Environmentally damaging Encouraged for some pharmaceuticals Must provide other options Incineration Recycling programs Take-back programs

Flushing should be strongly discouraged

Environmentally damaging

Encouraged for some pharmaceuticals

Must provide other options

Incineration

Recycling programs

Take-back programs

Take-back programs Reverse distribution Pharmaceutical companies reclaim unused and out of date medications Limited to hospitals and pharmacies Hazardous waste recycling days Returns to pharmacy for residential customers Mail-back programs Maine is a good example

Reverse distribution

Pharmaceutical companies reclaim unused and out of date medications

Limited to hospitals and pharmacies

Hazardous waste recycling days

Returns to pharmacy for residential customers

Mail-back programs

Maine is a good example

Environmental Pharmacy Taught as part of the core curriculum Medical schools Schools of pharmacy Nursing programs Industry examples Pharmaceutical roundtable (PIE) PhATE and PhACT

Taught as part of the core curriculum

Medical schools

Schools of pharmacy

Nursing programs

Industry examples

Pharmaceutical roundtable (PIE)

PhATE and PhACT

Opportunities for the medical community to support Green Pharmacy Research Support for the discovery and development of safer medicines Education Incorporate environmental pharmacy Provide brochures to patients and medical staff

Research

Support for the discovery and development of safer medicines

Education

Incorporate environmental pharmacy

Provide brochures to patients and medical staff

Available Options and Tools to Encourage Green Pharmacy Promote the use of green chemistry Already part of pharmaceutical and industrial chemical manufacturer’s practices Change education Incorporate “environmental pharmacy” into the curricula Medical and pharmacy schools Nursing programs Take-back programs

Promote the use of green chemistry

Already part of pharmaceutical and industrial chemical manufacturer’s practices

Change education

Incorporate “environmental pharmacy” into the curricula

Medical and pharmacy schools

Nursing programs

Take-back programs

Uncertainties Associated With Implementing a Green Pharmacy Sources Disposal Excretion Occurrence National vs. local data Treatment Hazard assessment Fate and transport

Sources

Disposal

Excretion

Occurrence

National vs. local data

Treatment

Hazard assessment

Fate and transport

Conclusions The practice of “green pharmacy” has already begun Green pharmacy is a holistic approach to reducing the environmental load of PPCPs

The practice of “green pharmacy” has already begun

Green pharmacy is a holistic approach to reducing the environmental load of PPCPs