Avaliação da efetividade da logística reversa do descarte de medicamentos: estudo de caso do programa traga de volta do Conselho Regional de Farmácia de Minas Gerais

Reverse drug logistics (LRM) has been one of the most appropriate environmental solutions to the problem of pharmaceutical waste disposal. In view of this, the present study aims to evaluate the execution of the LRM program of the Regional Pharmacy Council of Minas Gerais (CRFMG), through techniques of Environmental Management System (SGA). For this purpose, the research was presented in four chapters, so that, in Chapter I, a systematic review was presented describing the main initiatives in LRM, with a focus on treatments - incineration and co-processing - and final dispositions - launching into a sewage system and disposal in landfills - applied to pharmaceutical waste. As a result, it was found that most developed countries opt for incineration and in developing countries, there is no widely available scientific material on the subject. In chapter II, we sought to understand how a municipality, where there are no LRM systems in place, manages its drug residues. Thus, the profile of medication use of the population of Bambuí, a city located in the Midwest region of Minas Gerais, was evaluated, the ways of disposing of pharmaceutical waste, with a view to the identification of probable routes to environmental destinations as well as the characterization of pharmaceutical residues found at the collection point of a Basic Health Unit (UBS). It is concluded that: i) the drugs most consumed by the population, are also the most discarded; ii) the majority of the analyzed population does not dispose of their medical waste, accumulate it in their homes or dispose of it inappropriately in the domestic solid waste; iii) the use of the LRM tool available in the UBS of the investigated municipality is inadequate, since it contains non-medicated residues inside. In chapter III, the history of the collection program for expired or unusable medicines, the Traga de Volta of the Regional Pharmacy Council of Minas Gerais (CRFMG), was investigated, evaluating the main aspects involving its execution, as well as seeking to understand the perception of the actors involved - responsible for the collection points and representatives of the CRFMG - in the program's actions. In this way, consensus was reached for most of the benefits of Traga de Volta, however, regarding the obstacles, there was no agreement among the specialists, suggesting that, with due legality and a process of improvements, the program could continue. It is concluded, therefore, that although there is no LRM system properly implemented in Brazil, isolated initiatives, such as Traga de Volta, become the option for establishments to optimize the management of their pharmaceutical waste. However, it is essential that these programs adapt their activities to EMS techniques, so that the social and environmental responsibility of the entities in the pharmaceutical chain is focused on the protection of public health and the environment. Finally, Chapter IV was developed, which consisted of the elaboration of a technical product for didactic and instructive purposes, making it available to the Class Council of the Pharmaceutical profession, the CRFMG. Thus, it was possible to provide technical subsidies for the improvement of LRM programs, for the training of pharmaceutical professionals on the subject and for campaigns on the rational use of medicines.