Student feature: Rescribing - Recycling unused medicine
16 November 2009
Medical student Jessica Wynter-Bee describes how African health centres can benefit from unused UK medicine, in an article first published in Perspectives.
Recycling is in. Big time. It started off small but it’s been growing and growing till now pretty much everyone wants in on the act. This rush in popularity has led to improved recycling techniques, meaning that it’s now possible to recycle almost anything – paper, tin cans, plastic, car tyres, mobile phones, batteries, water, food, clothes etc. Something that is generally harder to recycle is medicine.
Many patients in the UK do not take the drugs prescribed to them for various reasons. Some patients have multiple medications on repeat prescription and continue ordering and collecting all of them, even the ones they no longer use. In other cases drugs are only prescribed in case certain symptoms occur such as an asthma attack or pain after an operation, and so may never be required.
When patients pass away, especially older patients who tend to take daily medications, they often leave a surplus of drugs behind them which tend to be binned by the family. In one BBC news video, a pharmacist displays over £1,000 worth of drugs which were returned by the family of one patient who came into hospital.
The Department of Health estimates that as much as £800 million worth of medicine prescribed in primary care is wasted every year. If hospital and other secondary care prescriptions were also taken into account this figure would be significantly higher still. Currently the UK government has no recycling scheme for unused drugs and the majority of unwanted medication is thrown away by patients or taken to the pharmacy for incineration. There is another option however.
Inter Care – Medical Aid for Africa is a UK registered charity which collects unused medications from GP’s surgeries in the UK and then delivers them free of charge to over 100 health centres in 7 countries in sub-Saharan Africa.
Patients deliver their unwanted drugs to registered GP surgeries and these are then collected by Inter Care and quality-control checked by a panel of volunteer doctors, nurses and pharmacists. Certain medications cannot be recycled by Inter Care and these are disposed of as clinical waste.
Drugs which can be used are checked to ensure that they are at least 15 months from expiry and are housed in their original packaging with no visible signs of tampering. Suitable drugs are then packaged and sent at regular intervals to the African health centres which have requested them.
Inter Care was founded in 1974 by a couple called Dr David Rosenburg and Dr Patricia O’Keefe. Working as GPs in Leicestershire they saw first-hand the wasting of medication occurring in the UK whilst at the same time learning from friends about severe shortages of drugs in Africa. This injustice galvanised them into action and they started collecting unused medications.
During visits to Africa in the early ‘70s Dr Rosenburg discovered a network of African Catholic nuns who were trained as nurses and who ran small rural medical units. The doctors used this network to distribute the medications they had collected and so Inter Care was created.
Nowadays Inter Care supplies over 100 units run by people of many different faiths, including Catholicism, Anglicanism and Islam. Sadly the couple have now passed away but their work is continued by trustees and other volunteers.
How can I help?
If this has sparked your interest, there are several ways to help Inter Care continue its work. Firstly, check with your GP surgery to see if they are registered with Inter Care and if they are not, encourage them to look at the Inter Care website and do so.
Secondly, if you do know of anyone with suitable unused medication ask them to take it to a registered surgery for recycling. Packaging and delivering the medications to the health centres is the major expense for Inter Care and is increasing significantly over time. To cover this and other costs, Inter Care runs several donation schemes which can be found on their website.
Obviously it would be preferably to have less wasted medication in the UK and for the African health centres to be able to afford their own medications without relying on our excess. Greater education for healthcare professionals and patients, and regular medication reviews are needed to help combat overprescription and drug wastage in the UK.
Change and development of the pharmaceutical industry along with a host of other things is required to help combat drug shortages and imbalances throughout the world. However whilst we work to achieve these goals, this small but active charity is providing a very practical approach to a significant problem.
Jessica Wynter Bee, fourth-year UCL Medical Student