The True Cost of Unused Pills: Medication Reviews
In the UK, the NHS recommends that each patient receives an annual medication review with their GP or pharmacist. This is aimed at ensuring that patients (especially those on long-term or multiple medicines) are only taking what they need. And to avoid medication waste, a huge issue for the planet, and wasted costs that could be spent elsewhere.
This medication tracker (with optional magnet backing) is printed on recycled paper, and sent in plastic-free packaging. Printed with green energy and nontoxic inks, it has 52 tear-off pages to keep you on track.
Medicines may do good, but also come with side effects. Although in many cases medicine is needed, sometimes so-called ‘dinosaur doctors’ just prescribe pills, when there are alternative methods like counselling (for anxiety/depression), gym memberships (for obesity) or or therapeutic massage or medical acupuncture (for pain).
What does a medication review entail?
The idea is to take along all your medicines (and supplements, as some have interactions) and ask if they are still appropriate, necessary, effective and safe.
For instance, if you take medicine for type-2 diabetes but have changed your lifestyle to need less insulin, your GP may be able to safely reduce or even eliminate the dose. Same with statins to reduce cholesterol.
And if you take medicines that are not helping, you may be able to safely come off them too with permission. Sometimes there are recalls, or more effective medicines to replace those you are already on.
Many people with long-term conditions (and patients especially over 75) are on many medicines. And reducing the number to what is only needed, reduces risk of over-dose, and interactions. Especially for older people who may be getting the first signs of dementia, so taking too many medicines confuses.
Who can conduct a medication review?
Ideally your GP, but clinical pharmacists are also able, if you prefer. The medication review can be face-to-face or even by phone or by home visit. Ensure you discuss any side effects, and you should also have blood tests reviewed, before deciding whether medicines can be adjusted, replaced or removed.
Is this not just more work for busy GPs?
On the contrary. If the GP’s job is to keep you healthy, reducing unnecessary medicines helps you to feel better. It also means he has a better patient, so should mean less work for him or her in the long-term. And it frees up funds from prescribing unnecessary medicines, to help other patients.
How to prepare for a medication review
After requesting a medication review, you should prepare by listing all current medications (and those you have been prescribed but for whatever reason are no longer taking). Along with supplements, over-the-counter medicines and herbal remedies. Including those being prescribed by holistic therapists.
Include the date your were prescribed, dosage and number of times a day or week you take them. Also be honest about if you feel ‘addicted’ to any medicines, as this is as serious an issue as for illegal drugs.
Why is medication waste such an issue?
In the UK, it’s thought that the NHS loses around £300 million each year from unused or partially used medicines, with around half returned to pharmacies for recycling each year. The other half languishes at home in cupboards, or is incorrectly disposed of in the trash, recycling bins or down the loo. Which then ends up in our waterways, messing up ecosystems and harming fish and marine wildlife.
This also creates safety risks (for instance some medicines are administered by needles). The cost of wasted NHS medicines each year could fund over 11,0000 community nurses or 80,000 hip replacements.
Why is there so much medication waste?
Due to the NHS over-ordering repeat prescriptions, and some ‘lazy GPs’ who just keep prescribing medicines to patients who often don’t even bother to take them, due to being ineffective or having side effects.
Many people also don’t like the ethics of medicine. All items by law must be tested on animals, and many include animal ingredients (like red dye colours from insects to lanoline to gelatine pack covers). So a person being prescribed such medicines, may feel uneasy to speak up, but then just stockpile at home.
Unused medicines at home are also a poisoning hazard, or at risk of misuse by people with addiction problems.
How to dispose of unused medicines
Never flush down the loo, nor bin or put in recycling bins. You can take any unused medicines (along with herbal remedies and supplements) to your local pharmacy for safe disposal. Remove your personal details for privacy, before doing so.
Unused medicines can’t be reused, even if they have not been opened. So are incinerated, to prevent environmental contamination. This causes greenhouse gases, another reason for not being given medicines that you don’t need, in the first place.
The plastic packaging can (along with paper and cardboard) be recycled at home. However, blister packs can’t, so them them to Boots recycling schemes (Supermarket also have a box in partnership with Terracycle).
Used needles should be disposed of in a dedicated sharps bin from your GP or local council.
Inhalers (used or expired) should be returned to pharmacies. They contain gases that harm the environment if sent to landfill, so this way they will be safely disposed of.
Insulin pens again can be recycled in Boots, and some brands offer postal recycling schemes for pens.
Why not take a few hours to gather together all your medicines and supplements (keeping them out of reach of children and pets), and group them into what to take to the GP. Along with whatever your GP takes you off, which can then all be sorted and recycled/disposed of safely, to get out of your home forever.
Is over-prescribing medicines harmful?
A National Overprescribing Review found that around 10% of prescriptions issues in primary care are unnecessary or potentially harmful. Over 8.4 million people in the UK take five or more medicines on a regular basis, and taking 10 or more means you are 300% more likely to be admitted into hospital, with adverse drug reactions.
It’s interesting that overprescribing is more common in deprived areas and in specific groups (like adults with learning disabilities). One in six people with a learning disability was found to have been prescribed anti-psychotics, without a proper diagnosis.
Why is this? It was found that it was less to do with lack of GP skill, and more cultural factors. Deprived areas often have more workloads, and this leads to less time for each consultations and proper medication reviews.
Unlike holistic medicine, clinical guidelines for orthodox medicine often focus on one issue at a time. So if a patient has multiple conditions, he or she may end up on a cocktail of drugs. Other surveys found that GPs also sometimes are pressured by patients to prescribe medicines, when they are not needed.
Also be proactive. If you visit a GP and are being prescribed a medicine, don’t be afraid to ask ‘What are the benefits and side effects?’ and ‘are there non-drug alternatives I could try first?’
Also in low income areas, prescriptions (unlike in Scotland where everyone gets free prescriptions), you don’t pay for them. So people who do like to take drugs, may end up asking for more than they really need.
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Together Health CPD Hemp is a quality organic supplement that’s batch tested for purity and potency, each dose provides 10mg CBD for chronic pain, and includes piperine (black pepper extract) for improved absorption.
The full spectrum powder capsules contain complete hemp material with CBD and terpenes, for a full spectrum of cannabis, terpenes and important compounds including phenols, flavenoids and essential fatty acids.
It is recommended to start witha low dose, increasing the dose to help pain. As the body builds tolerance to CBD when taken regularly, so it may be needed over time to increase the dose to maintain effects. Made with organic hemp grown in the European countryside.
Always check with GP if pregnant/nursing or taking any medication, before using supplements.
The capsules are made from plant cellulose from the Pinus Elliottii tree, and can be separated and the contents mixed with food or drink if preferred.
The supplements are sold in easy to recycle pouches that are plastic-free and contain a protective film made from wood pulp. All layers are home compostible.
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Is It Worth Paying for Private Health Insurance
With the NHS at bursting point for waiting times, should you wait for an operation or take the plunge and pay for private health insurance, to get immediate quality treatment. Of course it’s up to you. The NHS is a political hot potato, with some parties suggesting some people should pay for (non-emergency) care.
But believing in the NHS is not going to fix an urgent operation, if you have to wait years. So it is worth paying for health insurance, in order to get better and faster treatment?
These medication tracker pads are printed on recycled paper and sent in plastic-free packaging.
What does private health insurance pay for?
Do your homework, as all these companies are for-profit. Which usually means that there are often caveats like pre-existing conditions. And they employ people who go through everything with a fine-toothed comb to try to avoid paying out. Same with finding affordable pet insurance.
Most will offer fast scans and consultations and non-emergency surgery like hip replacments or cataract operations. You also usually benefit from private wards with en-suite rooms (though the price you’re paying should really be for the medical care, not extra luxuries). A few offer specialist treatment and drugs not yet on the NHS, due to funding limists.
Private health insurance does not cover emergency care (you then go to an NHS hospital). It also rarely covers ongoing long-term conditions like diabetes, asthma or rheumatoid arthritis. Nor conditions you have had in the last two to five years. Read the small print.
Private health insurance does not cover organ transplants, normal pregnancy/childbirth costs, cosmetic surgery (for appearance reasons) nor injuries related to dangerous sports.
You may get quicker access to treatments like physiotherapy (but to be honest, the premiums you pay may be better used just finding a local physiotherapist in your town).
How much does private health insurance cost?
It depends on the company, as it’s a private competiton market. Expect to pay around £70 to £140 a month for the average individual policy, you may get discounts for families. Premiums may rise as you get older (as you are more likely to get ill) and sometimes premiums are higher or lower in certain areas).
You usually have to pay an excess (£100 to £500), which can lower monthly premiums.
Is self-insurance better?
This basiclaly means putting money away in a rainy day account, so you have the money spare if you need it. It can work out cheaper if you only have a small oepration. But obviously if you have a major condition that would cost tens of thousands of pounds, this may not pan out. Yoru savings may not be enough to cover a large private hospital bill. Or they may.
How to decide what’s right for you
- If your budget is tight and your health is pretty good, you may wish to ‘rough it’ and know that we have an NHS for emergencies. Most countries don’t. This provides free world-class care in most cases, at point of use.
- If you have complex health issues, most private healthcare companies won’t touch you anyway. So if you decide to go with them, do your homework first. To ensure any conditions are not excluded. And what you would be able to claim for in the future, if you needed medical care.
- Check your employers, as some already offer included or discounted private health care. Don’t pay full price, if you don’t have to!
- If you’re self-employed, you may wish to find a low-cost private health insurance, to cover you if you can’t claim sick pay and had to wait months for an NHS operation.
The Hospital Saturday Fund is a registered charity that started out to help people, before the NHS. You obviously have to pay premiums for a while before receiving benefits. But you can then get a bit of money back on dental, optician and holistic services, plus hospital stays.
What are NHS political party policies?
Labour. Wishes to reduce waiting times by investing in more staff (especially GPs and midwives) and digital ideas (like seeing a GP online). It hopes to build 50 hospital and improve mental health services.
Conservative. Add 92,000 more nurses and 28,000 more doctors, and also build 40 new hospitals and increase mental health care support, and reduce managers by 5,500. And legislation to prevent doctor strikes.
Lib Dem. Spend an extra £5 billion a year, focusing on free personal care and mental health hubs for young people.
Green. Properly fund health and social care (by £30 billion by taxing the super-wealthy), remove profit motives and guarantee access to an NHS dentist.
Reform UK. The claim made by some that Reform UK wish to scrap the NHS is not true, but Nigel Farage has said that we need to look at how to fund the NHS, as just throwing money at it, is not working.
He’s a fan of the French system that works a bit like ‘you pay if you can, not if you can’t, and wants to look at something similar. But still wants the NHS to be free at point of use (say emergencies). So not like the USA.
It proposes spending £17 billion on the NHS (so way more than the main parties, but half of the Greens, as it would not tax the super-wealthy). The promise would be to eradicate waiting lists in 2 years, and would also give 20% tax relief for private health insurance and providers.
Why Is Medical Acupuncture Not More on the NHS?
Acupuncture is a holistic medicine that is widely practiced worldwide. It works in a very different way to conventional western medicine, in that it uses very thin needles (they don’t hurt!) to ‘open up meridians’. We won’t go into the science, as only the practitioner can really tell you in detail, and you likely just want to feel better.
There have been quite a few double-blind trials to show that medical acupuncture can be affected for various conditions, the most common is long-term chronic back pain. And other kinds of pain like arthritis or migraine. It kind of works by stimulating nerves to prompt your body to release endorphins (natural pain killers) and improve blood flow.
It will only work in conjunction with a healthy lifestyle. So if you visit an acupuncturist say for bad migraines, the practitioner could possibly help with improving blood flow and relieving pain over a number of weeks. But if you go home and then live on black coffee and red wine, it won’t cure your migraine! Holistic medicine always involves lifestyle changes.
Acupuncture is pretty safe when done professionally, there are a few caveats (above) and some people may feel a tingle or dull ache during treatment (which lasts 20 to 40 minutes). But for most people it doesn’t hurt, and some people even find it relaxing. Your practitioner is also sure to give healthy lifestyle tips, to continue between treatments.
Be careful, as a few may recommend herbal medicine. This DOES often have serious side effects (and should never be given without consultation with your GP). Which is why it’s so important to only use properly registered medical acupuncturists.
Another reason is that some unlicensed practitioners still (illegally) use medicine that uses animal parts (like powdered tiger and rhino horn, bear bile or ingredients critically endangered pangolins (all victims of wildlife crime).
Don’t worry about infections, as acupuncture needles are all sterile, and single-use (just like syringes).
Where to find qualified acupuncturists
The good news is that some reputable medical acupuncture is available on the NHS, but you may have to ask your GP (especially sceptical ones) although some GPs are actually trained in acupuncture too. But they can legally refer in most cases, if there is one that is licensed to practice to NHS guidelines.
Acupuncture is often not given to people with pacemakers/implants, bleeding disorders (including those on medication) and those at risk of infection. And nobody with a metal allergy!
Enter your postcode at British Acupuncture Council to find one of 3000 members, who belong to an accredited register that is regulated and approved by the Professional Standards Agency for Health & Social Care. GPs can legally refer.
More affordable are community acupuncture clinics across England that offer the same, bringing the price down to around £20 (rather than £40 to £80). One practitioner treats several people in one room, each person behind a privacy screen
Where to Buy More Sustainable Aromatherapy Oils
Aromatherapy oils are popular for beauty and medicine, but many brands are from endangered trees and packed in plastic. Also it’s important to dilute them, as neat oils poured down sinks can harm aquatic life.
Avoid aromatherapy oils for pregnancy/nursing and epilepsy, and avoid use near babies and pets. Air rooms after using, and don’t use in bedrooms, if pets sleep on your bed.
Always choose organic eucalyptus oil, for sustainable harvesting methods (to avoid companies that use chainsaws to chop down forests that are home to koala bears).
Rosewood oil is from an endangered tree, choose ho wood as a sustainable alternative.
Keeping safe with essential oils
- Avoid going out in the sun for 18 hours, after using photo-toxic oils (bergamot, grapefruit, orange, lemon) to avoid burns and blisters.
- Use natural reed diffusers over candles (if used, read our candle safety tips).
- Dilute essential oils with carrier oils (avoid oils in baths).
- Avoid use in cars (allergies, babies, pets). Use charcoal bags to absorb odours.
Aromatherapy was ‘founded’ when a French perfumier burned his arm, and plunged it into a vat of lavender oil, and found it healed. Today it’s used for beauty and medicinal use.
Tisserand offers sustainable aromatherapy oils, founded by teacher Robert Tisserand. The organic oils are certified by Soil Association. Use a few drops of essential oil to blend with organic jojoba oil (you can use this oil without essential oils to heal dry and damaged skin).
Just add a few drops to your skin. This oil is also good to prevent razor burn, after shaving. Or use as an alternative to body lotion. Jojoba oil is also good for your hair, to help prevent split ends. Just rub in and leave for a few minutes, then shampoo as normal.
For an aromatherapy bath, add 4 to 6 drops of pure oil to a warm bath, avoid base oils to avoid slipping).
- Relaxing oils include lavender, ylang ylang and patchouli
- Warming oils include ginger, black pepper and juniper berry
- Refreshing oils include peppermint, rosemary, citrus, tea tree.
Tisserand aromatherapy spa diffuser
If you wish to scent a room, you can use Tisserand’s Aromatherapy Spa Diffuser (again, never use this around babies or pets, and air rooms before allowing them back in).
This is safer than candles. Switch on to vibrate water molecules that produce steam with tiny bubbles, with the essential oils heated in the reservoir, to produce rising steam. It runs for 4 to 5 hours, then automatically shuts down, when it runs out of water.
Place on a stable surface and never bend the cord, and do not use in smoky, damp places, nor near strong vibrations like music. Only use with tap water (don’t add more than 8 drops of essential oil).
Homeopathy (it’s more than just ‘water with a memory!)
Homeopathy gets a lot of attention because it sits in a space many people feel strongly about. It’s a form of alternative medicine that uses highly diluted substances, chosen to match a person’s symptoms in a very individual way. Some people turn to it for everyday problems, such as hay fever or poor sleep. Others remain doubtful, especially because views on how well it works are mixed.
So, it helps to keep two questions in mind. First, what is homeopathy, in plain English? Second, where might it fit, if at all, in a wider approach to health and care?
Holistic medicine can be good, but only if you know what you’re doing or can find a good holistic doctor. Unlike say in Germany (where holistic medicine is routinely offered by GPs), sometimes for minor illness (or when conventional medicine can’t help) you have to travel through a minefield of info online to find the truth. Which is not the best idea.
Homeopathy is one holistic medicine that gets a lot of flack, because it’s basically watered down so much, that it’s a bit like ‘water with a memory’. However (as long as you don’t use it alone in defiance of medical advice for serious conditions), unlike some medicines, it’s more or less harmless (especially as it’s kind of water!)
However, do be sure to check ingredients. Many pills use lactose (from milk) and a few remedies are not vegan (apis for instance is from bees, so not good for welfare).
The theory behind homeopathy
Homeopathy was actually ‘invented’ by an 18th century German medical doctor (Samuel Hahnemann), using the premise of ‘like cures like’. A simple example of this is a vaccine. If you have a vaccine for chickenpox, you are going to be receiving a tiny bit of chickenpox, so your body will fight it and gain immunity.
Likewise with homeopathy. For instance, a remedy for a streaming nose may contain onions! A remedy for insomnia may contain coffee. But seriously watered down. Homeopathy remedies are sold in the ‘law of minimum dose’. So they are made by serial dilution by vigorous shaking, to make the remedy more gentle (yet more potent).
Say you make a cup of tea and stir in sugar. If you keep adding water, the taste will grow less sweet. But the sugar is still there.
How homeopathy works in practice
You can visit the health shop to find some gentle remedies. For instance, many people keep a tube of arnica (for bruises) on hand or a tube of calendula cream (to heal cuts). Also choice depends on type of illness. For instance, one person with a migraine may feel better in the fresh air, another feels better with firm pressure on the head.
That’s where professional homeopaths can help, as they are highly trained (for years) in knowing which remedies are best for which symptoms. They then prescribe remedies in different potencies (like 6C or 30C).
Remedies are stored in a cool dark place, and usually should not be used alongside minty (toothpaste, mints, breath freshener, gum, peppermint tea tea). Once opened, treat the bottles like would you spices, as they fade in effectiveness, if the tops are left open.
What conditions can homeopathy help?
Alongside lifestyle changes, some common conditions that homeopathy can sometimes help are:
- Allergies: Streaming eyes and noses, sneezing fits.
- Digestive upsets: Nausea, bloating and sluggish digestion.
- Stress and mood: Grief and mental fatigue.
- Minor injuries: Bruises and small cuts or grazes.
- Colds and flu: Heavy limbs, aching bones and droopy eyes!
Due to limited ‘evidence’, homeopathy is not that common on the NHS (it’s only allowed when there is evidence). But some GPs do train it or refer to others. Keep your GP informed of any possible treatments.
Benefits and limitations of homeopathy
Although not suitable for emergencies (an acute infection or road accident needs antibiotics or a medical doctor), for other conditions, many patients prefer its gentle approach. And the one-on-one deep discussion with a qualified practitioner, rather than just a 15-minute ‘doling out pills’ appointment.
Find qualified practitioners at Society of Homeopaths or the Faculty of Homeopathy (some insurance companies will pay out for properly trained and insured homeopaths). You must tell the practitioner if you take drugs, or are under a GP care for any medical condition).
What does the evidence say on homeopathy?
There is not a lot of evidence on homeopathy. But that’s usually because (unlike medical acupuncture) not a lot of trials have been done). As you likely know, Queen Elizabeth II had her own personal homeopath (and whether it was good genes or not, she remained incredibly healthy for her age, right up until her death).
NICE (the organisation that approves medicines for the NHS) does not recommend it (nor does World Health Organisation for serious diseases like HIV, TB or malaria). However, it also must be said that many people die or get bad reactions from medically-approved pharmaceutical drugs, so the end result is not so clear-cut.
One good thing is that due to not being ‘approved for use’ for the NHS, it means that homeopathic medicines are not tested on animals (the law currently says that anything prescribed must be).
Further reading on homeopathy
- Claire Gardener Homeopathy is proof that homeopaths can offer plant-based remedies in sustainable packaging. If she can do it, so can the others.
- Dr Jonathan Hardy is a medical homeopath with information on how it works. He switched from studying medicine after being amazed by results.
- Homeopathy & Natural Remedies for Children is a book by a homeopath who has treated many childhood ailments over the years. Her site offers information and courses from 17 years experience, including one patient’s story of recovering from a near-fatal brain injury.
The Alliance of Registered Homeopaths also lists practitioners, which are often covered by private medical insurance.
How homeopathy can help animals
When Manchester’s Fox Rescuers have a fox with mange, they send out a homeopathic remedy (serious cases require wildlife rescues to humanely trap the fox for conventional medicine).
Homeopathy at Wellie Level offers help and vet-endorsed courses (in person or online) for farmers to help prevent and treat common conditions. These can improve overall farm animal welfare, reduce antibiotic use and help towards organic certification.
One Irish vet had cattle recover from mastitis using homeopathy. Deciding it was a coincidence, he took them off it, the disease returned, so he put them back on homeopathic medicine, and is now a convert!
Why is Therapeutic Massage Not More on the NHS?
Therapeutic massage is not like some dodgy back-street parlour. It’s performed by properly trained therapists and has huge benefits for stress, aching joints and muscles, recovery from illness and better immunity. Yet it’s hardly ever offered on the NHS, when it could do much good, and massively reduce medical bills.
The NHS often offers physiotherapy, but proper massage therapists are just as highly-trained, and can help all kinds of medical issues including stiffness, rheumatic pain and post-broken-bone care.
Ask your GP before massage (it can have contraindications for medical conditions). Avoid essential oils for pregnancy/nursing or affected medical conditions, and keep aromatherapy away from children and pets. Don’t pour neat essential oils down toilets or drowns (bin securely, as undiluted they can still harm aquatic life).
Press Here! Massage for Beginners is a beautifully illustrated guide, and the book includes tips for self-massage. All written by a licensed massage therapist, the book uses fun and modern illustrations to help you relieve pain, alleviate tension and recover from sport.
The book includes massage techniques for the shoulders, back, neck, arms, hands, legs, feet, head, scalp and face (plus massage for relaxation). There are also treatment plans to help:
- Headaches
- Sinus congestion
- Constipation
- Menstrual cramps
- Pain relief
- Insomnia
- Inflammation
- Arthritis
Campaigns for massage on the NHS
Massage is only available as osteopathy for certain conditions. One massage therapist has put up a petition at 38 Degrees, asking for massage by qualified therapists to be free on the NHS.
Massage can help with many medical conditions and disabilities, and could not only benefit patients, but save the NHS a fortune on preventive medicine, so less drugs were needed. Qualified lymphatic drainage masseurs have absolutely amazing results.
NHS England spends up to £10 billion a year treating musco-skeletal conditions (with 7.5 million days lost due to ill-health and up to 60% of patients on long-term incapacity benefits, 10% of which suffer depression).
30% of GP appointments are related to such conditions, and yet these are the kinds of conditions that massage therapists can treat (yet most patients can’t afford the £50 or so treatment cost). Having them available would also free up time for doctors and nurses to treat patients with other conditions.
