Modern medicine generally helps us live longer and live better, but it is also an industry that largely relies on fossil fuels for energy (healthcare in Australia was estimated to contribute to 7% of the country’s total emissions in 2014-15) and so also contributes to environmental damage and climate change.

Reducing the number of unwanted/unnecessary medicines we have

Although having spare medication around the house might feel reassuring, it can also be dangerous: accidental poisoning (which is commonly with prescription medications) accounted for 10,800 hospitalisations in 2020–21 with the highest rate of poisoning happening in the 0-4 age group. Out of date medicines also pose risks from degradation – their potency can decrease with time and the other chemicals used to make up a pill can break down into toxic substances. Not only that, but unless they are properly disposed of, pharmaceuticals can also cause environmental damage. Flushing medications down the toilet or putting them in your standard waste bin (which will most likely go to landfill) means that eventually your medications make their way into the nearest water source. Although the effects of this medication leakage into the natural environment is an area that is still being researched, there is already documented negative health impacts on the wildlife in these systems (e.g. changes in fish and mollusc behaviour that is affecting their reproduction and feeding habits).

The solution? There is a free and convenient way to dispose of your unwanted medicines responsibly via your local pharmacy, it’s called the RUM Project...Return Unwanted Medicines - just return them to your local pharmacy and your pharmacist will put them in a secure bin for collection and safe disposal.

Still picking up prescribed medications you don’t use?

It is estimated that 10-30% of all prescribed medications aren’t taken. This represents a great opportunity to save yourself money and reduce your environmental impact. Just book an appointment with your family doctor/your general practice’s pharmacist to review whether this is still needed.

Greener inhalers

Asthma, COPD are two common respiratory conditions which are treated with medications taken in an inhaled drug form. There are currently three medication delivery systems – a pressurised metered-dose inhaler (pMDI), a dry powder inhaler (DPI) or a soft-mist inhaler (SMI). The most commonly prescribed form is the pMDI inhaler, especially for the ‘rescue/reliever’ Salbutamol (usually comes as a blue inhaler). These pMDI preparations use a propellant that is usually some form of hydrofluorocarbon (HFC), which, although they don’t damage the Earth’s ozone layer like their predecessors, the hydrochlorofluorocarbon (HCFC), they are still potent greenhouse gases – many times higher than CO2! Therefore, there are a couple of things you can do:

If you are over 6 years old and have a good rate of inspiratory flow (how fast you can breath in), you may be able to have your medications as a DPI instead, which have a significantly smaller carbon footprint across their lifetime, so go and see your GP and see if you might be able to change your medications.

If you aren’t able to have your medications as a dry powder inhaler, don’t panic, a key thing you can still do is achieve good asthma/COPD control via use of your preventer inhalers. This will reduce the amount of the reliever/rescue medication you use. So, again, go and see your GP to ensure that you’re doing everything you can to keep your condition under control – this will also help reduce your risk of your condition getting worse and will keep you healthier!

On another positive note, as part of the Kigali Agreement (which 148 countries, including Australia have signed up to so far), there is the aim to phase out HFCs by 2047, so hopefully change is coming in this area.

We still need medicines, so what do we do with the waste?

Not all medication packs can be recycled and if you are unsure, taking them back to your local pharmacy for safe disposal is certainly better than putting your waste in the bin. Blister packs can now be recycled - but not via your kerbside bin. Pharmacycle provides a full recycling solution and their local processing capabilities ensure that all recovered materials from blister packs stay right here in Australia! You can simply drop your empty blister packs into the special collection bins at participating pharmacies to be transported to a processing facility where they are put through a series of mechanical recycling processes to separate the aluminium from the plastic. Finally, the separated aluminium and plastic materials are sent to end-users to be turned into a range of new products.

Find a drop off point near you:

Prevention is the best medicine

Finally, and probably most importantly – stay healthy. This is clearly easier said than done, but many aspects of health remain in your hands. Having a good diet (and a plant-based diet, if you had to pick an environmentally minded diet), keeping active, reducing your alcohol intake and not smoking are all things you can do to reduce your risk of getting a whole range of conditions like diabetes, heart disease, or having a stroke. Look after yourselves!

By Jonathan Foulkes 

Jonathan is a junior doctor currently working in the Royal North Shore Hospital with interests in sustainability in healthcare and the health impacts of climate change.