Pharmacy
How Is Climate Change Affecting Pharmacies and Medications?
Medicines use pivots around a global network of services, with most drugs traversing the globe before the point of use. From identification and development of primary compounds, to research activities and trans-continental manufacture processes, all of which culminate in products ready to be selected for international delivery. As a result, access to medicines is typically based on a ‘just in time’ framework, with little to no capacity to replace missing elements.
Extreme weather events, such as hurricanes and heatwaves threaten individual steps within these systems, preventing movement of medicines along critical supply chains, which will increasingly fracture as climate change escalates and extreme weather events become more common.
Simultaneously, climate change is driving an ever greater need for medication - the most commonly offered healthcare intervention. Changes in our environment are leading to an increase in infectious disease, allergies, malnutrition and mental ill-health, while fossil fuel pollution affects every bodily organ system of those alive, as well as the health of those not yet born. In every situation, drug-therapy is front and centre of patient care.
Our ability to provide pharmaceutical care will be compromised as climate change interacts with health infrastructure. In periods of high temperature, medications deteriorate more quickly, while UK hospitals have already been evacuated due severe wet weather events. The UK environment agency estimates that nearly 10% of hospitals and GP surgeries are situated in areas at risk of flooding.
As climate change progresses, we will see increasing demand for pharmaceutical care from systems increasingly under stress.
How is Pharmacy Affecting Climate Change?
It’s an often quoted fact that should global healthcare be a country, its carbon-footprint would make it the 5th largest polluter on the planet. Nationally, healthcare services are responsible for up to 10% of greenhouse gas emissions, particularly in wealthier, westernized nations. In England, it’s estimated that a quarter of the carbon-footprint of healthcare is as a result of medication, predominantly from supply chain activities but also because of the greenhouse gas emissions that come about because of other aspects of drug use (e.g. transport, storage, administration, monitoring).
Future demand for healthcare will lead to increasing levels of polypharmacy which for some patients will cause adverse drug events, driving patients to seek further healthcare, including admission to hospital.
Medications also cause environmental harm through pollution of the natural world. They enter the environment via a number of processes, some of which are out of the control of health professionals (such as agricultural use) but pollution is also directly related to improper waste disposal practices, from health facilities and patient homes. Waste water processing facilities aren’t able to remove drug molecules and residues are found in rivers, lakes as well as groundwater aquifers and soil.
It’s widely documented that medications are an ecological concern to non-human health because of the potential for effects on animal behaviour, growth and reproduction, even at trace concentrations. Pharmaceuticals in animal food chains have led to morbidity and mortality of populations; a result of their biological active properties, designed specifically to cause pharmacological effects in living organisms.
The Royal Pharmaceutical Society (RPS)
The RPS has Comprehensive Information on Climate Change and pharmacy. Click below for more information.
Discussion Ideas with Patients
Pharmacy teams sit in the heart of communities and healthcare institutions. We are present in hospitals, GP surgeries and on every high-street. We know that increasingly, patients are aware of the threat of climate change and anxious for action to be taken.
Conversations about medicines can provide the perfect springboard to conversations which increase understanding of planetary health and the confidence to take action, either to reduce the impact of climate change on pharmacy, or vice versa.
Patients Discussion Ideas:
"The best medicine is actually one that you don’t need! Use medicines when you really need them but a lot of drug-therapy can be avoided by moving more, eating healthily and sleeping well"
"Air pollution can aggravate respiratory illnesses, in fact it can have a top-to-toe effect on our health and causes problems for all body systems. Everything we can do to reduce that will help, but in the meantime we can help you to get the maximum benefit from your inhaler."
"Did you know that once medicines leave the pharmacy they can’t be reused? If they’re put in normal rubbish or down the toilet/sink, they end up polluting our waterways! The best way to help is to ‘Only Order What You Need’ and then, if you have any unwanted medicines, make sure they’re given to a pharmacy to dispose of properly"
Highest Impact Actions for Pharmacy Departments
Integrate sustainability and climate change into educational and governance meetings
Prevent need: Use our role to promote green/blue/social prescribing and public health. The most sustainable medicine is one that’s not needed! Let’s treat the cause of the illness, not just medicate the symptoms
Empower Patients: Patients who are confident to discuss their medication and their concerns about it are more likely to take it as needed and volunteer when they need adjustments. Medicines Reconciliation and counselling are incredibly powerful sustainability tools
Create Lean Systems and Reduce Waste: Consider setting up a "Pill School" to help children use tablets rather than liquids, optimise prescribing an encourage patients to only order what they need.
Move finances: If you work in an independent pharmacy, check to see if the pharmacy's bank invests in fossil fuels, and consider campaigning to transfer accounts if they do.
For More Information
Visit Pharmacy Declares, an independent organisation working to make pharmacy across the UK more sustainable