2. Materials and Methods
3.1. Medicines as Common Commodities
3.1.1. Physical Appearance
“When will the reuse of medication become legal? As long as it’s sealed, I would be happy.”(Participant 91).
“As long as medication is in sealed blister packs showing expiry date then it has to be a good thing.”(Participant 23).
“No reason at all not to re-use medication that is sealed and labelled.”(Participant 185).
3.1.2. Social Life of Medicines
“Please do it. I have had to return medication in the past just for it to be thrown away. It is wrong and wasteful when there is nothing wrong with it.”(Participant 112).
“I think it is a brilliant idea. I have returned medication to the pharmacy in the past and thought it wasteful to destroy.”(Participant 135).
“Having had to return medication from 2 people who died and had much surplus, it has always seemed to be to be such a waste.”(Participant 177).
3.1.3. Social and Economic Benefit
“I am entirely in favour of reusing medication. Far too much is wasted at great expense to the NHS and thus the taxpayer.”(Participant 10).
“Blisters go to landfill and cannot be recycled.”(Participant 40).
“I believe that unused, unopened pills should be reused, instead of being destroyed. Even given free to places where medications are too expensive for people who are living in poverty.”(Participant 191).
3.1.4. False Analogy
“(reuse) Applies to other things within NHS e.g., dressings, stoma products.”(Participant 21).
“As long as medication/dressing etc. has not been tampered with, use and not waste them.”(Participant 149).
3.2. Medicines as Powerful Potions
3.2.1. The Drug Development Process
“Need to see published trials.”(Participant 192).
“Only reuse quality medications not generics.”(Participant 88).
“Adhesive on morphine patches not of best quality.”(Participant 82).
3.2.2. Specially Regulated Products
“Conditions under which it may have been stored are unknown e.g., insulin in fridge.”(Participant 90).
“Many people will be afraid that re-using meds runs a risk of contamination.”(Participant 36).
“Even though the medication would appear to be sealed in its original packaging you don’t know how it has been stored, this could have an effect on it if stored in too hot or too cold temperatures.”(Participant 66).
“Proof of stability is a big concern.”(Participant 38).
3.2.3. Unique to an Individual’s Health
“I am type 1 diabetic and don’t feel that reusing medication is for any diabetic.”(Participant 203).
“I would reuse sealed medication only if my Dr said it was safe.”(Participant 5).
3.2.4. Handling to Meet Legal and Practice Guidelines
“I worry about fake medication.”(Participant 28).
“Providing everything has been checked out by professionals and have long use by date.”(Participant 96).
“There would need to be very strict guidelines in place to ensure patient safety.”(Participant 130).
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Medicines as Common Commodities||Medicines as Powerful Potions|
|This category encapsulates commonly held ideas about what makes medicines the same as any other commodity and therefore suitable for reuse.||This category describes what confers medicines their potency and special status distinct from ordinary commodities, thus cautioning against reuse.|
|Physical appearance||The drug development process|
|The external features and overall physical appearance of a commodity are adequate to indicate what is held within. Therefore, intact sealed packaging of medicines suggests an authentic product of good quality inside.||Drug discovery and development processes are time consuming, expensive and intricate. Numerous stages ensure stable and effective final formulations, making medicines complex compared to other commodities.|
|Social life of medicines||Specially regulated products|
|Medicines have metaphorical life stages, with a medicine’s death (when consumed) resulting in its afterlife (internal effects) to restore, improve or maintain health. Failure to reuse unused medication therefore makes its existence meaningless.||Medicines are strictly regulated by authorities to illustrate quality, safety and efficacy before and after authorization. This includes giving expiry dates and storage conditions to maintain the shelf life.|
|Social and economic benefit||Unique to an individual’s health|
|Here, medicines are standardized commercial goods with economic value, exchanged between manufacturers and consumers to meet their needs. Reusing medicines thus brings benefit by reducing medicines spending and waste.||Medicines are prescribed for specific individuals with the unique therapeutic effects dependent on the individual’s circumstances. Medicines must not be reshared as their outcome in others cannot be guaranteed.|
|False analogy||Handling to meet legal and practice guidelines|
|This fallacy assumes that if two things are alike in one aspect, then they will be similar in another aspect too. Thus, if devices and appliances used to diagnose and treat health conditions can be reused, then so can medicines.||The sale or exchange of medicines (over the counter or via prescription) must adhere to legal protocols and accuracy and clinical checks. As powerful substances, their casual handling could cause harm to patients.|
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