The first lecture I had on medicines at university opened with a simple statement: ‘Drugs don’t work’. 

As an opening gambit this felt like heresy to a group of enthusiastic 18-year-olds embarking on their medical careers and in fact was deliberately provocative, to get us paying attention.

But in the 20 years since that talk, I’ve come to realise it was profoundly true.

There are, of course, a few miracle drugs that extend and improve life: certain cancer therapies, for instance, as well as insulin, drugs for epilepsy, infections, faulty heart rhythms, and even the contraceptive pill. 

These have all helped millions of people.

From The Doctor Who Gave Up Drugs. Chris van Tulleken opened a drug free clinic in London to show patients how diet and exercise can work as a permanent solution

But the fact remains, most drugs don’t work well most of the time for most people.

 I’m talking about the drugs we take because the world we live in makes us unfit, unhappy and overweight – antidepressants, painkillers and drugs like statins.

These are amongt the biggest selling drugs — prescriptions for antidepressants and statins have increased by a staggering 300 per cent in the last decade – but compared to non-drug alternatives such as exercise, their effect is feeble.

Not only that, but like all drugs, they can be harmful: there’s the harm of specific side-effects such as gastric bleeding, and there’s the more subtle harm of medicalising healthy people, turning them into ‘patients’ when, with proper support, they could be living pill free.

However, because writing out a prescription is so easy, it distracts both doctors and patients from alternative treatments that actually fix the cause of our most common health problems.

And by alternative treatments I don’t mean crystals or cupping, but interventions that have solid evidence to support them, primarily exercise and diet.

But can patients and doctors be weaned off our growing dependence on these pills?

This was the aim of a BBC documentary I’ve just spent six months making: I wanted to treat patients without using any drugs and of course without killing them. 

An NHS GP surgery, Churchill Practice in Chingford, London, nervously agreed to allow me to run a (closely supervised) drug free clinic.

I turned up on my first day quietly confident: I’d simply explain to patients that the drugs didn’t work well and that the alternatives did and pretty soon the practice would only be giving drugs where there was no alternative. 

My drug free clinic would be packed with patients desperate to throw away their pills, shake off their side-effects and get on with life. 

Not only would patients become healthier, the practice drug bill would shrink.

Upon opening his drug free clinic, Dr van Tulleken hoped it would be packed with patients desperate to throw away their pills, shake off their side-effects and get on with life

I don’t think I’ve ever underestimated any challenge so severely. In the end some of the results we achieved were astonishing but it all started very badly.

It quickly became clear that it was impossible not to prescribe. On that first day I saw 40 patients – and gave out 39 prescriptions. 

By the end of the day I’d have pretty much prescribed anything anyone wanted just to try to get every patient seen.

The number one problem is time. Just as I’d started to explain the risks and benefits of a drug, that tiny sliver of time that GPs have per patient – 8 to 12 minutes – was up and I hadn’t even started on what they might do instead.

As my appointments ran later and later each day, conversations with increasingly, and justifiably, angry patients about complex issues became impossible.

And even when someone did seem keen to try to stop a long term medicine there was no immediate alternative. 

Physio appointments could take weeks, counselling even longer. I found myself shouting ‘lose weight and do exercise’ lamely as the patients stormed out the door, prescription in hand.

‘It takes 30 seconds to prescribe and 30 minutes not to prescribe,’ one of the GPs said to console me in a 30-second coffee break.

It quickly became clear that it was impossible not to prescribe. During his first day Chris van Tulleken saw 40 patients – and gave out 39 prescriptions

Patients want the quick fix of a drug and doctors need it. The process is lubricated by the drug companies. 

Overuse of medication is a problem with many complex causes but one of them is corporate greed. 

Drug companies have behaved very badly over the last few decades and have paid billions in fines for, among other things, overselling data showing that their drugs work.

They pay drug reps to talk to your doctors about what drugs to prescribe; they also pay pharmacists to go into GPs surgeries to ‘optimise prescriptions’. 

They’re now banned from supplying GPs with the branded mugs, pads and pens that still litter many practices but they’re allowed to buy your GPs lunch, and there’s good evidence that this kind of thing influences prescribing. 

Of course it does. Or they wouldn’t do it.

They’ve created a culture where the most common treatment for any medical condition is a drug.

And trying to run a drug-free clinic in this kind of culture was doomed to fail, so I decided to target particular groups of patients with conditions traditionally heavily medicated but for which there are decent alternatives.

Dr van Tulleken quickly abandoned his clinic, and decided to target particular groups of patients with conditions for which there were decent drug free alternatives

My bargain would be that they’d get more time with me but no drugs.

The GPs helped identify a group of people at risk of strokes and heart attacks and who wanted to come off their pills – the patients all had type two diabetes, high blood pressure and high cholesterol, and were on statins.

One of them, Mike, told me his pills were like ‘a prison’ and I have no doubt that many people feel the same. 

It wasn’t that he was having side-effects, he just hated the idea of being on medication. 

Drugs make people feel that they’re ill, which in turn means they’re less likely to make the lifestyle changes needed for a long and healthy life.

And there’s good evidence that these changes – not always easy to make, I know – can be extremely effective. 

A large study in 2002 compared the most popular drug for type 2 diabetes, metformin, with diet and exercise and found the drug was about half as effective. 

Not only does metformin have nasty side-effects, it won’t reverse type 2 diabetes.

But diet and exercise can.

A large study in 2002 compared the most popular drug for type 2 diabetes, metformin, with diet and exercise and found the drug was about half as effective

My prescription was a miracle cure: it would improve mood, pain, blood pressure, bone density, anxiety and cholesterol all at once, with no side-effects. 

And all it involved were five, brisk 30-minute walks a week, as a group, for two months. They also stopped their statins.

The idea of a group was so they could keep each other motivated when I wasn’t there.

In many respects this plan, like my drug-free clinic, was also a disaster: of the original dozen patients fewer than half kept walking regularly.

But for those who stayed the course it was far better than I could have imagined. 

Their blood sugar levels improved more than you might expect from a new drug. They also experienced better sleep, reduced aches and massively improved moods.

All the walkers have decided to keep walking and remain off their statins (off the statins their cholesterol remained high but eight weeks was too short to change it).

The GP surgery is now supporting the walking group and report that numbers are growing.

Dr van Tulleken prescribed five, brisk 30-minute walks a week, to improve mood, pain, blood pressure, bone density, anxiety and cholesterol all at once, with no side-effects

The key thing here is the word ‘support’: we treated the walkers in the same way as if they were on a drug, with regular follow ups and check ups. 

Doctors normally only have time for a ‘do some exercise and we’ll see you in three months’ – but we gave our patients clear exercise prescription and ensured they were able to do it.

But it wasn’t just the walkers who saw astonishing changes. We also had success with weaning patients off their antidepressants. 

Even the most favourable studies show that for many people, antidepressants are not much better than sugar pills. 

Side effects, such as sexual dysfunction, are incredibly common. Some may even increase the risk of suicide in young people.

There is no quick answer for depression. 

For Sarah, whose story is told below, they combined exercise, mindfulness, and socialising through swimming

For our patient Sarah, whose story is told below, we decided to offer an activity that would combine lots of the things that we know can help depression – exercise, mindfulness, and socialising: swimming. But in cold water in a lake.

It sounds Victorian but there’s science behind this. 

We took Sarah to see Professor Mike Tipton, a world expert on what happens to when the body is put to extremes, and his team at the University of Portsmouth and Dr Mark Harper an anaesthetist with an interest in the effects of cold water on depression.

The theory is that repeated exposure to cold water improves your response to the stress that often accompanies depression. 

After a day of acclimatising Sarah – and I – got totally addicted. 

Sarah is off her pills and my wife and I have now joined the ranks of people who will bore you at any opportunity about the power of cold water swimming (try it, though do it safely. See

My final group of patients had been on painkillers for many years – even though painkillers don’t work well. 

Like antidepressants. any effect they have is quite small and the side-effects are amongst the most severe. 

Some, such as ibuprofen, can cause gastric ulcers and bleeding, while codeine makes you constipated, drowsy and depressed.

One of the patients we helped, 36 year old Crystal was on huge doses of Tramadol and codeine (both opiates related to morphine), hardcore painkillers that left her feeling foggy, as well as anti-inflammatories. 

After taking up the cold water swimming, Sarah has been able to come off the antidepressants that she has been on for eight years

She was also on medications to combat the painkillers’ side-effects, such as laxatives and stomach-protecting drugs.

Crystal hated the pills and if they were working at all, then they weren’t helping her do what she most wanted — to leave the house and find a job,

But when Crystal was introduced to White Crane Kung Fu, that all changed. 

This martial art combines strength, balance and mindfulness and while Crystal is not cured, she’s now off her drugs completely and feeling infinitely better – and is continuing with the classes.

I don’t think we should ban drugs, But patients should be told the truth about their drugs if they decide they don’t want them and there should be other options that doctors will support them through in the same way we support people with a prescription.

The fact is, the changes we saw over the last few months at the Chingford GP surgery weren’t easy, but they all had joyful life prolonging benefits of the kind you simply can’t put in a pill.

The Doctor Who gave Up Drugs: BBC1, 9pm, Thursday 15 September