Will you have Enough Medication at the Time of a Disaster?
As we see people across the world struggle with unexpected disasters, we might wonder how prepared are we if one should strike where we live? There is a certain amount of preparation that we can do. We can try to live in a safe place. Some people build tornado cellars. One might have supplies to board up the windows. You might have a standby generator. There are now generators that work by solar energy. You can store extra food and water and keep a supply of fuel for your generator and for your car. It’s a good idea to have extra batteries, a hand-cranked flashlight and radio and alternate methods of communicating when the Internet and phone lines might be down. It’s also a good idea to have a first aid kit and supplies. But what about medications??
Would you have a sufficient amount of medication if your hometown were devastated by a catastrophic event and you are isolated for a period of time? What if the local pharmacies weren’t available to renew your medication or if the pharmacy supplies were cut off in an emergency? Suppose you couldn’t reach your doctor for a renewal of your meds? What if the computer systems were down and it cannot be verified that you had insurance for your medications?
Potential Serious Problems If You Run Out of Medication
Since this is a psychiatry blog, let’s start with some psychiatric medications. Certain tranquilizers such as the benzodiazepines can cause withdrawal symptoms if abruptly stopped. This includes Xanax, Ativan, Valium, Klonopin and other drugs especially if these medications are abruptly stopped and especially if you have been using them for a while. In addition, anxiety symptoms including PTSD that these medications may have been treating can be exacerbated at times of a disaster event. If a person who is taking major tranquilizers also known as anitpsychotic medicines such as Seroquel, Abilify, Risperdal, Zyprexa and many others or mood stabilizers such as Lithium, Depakote, Lamictal and many others if withdrawn may be expected to bring about a return of symptoms for which they were being prescribed. This could mean the development of psychotic symptoms with hallucinations, paranoia and delusions or the return of serious mood fluctuations including mania and depression. Similarly, a cessation of a needed antidepressant can cause return of the symptoms of depression and even suicidal ideation although it usually takes a couple of weeks for most of these types of medications to wear off.
Obviously there are similar major problems with a sudden cessation of other classes of drugs. Stopping anti-seizure medications obviously can lead to seizures. Cardiac medications are essential and their removal can lead to very serious problems as can medications for hypertension, diabetes, and various endocrine conditions. The abrupt cessation of medication being prescribed for pain most of which may be opiates can not only bring about the return of pain but some serious withdrawal symptoms. There are many other scenarios which can occur with the unavailability of various medications. And what about birth control pills?
Is it Possible to Have Back-up Medications?
There are also many scenarios where a person may have backup medication and also depending on the situations where that may not be the case. Doctors often prescribed a one-month supply of medications with a certain number of renewals. This might tide you over, but if you were a few days from a needing a renewal when the disaster event occurred, you would have a problem. Sometimes a 90-day supply may be given which probably would be okay unless you were coming near the end of your prescription at the time of the disaster event. Could you reach your doctor or some emergency coverage to get a renewal? Would there be an open pharmacy and will such a pharmacy be supplied with your medication? Also in an emergency or disastrous situation, power and Internet may be down and this could prevent your pharmacy from getting insurance authorization and approval. As you may know, without such approval, many medications can be extremely expensive.
Some people have told me that with each prescription they squirrel away a few pills so they can have a “stash” in case of an emergency. That approach may or may not work and keep in mind in such a situation the medication would most probably need to be rotated so the emergency pills were not outdated.
Could and would a doctor prescribe an extra supply of medication that would allow you to always rotate such pills and keep them current and therefore always have a supply in case of an emergency? Would this be judged as safe for a particular patient? For example, in case of potentially suicidal patients or in case of a situation where a particular medication can be abused, psychiatrists and the other physicians maybe reluctant to prescribe even a 90-day supply. As mentioned previously, medications can be very expensive and insurance companies are sometimes reluctant to authorize large amounts of medication. I also suspect that there may be regulations from state to state and in various different countries that would apply and which also may depend on the type of medication.
Proposed Project For Everyone
I would like to propose a project for the readers of this blog to undertake. Review your own medication. Check with your pharmacy and with your physician to determine if there is a method where you could always have at least a month supply of medication on hand in the event that you could not see your physician and that your pharmacy would not be available or able to fill your prescription at the time of an emergency or disaster. Also be sure to check any insurance coverage that you have whether or not that insurance company would cover the extra prescription and find out what the extra expense would be. Then, please report back to the readers of this blog and myself by putting a comment at the end of the blog. There is no need to publish your name. Perhaps it is time to advocate for some changes in regulations or perhaps we just need to remind people to be prepared.