Medications and Long Term Preparedness

Posted by: jcurphy

Medications and Long Term Preparedness - 03/27/08 08:24 PM

Basically the problem is that insurance companies (medicare included) do not allow people to stock pile any significant amount of medication, typically no more than one month at a time. The trouble is, what if disaster strikes your community when you are on your last week or even last day of a medication? There has been quite a bit of discussion on this topic, especially in the aftermath of Katrina, but nothing has been done as far as I am aware.

This could be a matter of life or death to a diabetic patient, or any number of people whose lives depend on daily medications. On a related note, how would one get access to antibiotics or pain medications that are not OTC if they can't see a physician during a disaster? I noticed that DR's very own PSK contains a Z-Pak (antibiotic) and Vicodin (a prescription narcotic pain reliever - brand name for tylenol and codeine). How would you get access to these meds to create a complete PSK short of convincing your physician that you needed them in an event of an emergency?

What has anyone else done? Obviously you hope you never need these items, but as it is you simply cannot purchase antibiotics without a prescription, nuff said...
Posted by: MartinFocazio

Re: Medications and Long Term Preparedness - 03/27/08 09:36 PM

The solution is to break the law. You can ask for - and get - scripts for drugs you don't need at the moment. Go ahead, ask a doctor. Tell them you want to lay in a supply for a storm kit. Unless the drugs are very perishable, they will accommodate you. You can pay for those drugs without your insurance company being involved. Yes, you can.

I have some prescription meds available to me as needed, if needed. They were legally purchased, and legally prescribed, and they have a decent shelf life.

When we had flooding along the river, one of the more dangerous things we had to do was shuttle meds to folks who didn't evacuate and ran out of heart meds.

Posted by: BobS

Re: Medications and Long Term Preparedness - 03/27/08 10:02 PM

I don’t know that many doctors will just rite a prescription for you if you tell him you want to stockpile them. Malpractice is a real issue today and the doc may see it as a problem if they are misused, sold or if it just comes out that he’s writing prescriptions a patent doesn’t need right then nor had an aliment to be treated at the time.


If I were a doctor, I wouldn’t do it and risk it.



Posted by: dougwalkabout

Re: Medications and Long Term Preparedness - 03/27/08 10:18 PM

I doubt that diabetic or high blood pressure medication would be a touchy issue. But it almost certainly would be for narcotic painkillers, where the risk of abuse or criminal activity is well known.

If you didn't have a regular physician, you might need to work up to an emergency stash. For example, if you can show him/her the unused prescription, or the full bottle, after 30 or 60 days, you will hopefully build up a degree of credibility and trust.
Posted by: CJK

Re: Medications and Long Term Preparedness - 03/28/08 01:13 AM

IIRC, when it comes to the 'expected storm is coming' situation, a lot of insurance companies came around and allowed you to refill the medicine before they would normally.....this came about (down here in FL) after Hurricane Charley blew through. so many people were without medications that they caused such an uproar that the companies saw the error of their ways. Dougwalkabout is right....when it comes to 'maintenence' medicines like for high BP or DM....the doc's don't have a problem....anyone on longterm pain Rx (like for cancer) have no problem getting additional from THEIR docs....long time relationship.....the average person asking for 'pain pills' for a kit....I don't see many docs agreeing to that one......

For those of you that may need to Bug Out to a shelter....one thing we learned down here in FL....our special needs shelters (which have LOX for those on home O2), has the health department at them and they figured that it would be a good thing to have a PA at the shelter....the PA is able to write scripts for patients who need or forgot some of their medicines...basically if anyone comes up and says they regularly take XYZ medicine for thier BP in a dose of --mg then the PA writes the script....the health dept even went so far as to make certain that there was a pharmacy OPEN within a few minutes of the shelter so that the person could get it filled. Even if you came from the other coast and said you needed an Rx filled...they'd do it....mind you things almost come to a stop and there is GREAT SCRUTINY of anyone requesting anything that even resemble 'pain meds' of the like. I've seen the PA contact patient's doctors to verify things if patients couldn't remember the dose....but for pain meds.....they would tell you to find a family member who could get you your meds or sorry but we can't fill THAT.
Posted by: nursemike

Re: Medications and Long Term Preparedness - 03/28/08 01:27 AM

Insulin and syringes are often available without prescription-but the insulin doesn't have much of a shelf life, especially if not refrigerated. (http://members.tripod.com/diabetics_world/InsulinRx.html)

It might be possible to reduce or eliminate the need for some medications by lifestyle changes-weight loss/exercise can modify the need for anti-hypertensive and anti-cholesterol medication.

There are some folks who have had success in using herbal/naturopathic/alternative/complementary therapies to reduce or eliminate the need for prescription pharmaceuticals.
http://nccam.nih.gov/

Or you and your physician may determine that your medications are doing as much harm as good. (http://blogs.wsj.com/health/2008/02/12/do-statins-dull-the-minds-of-some-patients/

When i was presenting my thesis about home-made IV fluid therapy, one of the more common responses was, approximately, "this is too difficult to attempt, so some people will die". Probably applies here, too.
On the other hand, many prescription medications are issued to treat maladies associated with the un-natural stressors that 21st century civilization inflicts on us. A good solid crisis reconfigures the stressors to a more natural array, and might be healthier than the 'normal' abnormality of modern life. Every er i have worked in has functioed better in a disaster than it has on a routine day. brings out the best in folks, and eliminates a lot of the bull....stuff.
Posted by: MDinana

Re: Medications and Long Term Preparedness - 03/28/08 02:32 AM

Originally Posted By: nursemike

When i was presenting my thesis about home-made IV fluid therapy, one of the more common responses was, approximately, "this is too difficult to attempt, so some people will die".


Not to hijack the thread, but the library at the hospital I'm at currently has a reprint of the original Merck Manual (that is, the 1899 version). It's essentially a "how-to" pharmacy manual: ie, codeine, dose 7gr, mixes well with water, not with alcohol.

If you can scare a copy up, it's kind of fun reading.
Posted by: Stu

Re: Medications and Long Term Preparedness - 03/28/08 02:45 AM

Tell your pharmasist you are going on a trip, and ask for a 2 month supply, then refil after 1 month.
Ask your MD for a few sample packs of your needed drugs
Posted by: BobS

Re: Medications and Long Term Preparedness - 03/28/08 02:48 AM

I don't know that I would want to trust 1899 era medical knowledge.

We’ve made a few advances and understand much more then we did over 100-years ago.
Posted by: MoBOB

Re: Medications and Long Term Preparedness - 03/28/08 03:02 AM

The amount of pills in the PSK is, or should, be limited to just a few pills. Doug listed 6 in his kit. The same for ZithroMax. Not exactly a huge cache of mindbenders.
Posted by: jcurphy

Re: Medications and Long Term Preparedness - 03/28/08 03:52 PM

Originally Posted By: MoBOB
The amount of pills in the PSK is, or should, be limited to just a few pills. Doug listed 6 in his kit. The same for ZithroMax. Not exactly a huge cache of mindbenders.


Understood, but the same problem exists in getting a prescription for any amount of pain and/or antibiotic meds. If you don't have a terrific relationship with a family physician, it's next to impossible to be as prepared as you might like to be.

Fortunately I happen to have a family friend that would write the script if only I asked... but the vast majority of people probably don't have that option. The need for prescription strength [insert any life saving name brand medicine here] in the event of a true emergency is obvious. OTC Zicam isn't going to do a thing for pneumonia. If you are in severe pain due to a superficial trauma or medical condition (broken bones, kidney stones etc.), Tylenol or Advil will be ineffective. This is exactly why DR includes prescription medicines in his PSK, because in a true emergency nothing less would suffice.
Posted by: MDinana

Re: Medications and Long Term Preparedness - 03/28/08 04:26 PM

True, but it's still kind of cool to see "how" to make medicines. But, yeah, there's a lot there that isn't used. And some stuff that is (like codeine and morphine)
Posted by: raydarkhorse

Re: Medications and Long Term Preparedness - 03/28/08 05:18 PM

My mom uses a mail order pharmacy called express script, they take her tricare and medicare insurance. The good thing about them is they send her a 90-120 day supply at one time.
Posted by: MoBOB

Re: Medications and Long Term Preparedness - 03/28/08 05:24 PM

Originally Posted By: raydarkhorse
My mom uses a mail order pharmacy called express script, they take her tricare and medicare insurance. The good thing about them is they send her a 90-120 day supply at one time.


I have to do the same thing pretty soon. Either TriCare Mail Order or ExpressScripts....

Thanks for the reminder.
Posted by: philip

Re: Medications and Long Term Preparedness - 03/28/08 08:04 PM

> Tell your pharmasist you are going on a trip, and ask for a 2
> month supply, then refil after 1 month.

That's what I did. The pharmacist called my insurance company and got it okayed.

The goal is to _keep_ that 30-day cushion.

Remember Katrina. If you're stuck in some devastation somewhere, a month's supply of all your medicine is not too much.
Posted by: nursemike

Re: Medications and Long Term Preparedness - 03/28/08 09:25 PM

With all due respect to DR, a z-pack won't do much for a serious illness, either. azithromycin is a macrolide, a derivative of erythromycin, and is efficient as heck-take the pills for 3-5 days, the azithromycin attaches to the white blood cells and remains active in the body for ten days. Useful for lots of different bacteria. lots of different kinds of infections-skin, lungs, sinuses-but only in mild disease. Penicillin-Pen V-K, amoxicillin, augmentin-are more common choices for moderately severe disease, but you gotta carry more of them, and you gotta take them for ten days to 2 weeks. Gets bulky. But it is like the multitool debate-a tiny one is easier to carry, less expensive to acquire...and almost useless if you have any significant work to do. A Z-pack is the ideal antibiotic to carry-compact and inexpensive-unless you actually need an antibiotic. Penicillin drugs are also one of the therapeutic choices for anthrax, for those of us who anticipate a bio-warfare scenario.
Posted by: NorCalDennis

Re: Medications and Long Term Preparedness - 03/29/08 12:24 AM

I use the Express Scripts too (or whatever BlueShield just switched me over to) for blood pressure meds. My doctor issues me a 90 day supply with three refills - a one year prescription. I can re-order after 60 days, so within three refills at 60 day intervals I now have atleast a 90 day surplus supply on hand, plus what ever is in the bottle I am currently using. Should a major event ever happen, I would hope that 90 - 120 days of maintenance meds would last me until things became more routine again.

OTC meds, like 24 hr Claritin, I've found at Rite aid in 120 count generic label bottles for under $30. I am guessing that Costco, Sam's Club, etc. has comparable quantities and price brakes.

I think with a little wiggling within the system you can get a surplus of maintenance-meds (BP, Cholesterol, heart, etc.)without having to stretch any laws.
Posted by: KG2V

Re: Medications and Long Term Preparedness - 03/29/08 12:26 AM

Get a supply of zyvox (hahahahahahahahaha) - Unfortunately, I get to start on a 2 week course tomorrow (yes, I'm a sick boy) (the laugh is due to the massive side affect posibilities and the even more amazing costs - 2 weeks worth - $2800)
Posted by: BobS

Re: Medications and Long Term Preparedness - 03/29/08 01:05 AM

I know all about the high prices, I was in the hospital 2-days and the medicine cost was $10,000
Posted by: MoBOB

Re: Medications and Long Term Preparedness - 03/29/08 08:10 PM

What is the bottom line then?
Posted by: nursemike

Re: Medications and Long Term Preparedness - 03/30/08 08:26 PM

IMHO, based upon observed physician practice patterns in ER and acute care hospital patients:

Find a friendly physician or veterinarian and get a big brown bottle of penicillin or amoxacillin: 500mg caps or tabs in a brown container. store it somewhere cold and dry. Get dosing information from your friendly doc. If allergic to penicillin, or more adventurous and wealthier, get levaquin. Pen and amox are available in generic form: http://www.petcarechoice.com/index.cfm?fuseaction=product.search&product_namefilter=amoxacillin

To anticipate some of the objections:

1) Antibiotics are dangerous in untrained hands: (so are guns, knives,hatchets, ferrocerium rods, fish hooks and scalpels: it is generally asserted that these things have their place in survival planning)

2) People who need antibiotics are going to die anyway: (everybody is going to die anyway. Survival planning and most medical therapy is about delaying the inevitable. Even the DR designed aviation survival kit does not promise eternal life)

3) People treated with these meds in optimal settings suffer side effects, toxicity, and bad clinical outcomes, which would be worse in sub-optimal crisis conditions. (see (2) above)


Posted by: MoBOB

Re: Medications and Long Term Preparedness - 03/31/08 05:37 PM

Thanks NurseMike. I'd have to go the whatever route folks allergic to Penicillin/derivatives go. I think Erythromycin was fine for me. Either way, it still takes a visit to the doc. A careful explanation of why you are asking for the scrip and hopefully cooperation on his/her part.

I like your objections treatment.
Posted by: KG2V

Re: Medications and Long Term Preparedness - 07/18/08 07:08 AM

RE Pain Killers:
Frankly, I'm on fairly high does pain killers and have been for a year - the classic "we will write you a 15 script" kinda meds, with NO refils

Thing is, I find that a LOT of days, I don't need them every 6 hours, but more like ever 8-9hours. When do I refill? At 15 days. At this point I probably have a spare 2 week supply

I REALLY, Really hope I never have to long term (or for that matter, short term) bug out. Last year I developed a serious chronic health problem, and I lug around more drugs than you might imagine (along with dressing and the like to deal with the problem. Falls in the "this is no fun" zone
Posted by: dweste

Re: Medications and Long Term Preparedness - 07/18/08 09:58 AM

I heard on the radio that authorities are concerned about internet pharmacies selling just about anything without requiring prescriptions.