Home Pharmacy Preparedness, by Michael V.

Wednesday, Jul 28, 2010

Don’t plan on your pharmacy being open or not looted after Day 1 after the SHTF.  Just like most cops have reported on this site that they will leave their posts to protect their families, pharmacists will do the same.  Most chain pharmacists have no loyalty other than a paycheck, so unlike “One Second After” it would be unlikely that a chain pharmacist would show up to work and risk their life after the SHTF.  Independent pharmacists who own their own store, and have their fortune tied to it have a better chance of being there, armed, with a more controlled environment, but even those will only last for a few days, at most.  Once armed bands of thugs start roaming, they will be long gone.  All pharmacies get deliveries every business day. (I have worked as a pharmacist in both chain & independent stores as well as hospital pharmacy, so I am familiar with all three types of facilities).  Most pharmacies have to pay for their drug orders within seven days, and many drugs are so expensive that inventories are kept low, (typical inventories are about $200,000) since re-supply is almost daily it is not a problem until deliveries dry up.  Within one day, many drugs will be dispensed, especially if patients are given a larger than normal supply.

Insurance companies, Medicaid, and Medicare Part-D all try to stop patients from stockpiling drugs.  So, what can be done?  First of all, as mentioned here on this site; improve your health by diet & exercise.  Stock up on the vitamins & supplements your family uses.  Keep all over the counter (OTC) drugs in the sealed, original container, and rotate your stock.  Store all medicine according to the storage directions from the manufacturer; I’ve seen mentioned on this site or others where drugs should be stored in the refrigerator, but not all drugs should; so read the label or check with your pharmacist.  Have your Doctor write prescriptions for a year supply as a quantity and you should be able to purchase whatever quantity you can afford at the pharmacy.  Use the generic or ask your pharmacist if there is a generic available that is similar to the brand name in the same therapeutic drug class; he may be able to get the doctor to change your prescription for you.  Pharmacies typically carry much larger quantities of generics than the high priced brand names.  If you are on high priced brand names (like Insulin), try refilling your prescription every 23 days, a little known fact is that many insurances will allow an early refill as long as it is within 7 days.  Begin to stockpile your insulin or expensive brand name drugs by marking your calendar and getting a refill whether you need it or not; every 23 days.  Some insurance companies like Medco keep track and won’t allow any early refills, so ask your pharmacist and try.  Work with your doctor and pharmacist to increase the quantity of critical expensive medicine like insulin so you can increase the number of vials you can get, and get it refilled regularly until your stockpile grows. 

Ask your pharmacist if you can have your long term storage meds dispensed in the sealed original containers with the expiration dates visible and rotate your stock.  If not; ask that they include an “adsorbent” which is typically found in the original containers, and have the pharmacy staff write the expiration date of the drug on your label.  Having anti-virals like “Tamiflu” and antibiotics like Ciprofloxacin, a broad spectrum cephalosporin like Cephalexin, an antibiotic eye drop like Gentamycin, an antibiotic ear drop like generic Cortisporin at home is also a good idea.  Avoid Tetracycline; one of the few antibiotics that is toxic once it expires. Doxycycline is the drug of choice for Lyme disease, but is related to Tetracycline and should be discarded after the expiration date. Clearly mark your bottle with the expiration date, and rotate your stock.  Pain meds like Hydrocodone or Acetaminophen with Codeine will be useful too.  Don’t forget anti-fungal creams, topical steroids, and assemble a great first aid kit. 

In my years of being a Boy Scout leader and dealing with scouts at summer camp I have treated a large number of ‘usual cases’; so these are conditions that regularly occur while away from civilization: diarrhea: use Loperamide it’s OTC now and a good drug, prescription drugs like Diphenoxylate/atropine are better and Belladonna Alk with PB help with cramping if available. Stomach aches: have an antacid like Tums EX, plus a PPI like Omeprazole (now OTC). 

For cuts and scratches, have Hydrogen Peroxide and triple antibiotic ointment (and Band-Aids).  Knife cuts: use Steri-strips are a great product made by 3M. I have used many times to avoid an ER visit, works great except for hairy areas that are difficult to shave.  Head lacerations may require stitching or staples; so get a suture kit with 1% Lidocaine (to deaden the area before stitching).  How to suture a wound can be found in this US Army video.  Poison ivy: use Tecnu wash to cleanse the area after exposure and treat with topical steroids like Hydrocortisone or non-steroid Domeboro. Both of these are OTCs that work, but prescription steroid creams like Desoximetasone or Fluocinonide are better.  Topical fungus are common (ringworm, jock-itch); use Clotrimazole (OTC) or Ketoconazole (prescription).   Developing a relationship with your doctor and pharmacist is crucial in getting the supplies you need before TSHTF

Are your vaccinations up to date?  Recommended immunization schedules can be found at the CDC’s web site. If TEOTWAWKI does happen having your family up to date on vaccinations will improve your chances of staying healthy.  Many of the diseases that are found in third world countries are controlled here in the United States by vaccinations, proper hygiene, sanitation and working sewer infrastructure; when that disappears these diseases will reappear here.  The CDC has a very cool web site with travel information and vaccines for every part of the world. It is worth a look.

Is your training up to date?  We had not only our leaders, but all our scouts in the Venturing Crew take the Standard First Aid Course with CPR from the American Red Cross.  I have taken the Wilderness First Aid Course by them also, which is a ‘step up’ in training.  The National Outdoor Leadership Schools (NOLS) has some of the best training available for wilderness medicine; check out their web site.  Their web site is also useful in planning a good first aid kit.  Click on the WMI store tab, and search their first aid kits to get the list of items they recommend.

If you are planning on going to your pharmacy on the day TSHTF, remember; with no electricity your pharmacist is going to have to rely on knowing you and seeing your bottle before you are going to get any medication, since he cannot access any of his records.  Also, developing a relationship with an independent pharmacist if you are on life saving medication is critical, since he is going to be taking a lot of that inventory back to his home or retreat to use it for barter.  Walking into a pharmacy where the employees don’t recognize you (big box stores) and especially without your bottle is going to get you nothing.  Hopefully, by planning ahead you won’t have to be one of the hundreds of people trying to get a refill on life saving medicine with no electricity available and no deliveries coming. - M.V. in Missouri


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