A Prescription For Any Disaster

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Although I've mentioned it before (see here), five weeks after Katrina devastated New Orleans I was there with my brother, trying to retrieve what little we could from his ground floor French Quarter apartment. 

Also on his list was getting refills on a prescription from his local pharmacy.  But 5 weeks after the storm, the power was still out across the city and his Mom & Pop pharmacy was still shuttered and vacant.

Like so many other displaced persons from Katrina, he not only lost everything, he was faced with having to find a new doctor in a strange town, just to get a prescription filled. 

For him, it was an inconvenience, but for those with more pressing medical needs, it could have had much more serious implications.

The AMA, FEMA, and others (including this blog) have long extolled the virtues of keeping a `disaster stash' of essential prescription medicines; enough for at least 2 weeks.

From  FEMA's Special Needs Require Special Preparation

“Disaster preparedness is not a ‘one size fits all’ concept,” said Federal Coordinating Officer Gracia Szczech. “People with special needs may require special attention and preparation. Everyone needs to get a kit, make a plan and be informed.”

Considerations for people responsible for disabled individuals:

• For those on respirators or other electric-powered medical equipment, make prior arrangements with your physician or check with your oxygen supplier about emergency plans, and be sure to have electrical back-up for any medical equipment.
• Maintain a two-week supply of items such as dressings, nasal cannulas and suction catheters.
• Maintain a two-week supply of both prescription and non-prescription medications.
• Keep copies of your medical records.
• Keep copies of prescriptions for medical equipment, supplies and medications.
• Keep extra contact lenses and supplies, extra eyeglasses and extra batteries for hearing aids.
• Make plans now to have accessible transportation in case of evacuation.
• Shelters may be limited in accommodations to meet some of the needs of those with disabilities. Prepare ahead of time to ensure you will have what you need.

 From the American Medical Association (2008):

 PERSONAL MEDICATION SUPPLY IN TIMES OF DISASTER:

Earthquakes, hurricanes and floods have headlined recent news reports. This new policy  supports allowing all patients with chronic medical conditions to maintain  an emergency reserve of prescription medications. It also encourages
 patients to carry a list of current medications and the prescribing  physician's contact information with them to ensure continuity of care in the event of a disaster or other emergency.

"There are more than 125 million Americans living with chronic  illnesses who rely on medication," said AMA Board Member Steven Stack, M.D. "Disasters can happen at any time, and ensuring that patients with chronic  conditions have access to needed medications may help minimize the uncertainty, confusion and health risks following a disaster."

Of course, all of this is easier said than done. Insurance companies are very strict about the timing and quantity of refills, and while most doctors will write the Rx for extra meds, many simply cannot afford the cash outlay.

Heeding the lessons of Katrina, on Friday the Governor of Texas, as part of his disaster declaration, issued the following order:

Hurricane Harvey
Emergency Dispensing of Prescription Medications

 
Governor Greg Abbott has declared a state of disaster in the following counties: Aransas, Austin, Bee, Calhoun, Chambers, Colorado, Brazoria, DeWitt, Fayette, Fort Bend, Galveston, Goliad, Gonzales, Harris, Jackson, Jefferson, Jim Wells, Karnes, Kleberg, Lavaca, Liberty, Live Oak, Matagorda, Nueces, Refugio, San Patricio, Victoria, Waller, Wharton and Wilson.

The laws and rules governing the practice of pharmacy in Texas, allow pharmacists to provide emergency refills when the prescriber cannot be reached. Specifically, in an emergency, a pharmacist may use his/her professional judgment in refilling a prescription drug order for a drug (other than a Schedule II controlled substance) provided failure to refill the prescription might result in an interruption of a therapeutic regimen or create patient suffering.

In most cases, pharmacists may not dispense more than a 72-hour supply of medication. However, in the event of a natural or manmade disaster, the Texas Pharmacy Act (Sec. 562.054) and board rule 291.34 allow a pharmacist to dispense up to a 30-day supply of a prescription drug, other than a Schedule II controlled substance, without the authorization of the prescribing practitioner if:

• failure to refill the prescription might result in an interruption of a therapeutic regimen or create patient suffering;
•  the natural or manmade disaster prohibits the pharmacist from being able to contact the practitioner;
•  the governor has declared a state of disaster under Chapter 418, Government Code; and
•  the board, through the executive director, has notified pharmacies in this state that pharmacists may dispense up to a 30-day supply of a prescription drug.
  

Accordingly, Gay Dodson, R.Ph., Executive Director/Secretary, has authorized ALL pharmacists in Texas to dispense up to a 30-day supply of medication (other than a II controlled substance) for patients affected by Hurricane Harvey. 

While this was absolutely the right thing to do, and will undoubtedly help a lot of people, many may still find themselves unable to get to a pharmacy for days, and there may also be delivery delays for certain medications, even if you can find a pharmacy that is open. 

All of which makes having that extra supply on hand still an essential part of preparedness, along with having enough food and water.

Particularly after a disaster - when families may be temporarily separated - every one in your family should have a medical ID card in their wallet or purse; one that lists their medical history, prescription meds, doctor's name, and emergency contact.

While we all would like to believe we'd never get caught up in a major, prolonged disaster, the reality is that none of us are immune. Regardless of where we live.

For more on how to put together your family's medical history, you may wish to revisit:

Thanksgiving Is National Family History Day