J20 minus 55 — help ensure access to medication and supplies for yourself and vulnerable community members

Medication is tricky. Many important medications are available only by prescription, some are controlled, and there is very little recourse that any person or community can do to ensure supply chain reliability, reduce costs, or ensure availability. However, there are some things that can be done to help reduce the risk of people being without critical medication. This post will cover a few things you can do to help ensure that you and your community can do to prepare for potential disruptions to medicine.

Do a risk analysis

As with most preparedness tasks, your first step should be to do a risk analysis. Not all disruptions are equal and not everything is a world-shattering emergency. It's important to think through what the likely scenarios are and what harms might arise if access to medications is disrupted. No two scenarios are alike. For instance, I take Levothyroxine, a thyroid hormone supplement. I will survive for a very long time without this drug. I can go long periods without it, and though eventually I will experience side effects like lethargy and weight gain, I will not die if I do not have access to it. On the other hand, a diabetic without access to insulin may find themselves in mortal peril.

When you do a risk analysis, think through what kinds of disruptions there might be. A natural disaster can come through, knocking out power that means that refrigerated drugs will spoil. You could get arrested and police could deny you access to medication. Supply chain issues might cause nationwide shortages of your medication for weeks or months on end.^[1]

This risk analysis will help you model different scenarios for what you might need to do to soften the blow of a disruption to medications. Talk to your doctor about what might happen if your access to meds is disrupted and how to manage that.

Create a list of your medications and who prescribes them

One easy thing to do is to write down on a piece of paper (or in a document on your computer or phone) the following information:

• your full legal name;
• what meds you take, including specific name, brand, dosage, and frequency;
• the name of the prescribing doctor or practice and their contact information;
• an attorney's number, if you have it.

You'll want to make sure that you share this list with some trusted people who can help you in the event of an emergency, such as a spouse, partner, or best friend. If you have a lawyer, make sure your lawyer has an up-to-date copy of this information.

If you are incapacitated, incarcerated, or incommunicado, your peer network can begin working through your details to make sure you have access to your meds. This may be as simple as going to your house or apartment and picking them up. Or you might need to work with a lawyer or doctor to ensure that they are able to get you access to the right medical care. In short, you shouldn't assume there's a central database that has all of this information. If you end up hospitalized or in jail, your support network will need accurate information to get you what you need.

Build a phone tree for medical support

A few days back I wrote about building phone trees. Well, putting together a medical care phone tree is a smart thing to do. Your tree should include relevant friends, family, doctors, lawyers, employers, or anyone else who might need to know if you're in need. Make sure the people on your phone tree know who to call and what to tell them. Practice using it from time to time and keep it up to date; you don't want your friends to discover your doctor moved her practice and her number doesn't work when you're in crisis. It's important to drill for the things you might need to do in an emergency.

It may also be worth building some networks in your local community for who might take the same medication you do. It's not strictly legal to share prescription drugs, but in an emergency it's possible you might need to "borrow" a day's worth of pills from a friend. I've definitely had times where I've been short my meds because of supply chain issues and needed to borrow a few days' worth from a friend.^[2]

Build up emergency OTC medications and other supplies

It's not easy to build up a backlog of medicine. Insurance companies and doctors are not likely to give you 6 or 12 months supplies of meds up front. But this doesn't mean there aren't best practices on how to build up resilience anyways.

When possible, get 3 month supplies of meds. This way, you're more likely to have sufficient supply in case of a short-term disruption, e.g. a blizzard shuts down your town for 2 weeks.

Have a stockpile of over-the-counter meds. Even though these can't replace prescription drugs, in many cases they can help the symptoms be more manageable. At the minimum, have some aspirin, ibuprofen, allergy medication, cold medication, expectorant, antacid, gas relief, or sleep aids handy. As always, keep out of reach of children!

Some medication can be available without a prescription. Drugs like Naloxone (Narcan), which reverses opiod overdoses, can be obtained without a prescription. Other meds, like epinephrine injectors (EpiPens) and some forms of HRT or birth control, can be obtained from overseas for not much more than a co-pay costs.^[3] The best time to test these alternative supply chains is now, not when you are in crisis.

Beyond medications, it's also important to keep a backup supply of the accessories you might need: blood glucose test strips, needles, inhalers, etc.

When you have this supply, distribute some of it among your local support network. This way, they can help get you access to your meds in the event that your supply runs out.

Ensure access to emergency refrigeration

If you have medication that requires refrigeration, be sure to have a backup plan in case of a power outage. This usually means having access to a cooler or thermos in the house and keeping cold packs in your freezer. In the event of a power outage, you can use this alternative storage to help keep your meds at the right temperature for a little longer. It depends on the refrigerator, but it's possible for food and meds to start to go bad as soon as four hours after the power goes out.^[4] I recommend a small cooler and some ice packs.

If you have access to a portable generator, consider bringing it to a disabled community member in need. This can help keep their meds cool and viable, but it's also important to have power to run CPAP machines^[5] or other home-care medical devices. Your community defense network should know who the vulnerable community members are and what their medical needs are. If you know that Mr. Smith down the street is a diabetic and uses a CPAP machine, then he should be one of the first people you think of when a big power outage hits.

Keep miscellaneous medical supplies on hand

Wheelchairs, crutches, braces, canes, CPAP machines, oxygen tanks, etc. All of these home-care medical devices and similar supplies become very useful in times of crisis. When trouble strikes, people may be forced away from home without these critical medical supplies. If you get access to these aids, don't throw them out! It's good to have them on hand in case of an emergency. You don't need to stock half a hospital in your basement, but if you have a community defense network, it's worthwhile to ask them to take an inventory of what surplus equipment they might have access to.

Support your disabled community

Disabilities vary, and what may be no big deal to one person may seriously affect someone else. Disabled people are part of the community, too, and they have every right to be able to protest, organize, prepare, and plan with the rest of the community. But their needs will vary. The best thing abled people can do is talk with disabled people to figure out their needs, comfort levels, and risk assessments. Together, a community can plan and prepare to support disabled comrades in times of need. If you have someone with a serious allergy, make sure you have an "EpiPen bloc." If someone joins a protest with a wheelchair, it might be nice to know your community can quickly provide a backup in the event that something happens and that person's wheelchair is damaged.^[6]

I've been at protests where people have been arrested and needed access to medications. Through our legal support and medical support networks, our community was able to ensure that they could get access to medical supervision even while they were being processed in jail. You can only do this if you know what people need, and you can only know what people need if you talk to them.

Concluding remarks

It's likely that the incoming administration will seriously disrupt access to medicine and other supplies. It's possible that legislative attacks will target birth control, HRT, or mental health medications. It's possible sheer administrative incompetence, tariffs, war, or climate disasters will shatter supply chains. It won't always be possible even for a well-prepared community to provide alternative care in the long term. We will hope this does not happen.

But if it does, it's important to start preparing a plan now for what might happen if your meds supply is disrupted. Speak with your doctors. Look for and test alternative supply routes. Build up a stockpile of meds and supplies. And network with your community to understand their needs and to help them understand yours. There are no magic solutions. There is only doing the best we can. So let's do the best we can.

Keep emergency medical supplies on hand