Weathering the Storm: Medication Preparedness in Hurricane Season

Hurricane season stretches from the beginning of summer through the end of fall, and the 2024 season has demonstrated the power of extreme weather. As recent storms Helene and Milton swept across the Southeast, residents in their path have had to prioritize being prepared, from creating evacuation plans and securing the home to ensuring access to a backup power source, and—importantly—safeguarding medications.

Hurricane Helene viewed from space / OSORIOartist - stock.adobe.com

However, health care providers and pharmacies face massive disruptions in the face of natural disasters. This year, hurricanes devastated a major IV fluid manufacturer, setting off a national IV bag shortage and forcing patients to postpone surgeries and procedures. In some instances, health care professionals have turned to prescribing alternatives such as Gatorade to conserve IV supplies.¹

With disruptions to health care infrastructure and operations comes obstacles in communication. Power outages and post-storm uncertainty can make it difficult for patients to reach health care professionals with critical medication questions. That’s why, according to Brad Phillips, PharmD, both pharmacists and patients should have well-defined medication preparedness plans for before, during, and after a storm.

“Planning ahead is key,” said Phillips, a clinical assistant professor and assistant director at the University of Florida College of Pharmacy Orlando Campus, nestled in the most hurricane-prone state in the nation. Ahead of a storm, pharmacists should prioritize patient counseling on medication care and supply assurance, as well as provide insights on how to handle any medication that’s been tampered with.

Before the storm, Phillips said, patients should take inventory of their medications. This should include prescription and OTC medications, as well as the dose of each medication and the reason that they are taking it. In the event of an evacuation, having a list of medications can help patients pack the correct drugs and the right doses. Moreover, for patients with chronic conditions or those who require specific medications, this inventory can aid in prioritizing medication needs and securing enough supplies to last through the storm.

Many states have laws allowing early medication access during states of emergency. However, patient awareness of these provisions is essential. According to Phillips, pharmacists should inform patients about any applicable state legislation well before the storm makes landfall.

“I encourage patients to obtain early refills if needed, especially during a state of emergency,” said Phillips. “This is something that the governor of the state can declare, and during times of states of emergency, if there are any refills remaining for that prescription, they can be pulled early, providing the patient anywhere from a 30- to a 90-day supply.”

Once patients have these refills in hand, they must be stored properly. Insulin, a temperature-sensitive medication, requires refrigeration for optimal stability. Other temperature-sensitive medications include biological agents, antibiotics, hormone therapies, probiotics, thyroid medications, inhalers, and emergency medications like EpiPens and nitroglycerin. When in doubt of cooling requirements, patients should refer to the prescription information sheet that gets dispensed with every prescription.

In the case of an evacuation, displacement, or power outage, Phillips’ advice to patients is two-fold: Identify refrigeration or freezing options at shelters or secondary residences, and stock up on backup power options to keep medications safe.

“What I mean by that is, identifying and contacting the designated hurricane shelters or the secondary residences that that patient might be at to determine the capabilities they have available,” said Philips. It’s also important to have multiple hurricane shelters in mind. “The reason why is, not all shelters might be open during times of emergency preparedness, in which case, it’s always better to have multiple options than the first option really falling through.”

When grid power is unavailable, battery-powered or manual thermometers can monitor the temperatures of medications, particularly those requiring specific temperature ranges. Additional solutions include reusable or disposable cooling packs, insulated bags or coolers, and portable generators to power these devices. Nowadays, many options are available for patients to protect their medications; pharmacists can play a crucial role by stocking these items in their pharmacies ahead of a storm, making them readily available to patients in need.

“There are batteries that have solar power charging capabilities, and even others that can be charged off car battery,” said Phillips. “In recent years, there’s been a lot of development in the capacity and portability of these type of devices that can empower patients during these times.”

Say a patient has successfully obtained a refill to last through the storm, but their previous supply of medication has been compromised. What happens then?

According to Phillips, proper disposal is essential, as unused or expired medicines in the home constitute a major safety concern. To ensure proper disposal, patients should consider utilizing local drug take-back initiatives. Many large chain pharmacies, including CVS, Walgreens, and Walmart, have convenient medication disposal kiosks at their thousands of locations across the country.^2-4

For certain medications, the FDA recommends flushing as an appropriate disposal method. The agency’s flush list includes certain medications—such as hydrocodone, hydromorphone, and oxycodone, among others—that can be disposed of by flushing down the toilet. These are drugs that are either sought-after for their misuse and abuse potential, or that can result in death from one dose inappropriately taken.⁵ If flushing isn’t an option, Phillips recommends patients securely wrap medication in tight packaging, remove any identifying information, and dispose of them in the household trash.

“I do recommend that patients remove the medications from their original containers so that they’re not as easily identified and place them in a sealable container with an unpalatable substance, such as coffee grounds, dirty cat litter—essentially, the less appealing, the better to put in it,” Phillips said. “Then, simply make sure that it is in a tight, sealed container that is not easily opened before it is then thrown away in the trash.”

“No matter how patients dispose of their medications, another recommendation that I feel like is the most important step is making sure to remove any personal information that is associated with the medication prior to disposing of any medication as well,” he concluded.

Although hurricane season is nearing its end, winter can bring blizzards and Nor’easters, and early spring sees the beginning of tornado season in the Midwest. Regardless of the type of emergency, effective communication between pharmacists and patients is vital both during and after.

“There can be a lot of communication barriers throughout disaster preparedness, but again, in this day and age, there’s a lot more routes of communication that occur during those times,” said Phillips. Establishing reliable channels and informing patients of these platforms prior to the storm can take out the guesswork of communication and facilitate timely assistance. These include text messaging, email, and social media.

Community partnerships can also be crucial in amplifying messaging, says Philips. Reaching out to local TV and radio stations, local health care providers, and community shelters to disseminate information can be a powerful way to connect with patients in times of uncertainty.

READ MORE: Public Health Resource Center

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References

1. Tin, A. As IV shortage continues after hurricane, US invokes wartime power to speed recovery. CBS News. October 15, 2024. Accessed October 28, 2024. https://www.cbsnews.com/news/iv-shortage-hurricane-defense-production-act/

2. A dose of reality: How to dispose of unwanted medication. News release. CVS. April 20, 2023. Accessed October 28, 2024. https://www.cvshealth.com/news/community/a-dose-of-reality-how-to-dispose-of-unwanted-medication.html

3. Drug Take Back Day: Safely dispose of unused medication at Walgreens. News release. Walgreens Boots Alliance. April 18, 2024. Accessed October 28, 2024. https://www.walgreensbootsalliance.com/news-media/press-releases/2024/walgreens-drug-take-back-day

4. Walmart and Sam’s Club support safe medication disposal with DEA National Prescription Drug Take Back Day events in communities across the country. News release. Walmart. October 21, 2020. Accessed October 28, 2024. https://corporate.walmart.com/news/2020/10/21/walmart-and-sams-club-support-safe-medication-disposal-with-dea-national-prescription-drug-take-back-day-events-in-communities-across-the-country

5. Drug disposal: FDA’s flush list for certain medicines. News release. FDA. Accessed October 28, 2024. https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-fdas-flush-list-certain-medicines