Let me say right up front that while writing this I realized it may be a subject that touches people differently and most assuredly there will be varying points of view. Because of that I have attempted to use only well sourced medical information and studies.
I hope that this article is helpful. It offers up-to-date statistics from reliable references and contains thoughts for your consideration. If you have addressed any of these challenges as regards preparedness and you are willing to share them, please leave a comment so that we can benefit from one another.
What would happen if the more than 16 million American adults with depression and another 40 million who suffer with anxiety disorder suddenly didn’t have access to their medications? Keep this question in mind as we review some statistics.
Anxiety disorders are the most common mental illness in the United States. According to the Anxiety and Depression Association of America (ADAA), 40 million Americans over the age of 18 are affected by anxiety — roughly 18 percent of the nation’s population.
In addition, the Journal of the American Medical Association says that as many as one in 33 children and one in eight adolescents have clinical depression.
According to the World Health Organization (WHO), 350 million people worldwide suffer from depression.
Surpassing even depression, anxiety is the most common form of mental illness in the United States. It’s estimated that approximately 10 percent of teenagers and 40 percent of adults suffer from an anxiety disorder of some kind and this does not include your average worrier.
The number of Americans, including children and teens, that are taking antidepressants has risen by 65 percent between 1999 and 2014, per a government survey. Surprisingly, the highest percentage was in those people over 60, coming in at 19.1%! That’s almost one fifth of the senior population. According to Thomas Moore and his colleagues of the Institute for Safe Medication Practices in Alexandria Virginia most people who take antidepressants are doing it long-term.
In 2014, about one in every eight Americans over the age of 12 reported recent antidepressant use, this is according to a report released from the U.S. Centers for Disease Control and Prevention. In only three years (2017) that ratio was one in six Americans taking some kind of psychiatric drug — mostly antidepressants. International research out of New Zealand shows that antidepressants cause more days off work than diabetes, arthritis, cardiovascular, respiratory and substances disorders!
Consider for a moment, how as time passes, this American ratio is becoming more and more disturbing. The increase has been speeding up and is on a path to increase that ratio to one in four Americans before 2020. Meaning 25 percent of the (over 12 years old) American population is on anti-depressants alone. Think about that number and the impact it will have on the preparedness of our society as a whole.
These drugs cannot be stopped “cold turkey”. When antidepressants that affect the brain chemical serotonin are suddenly stopped, the body often responds with heightened physical and emotional symptoms caused by the sudden stoppage of increased serotonin levels.
It can also trigger withdrawal symptoms, not unlike alcohol delirium tremors (DT’s). It can cause a relapse of depression or anxiety. If relapse occurs and the patient starts taking an anti-depressant or anti-anxiety drug again, it can take weeks for the drug to rebalance mood.
One major side effect of going cold turkey is suicide. In my nursing career, I have seen the “cold-turkey” approach and the side effects of that can escalate, with frightening rapidity, into a life and death struggle. Some people recover from cold turkey, others don’t, so it’s important to point out that if you think you’re ready to stop taking an antidepressant, ask your doctor to create a plan of action that will help your body gradually adjust to being without the medication.
Don’t try it alone. Don’t reduce the dosage alone. Talk with your doctor before making any change in your drug adherence. A good doctor will be more than happy to talk with you about any changes that may be needed. Please don’t try to stop or cut back without the guidance of a trusted doctor.
All antidepressants may increase the risk of suicidal thoughts or behavior in children, adolescents, and young adults (18 to 24 years of age). The same is true for adults but to a lesser degree.
For depression alone, the annual cost for treatment and lost wages may be as high as $52 billion and is rapidly growing with each passing year. There are more than 30 different kinds of anti-depressants on the market today. Anti-depression and anti-anxiety meds are big business! It seems that as society unravels, legal as well as illegal drug use increases.
Although there are alternative practices for these serious disorders, the pharmaceutical approach remains the primary method of treatment in the United States and much of the western world. But the number of mental illness patients remains high and only keeps increasing year after year! Do these drugs cure? Do they work? Since 2008 the use of anti-depressants has risen generally by 8.5% yearly. That is huge.
Now here is where the one of the challenges with medication preparedness kicks in. Access to these drugs can be interrupted in a minute, and as discussed earlier these dear suffers can experience terrifying withdrawal or even death from the sudden stoppage of some types of addictive drugs. The example below is about IV bags but the same thing has happened with several drugs in the past ten years.
As I was researching before I wrote this article, I decided to speak with my local pharmacist about the source countries for American’s pharmaceuticals where the import of products may be affected by weather or other world conditions. Of course interruptions could happen within the U.S. as well.
Puerto Rico is one of our source countries and produces about 44% of the IV bags used in the U.S. My pharmacist (John) told me that back in September of 2017, the United States was no longer able to receive any IV bags along with some drugs directly from Puerto Rico because of the destruction caused by Hurricane Maria. I learned that about three quarters of Puerto Rico’s manufacturing exports are pharmaceuticals and medical supplies.
Baxter International who had three crippled plants in Puerto Rico was able to fill in a portion of the shortages from their other two plants in Australia and Ireland until their Puerto Rico facilities were up and running again. Those facilities had to halt production for a relatively short period of time and still there were significant shortages of IV bags nationwide.
John told me that they were able to continue receiving certain medications and hospitals were receiving their ordered IV shipments for 2 weeks because that amount was kept in reserve and stored as a backup at another facility outside of Puerto Rico. By the end of that two week period when those backup supplies were depleted, other countries were able to pick up the slack and so the impending longer term shortage was averted.
If there happened to be a more widespread, more prolonged crisis of any kind, in countries that provide pharmaceuticals or medical apparatus around the world, the potential for pain, suffering and death and could become massive.
Yet another more widespread shortage of intravenous bags made by Baxter International in Puerto Rico caused a large scale shortage of that product in hospitals and clinics all over the U.S. just as we reached the height of flu season.
The IV bag shortage has happened several times before and has remained for a longer duration than the Hurricane Maria incident. During one such shortage, the United States worked out an agreement with several European countries and Canada and were able to obtain IV bags from them, until those countries also fell prey to the scarcity.
Eventually as a result of these experiences large hospitals that use thousands of these bags per week formed a task force and came up with some useful and cost saving, IV bag extending protocols. One of their discoveries was that they could do without IV bags in many cases where patients could take fluid by mouth – imagine that! Of course there were other useful IV bag sparing findings as well.
But the potential for more shortages with IV bags still exists because several companies that manufactured these bags in the United States have closed, so we are now even more dependent on offshore sources.
But weather disasters aside, a large portion of pharmaceuticals that many Americans are dependent upon are made abroad in those countries where tensions are rising. The stark fact is that all is not “Kumbaya” in the world so there could be shortages and/or higher prices from Aspirin to Zoloft as uncertainties around the globe and unique weather events become more intense.
John also told me that India, Israel, China and Canada are other big players in the production and importation of pharmaceuticals into the United States. So any civil unrest, wars, famines, pandemics, nuclear accidents or severe tariff disputes, etc. could leave sky-rocketing prices and/or severe shortages in their wake. That’s why at BDS, we advocate the idea, “Prepare for the worst but hope for the best”!
There are multiple scenarios but the fact remains that we need to know more about how to take care of ourselves and our medical needs. And now is the time to redouble our efforts to prepare for possible future events within the United States and around the world.
We can attempt to stockpile our family’s needed medications; a big job indeed and one that requires much thought and planning. Everyone must think about the possibilities of their own situation and find creative ways to prepare.
There are several things to consider:
- Over-the-Counter medications
It is easy to stockpile over-the-counter medications and this works fine as long as you rotate them and have a cool, dry storage area where they are protected from sunlight. This includes herbal and vitamin products, but more about those later.
- Prescription medications
It can be quite another matter to build a stock of prescription medications if your doctor is unwilling or unable to accommodate that request. There are rules they must follow, even if an insurance company or third party payer is not involved. If you have a long-term, good relationship with your doctor they will sometimes work out a way that will allow a slow accumulation of your medication.
Some people order medications from other countries via the internet. If this online option is the one you choose, there are dangerous pitfalls to be aware of that need to be rigorously and carefully considered before choosing to trust your health to a website, especially “pharmacies” that are outside of the United States.
There are pharmacy websites that operate legally and that provide safeguards for purchasing prescription medicines. You must provide a prescription and proper identification. It would not be likely that you could stockpile medications this way.
One such website is www.HealthWarehouse.com. This is what they require:
- If you’re ordering a prescription, ask your prescriber to send the script via e-prescription, fax. It will take 1-3 days to process your order after they receive it. You can also order your pet’s medicines while you’re at it.
Legitimate online pharmacies always require a health provider signed prescription, making this route less favorable for accumulating a significant amount of prescription medications. It is absolutely necessary to recognize which online pharmacies are legitimate and know which ones are likely to be scams.
Legitimate or Not?
How do you know if an online pharmacy is legit? This is what the National Association Boards of Pharmacy has to say.
“The Verified Internet Pharmacy Practice Sites (VIPPS) program has been accrediting websites offering pharmacy services since 1999. NABP recognizes the need to help safe and legitimate pharmacies with an internet presence stand out against the ever-growing list of rogue websites – 20 new illegal pharmacies appear on the web each day.
In addition to letting consumers know that they are on a safe site, the VIPPS accreditation satisfies search engine advertising requirements set by Google, Bing!, and Yahoo.”
Rogue Online Pharmacies
It is not uncommon for preppers to try to stock up on prescription medications by using an online “pharmacy” which doesn’t require a legal medical prescription. There are dangers in using unregulated pharmacy websites as you might imagine, but many people do it anyway.
The U.S. Food and Drug Administration has issued a warning that there are many rogue online pharmacies that claim to sell prescription medicines at deeply cut prices, without requiring a valid prescription.
These Internet-based pharmacies often sell unapproved or counterfeit medicines outside the safeguards which are normally followed by licensed pharmacies. There is no way of verifying that the medication you receive carries the measured dose you require, or even that there is any medication in it all at. There is also a chance that you’ll receive a tainted product that could be harmful or deadly.
Be aware that these fraudulent sites often clearly display the Canadian flag on their website to insinuate that they are an official Canadian “pharmacy”. They do this to gain the trust of a prospective buyer when in reality they could be criminals operating on the other side of the world, far from Canada. It often isn’t obvious which online pharmacies are safe and which are fraudulent, unless you have done extensive research, and even then it is difficult to be certain.
The FDA has some good safety advice about online pharmacies: https://www.fda.gov/?BeSafeRx
The FDA has produced a list of warning signs to help identify a fake online pharmacy:
Avoid pharmacies that:
- Allow you to buy drugs without a prescription or by completing an online questionnaire
- Offer discounts or cheap prices that seem too good to be true
- Send unsolicited email or other spam offering cheap medicine
- Ship prescription drugs worldwide
- State that the drugs will be shipped from a foreign country
- Are located outside of the United States (HealthWarehouse.com is located in Kentucky)
- Are not licensed by a state board of pharmacy in the United States (or equivalent state health authority)
Here are some tips offered by the Food and Drug Administration to help identify safe online pharmacies. To identify a safe online pharmacy, make sure that the online pharmacy:
- Requires a valid prescription
- Provides a physical address in the United States
- Is licensed by the state board of pharmacy in your state and the state where the pharmacy is operating
- Has a state-licensed pharmacist to answer your question
It is important to note that only 3 percent of online pharmacies reviewed by the National Association of Boards of Pharmacy are in compliance with U.S. pharmacy laws and practice standards.
So if you still decide you want to throw caution to the wind and roll the dice with an online medication purchase, you of course have that option. Just use these above precautions and you will have some guidelines that may provide a safety net, but only if you remain alert and cautious in your research to find legitimate online pharmacy sites.
If Drugs for Depression and Anxiety are No Longer Available
A long term world crisis scenario will present shortages of every kind.
The following information may cause some eyebrows to rise because it goes against the main stream story line. I am including it here because Professor Gotzsche is highly respected in his field and his credentials and research are impeccable. He is outspoken about Big Pharma and has written several well researched books.
At a Mental Health in Crisis conference in Christchurch, Professor Peter Gotzsche, MD. a co-founder of the Nordic Cochrane Collaboration—the foremost body in assessing medical evidence says, “there is little to no evidence psychiatric drugs including ADHD medication, anti-depressants and anit-psychiatric drugs work, but lots of evidence they increase harm, including risk of dying. Some studies have shown anti-depressants could heighten the risk of suicide.”
The reason I put stock in these findings is because as their site says, “The Nordic Cochrane Centre….. contributing to evidence-based decision making in healthcare by producing high-quality independent research and systematic reviews that are free from commercial sponsorship.” (Copenhagen, Denmark)
They are not dependent on pharmaceutical companies for research monies and sponsorship as are 99.9% of the reviews I have done in the US. In the years that I did this work there was one, only one trial study that came across my desk that was not financially supported by a pharmaceutical company.
Of course, there is pushback from drug companies to these findings. But a finding like this deserves the attention of the medical community and perhaps even more testing. It also deserves attention from patients in bringing this information to their individual doctors.
Gotzsche and his team have researched psychiatric drugs over the last twelve years and said clinical drug trials “proved” their benefits were flawed and biased.
My disclaimer: I have included this information from Dr. Peter Gotzsche in this post so you can look him up, read his books and perhaps get another point of view, if you have further interest.
I will say that in the years that I was an evaluator of clinical medical course materials I was stunned at the “unique way”, shall we say, that many trials were financed, very likely biased in their original forms, and finally promoted to physicians, pharmacists and nurses in required continuing education formats. In the years that I did this work, there was only one trial study that came across my desk that was not financially supported by a pharmaceutical company and it had nothing to do with any drug!
So if Gotzsche is right in his findings, that there is little to no hard evidence that psychiatric drugs work, then the major drawback of a shortage is the initial withdrawal dangers.
I am merely pointing out that there are alternatives to addictive drugs in treating anxiety and depression, especially in children. I am NOT making any medical recommendations nor am I advocating a cessation of your medication! I am wondering though, if asking your doctor some serious questions about medications might be in order. Perhaps some adjustments with decreased dosage or some medication eliminations can be discussed with your healthcare professional.
Many, but not all, parents facing medication decisions regarding their child, take the time to study it out, educate themselves and possibly get a second opinion before blindly agreeing to a possible lifetime of pharmaceutical drug use for their child. It is worth the time and effort to become a knowledgeable advocate when making such important medical decisions for yourself or your child.
Complementary and Alternative Treatments in Mental Health:Do They Really Work?
The National Center for Complementary and Integrative Health is affiliated with The National Institutes of Health (NIH). It’s important to learn what scientific studies have discovered about the complementary health approach you might be considering.
The Anxiety and Depression Association of America (ADAA) is a U.S. nonprofit organization dedicated to increasing awareness and improving the diagnosis, treatment, and cure of anxiety disorders in children and adults.
“There is growing scientific evidence about complementary and alternative treatments. Interest in complementary and alternative medicine, or CAM, is growing as consumers and health care professionals search for additional ways to treat anxiety, depression, and other mental health disorders”.
This organization offers resources where you can learn strategies to help you manage anxiety, whether it is everyday stress and anxiety or an actual anxiety disorder.
Their site says, “Visit the NCCIH Web site (nccih.nih.gov). The “Health Information” page has an A-Z list of complementary health products and practices, which describes what the science says about them, and links to other objective sources of online information. The Web site also has contact information for the NCCIH Clearinghouse, where information specialists are available to assist you in searching the scientific literature and to suggest useful NCCIH publications.
Now switching to antibiotic medications…
One Easy Way to Accumulate Extra Antibiotics
Accumulating medications for a possible world calamity or collapse is simple when it is only non-prescription, over the counter drugs like aspirin, ibuprofen or a muscle rub, but antibiotics are another story.
Here is one way to stockpile important, possibly lifesaving medications and a reasonable cost, locally and legally.
Having a store of antibiotics available could be lifesaving. But, you say, ”my doctor won’t write a prescription for me to have more than I need and I am told to take the whole prescription since stopping the treatment early could mean that I may have to start all over again because the bacteria will not be totally eradicated.”
There is a way to get around this challenge. First, the new emerging medical view is that taking a shorter course of antibiotics may be just as effective, plus do a better job, at preventing antibiotic resistance, than taking a full course.
Here is my small firsthand experience. Several months ago, I had little choice but to take a potent antibiotic or to end up in the hospital, so reluctantly I began taking it. After taking almost half of it, I developed an unexplained but significant negative side effect so called the doctor.
After explaining the situation and wondering if the antibiotic could be the culprit, I was told to stop the medication (which I’d already done). At a follow up the next day, I was told that it appeared that I had already taken enough to solve problem. So about half of that dose was all I needed in the first place. Of course I decided to investigate further.
Here is what infectious disease specialist Dr. Brad Spellberg, Chief Medical Officer at the Los Angeles County-University of Southern California (LAC + USC) Medical Center and a Professor of Clinical Medicine and Associate Dean for Clinical Affairs at the Keck School of Medicine at USC has to say.
“The science is clear, every study that has been done comparing longer versus shorter antibiotic therapy has found shorter therapy just as effective.” A few days of taking antibiotics, it seems, should usually be enough to knock infections on their heels, allowing the patient’s immune system to come in and mop up.”
Dr. Spellberg goes on to say, “Taking the full course of antibiotics unnecessarily wastes medicine, and more drugs translates into increased evolutionary pressure on the harmless bacteria in our bodies. These “good” bugs can develop drug-resistant genes, which can then transfer to bad bugs.”
“Furthermore, wiping out drug-susceptible bacteria in infections too quickly makes it easier for drug-resistant bacteria to compete over a host’s resources. Overall, the accumulating data lend support to the heretical notion of patients, in consultation with their doctors, stopping their pill-popping upon feeling better. The issue of continuing therapy until all doses are done is an old wives’ tale,” Professor Spellberg says. “There’s no data to support it. You can’t make a cured patient better.”
I can’t take the liability of saying that it’s okay to take only half of your antibiotics but you can do some research and decide for yourself hopefully with your doctor’s input, what you want to do. It often takes a long time for scientific evidence to trickle down to the front line medical community and become accepted policy.
This option, of using partial doses, provides a 50% surplus of that antibiotic which you can then store, but not enough to provide a safety net over a longer time frame. Obtaining these drugs in quantity will be even more difficult when hard times come.
Failure to store antibiotics now for the times ahead may prove fatal. In today’s world we tend to take the miracle of antibiotics for granted, probably because they have been around for 90 years (since 1928). Most of us have never been without them and so have no collective memory of the devastation that infections brought to large populations before their arrival.
These used to be readily available at larger pet store and tropical fish stores but that is changing and finding it there is more difficult than it was several years ago.
If you go online for it you face the same challenges mentioned above while shopping online for human medicines. There are many aspects to consider when thinking about using any animal/fish medical product for human consumption. Their safety and availability has transformed over the past several years.
The Survival Doctor has this to say, “Despite the fact that buying these meds is common, preppers struggle to find an answer to this seemingly simple question: Are fish antibiotics safe and effective for humans? The only answers provided thus far have been speculative.”
They went on, “We’ve spent weeks contacting pharmacists, drug manufacturers, veterinarians, and safety watchers. We located key experts who shared invaluable, never-before-reported information—some on the record, some off.”
I would refer you to that site for a more in depth examination of the topic.
Certain over-the-counter antibiotic ointments like Triple Antibiotic Ointment or Bacitracin are a must-have when regular medical care is not available. This ointment may seem like an inconsequential medication to have on hand.
But there will be a larger incidence of scrapes and cuts which increase the incidence of infection when people must fend for themselves and are doing things they may not be used to doing especially during times of crisis and stress. These wounds will very likely be dirty. Within a relatively short time, they can begin to show infection, in the form of redness, heat, and swelling.
The prepper community may be more prone to “toughing it out”. An infection can develop quickly from what began as a minor skin abrasion so don’t delay the start of caring for even the smallest skin break and you may avoid a full blown, spreading infection.
How Long Can Antibiotics Be Stored Safely?
Debate exists regarding the relative potency of medications beyond their labeled expiration dates. Drug expiration dates typically range from 12 to 60 months after their production. The military, attempting to find if their large, old stockpile of medications were still potent and in what degree commissioned testing and the report of those findings were reported in the New York Times, in part.
To quickly and simply summarize their findings I would say this: Yes, generally medications, stored in the proper way, retain a good portion of their potency about 6 years over the labeled expiration date, however, there were mediations that did not and some did become toxic after long storage. Particulars are too long to include here but you can read those findings here to learn more before making any decisions.
We do know that FDA regulations do not require determination of how long medications remain potent after that, allowing manufacturers to arbitrarily establish expiration dates without determining actual long-term drug stability.
If you’d like more information I would suggest further reading of the two articles below:
- “Stability of Active Ingredients in Long-Expired Prescription Medications” where more detailed information is available. There is also an excellent abstract by Jay M Pomerantz, Assistant Clinical Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts regarding the recycling of medications called:
- Recycling Expensive Medication: Why Not?
The point ultimately is to be able to function as fully and competently as possible right now and during any crisis situation. And to be able think clearly and act in a way that would be in the best interest of yourself and your family and to have on-hand the antibiotic preparations to take care of any injury that has caused a break in the skin, even the smallest cut or abrasion, well before an infection begins.
I know this article is detailed but I hope there was something here that was helpful to you in your quest for medication preparedness as regards depression, anxiety and infection. I plan to do two follow up articles very soon on natural ways that might be beneficial in reducing stress, anxiety and infection.
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