Dear Mr. Rawles,
First, I must thank you for the great service that you provide to society. I simply can’t tell you how much I have learned since beginning to read SurvivalBlog daily. I’ve decided that 10 cents per day is not enough, and plan to double it soon. Though I pray that I will die peacefully at the age of 98 without ever having to activate my prep plans, the feeling of security that comes from preparation will make my remaining years much more pleasant!
As a pharmacist, I wanted to make a few additional comments regarding Matt R.’s important suggestions regarding medication procurement. First, he is correct to assume that most manufacturer’s expiration dating is very conservative, and is often predicated on the worst possible storage conditions. Like for most other storage items, cool and dry are the most important considerations in extending the shelf life of drugs. As you so correctly point out in my new favorite book, Patriots, very few drugs degrade to toxic compounds; it is usually a matter of loss of potency over time. Since many drugs needed in a post-SHTF world, like antibiotics and vitamins, have high therapeutic indices (the effective dose is far smaller than the toxic dose, leaving you some “wiggle room” in dosing), one could titrate the dose up in an emergency situation if the expiration date has been exceeded by several years. Obviously, this is a “better than nothing” approach, and is not to be advocated while the world is still “normal”!
Interestingly, the U.S. Dept. of Defense has initiated a program throughout the active duty medical services called “SLES” or “Shelf Life Extension System”. As I understand it, the DOD, in cooperation with the FDA, conducted their own stability studies for many high volume drugs on their formulary. In order to save money (always a good thing when it’s taxpayer dollars that are being saved!) by using their own expiration date rather than the manufacturer’s, their “extended” shelf life is being employed. Of course, their findings are closely guarded, and is is prohibited to leak any information to the general public, as it would counter the very conservative expiration dates that cause millions of dollars of waste annually in the private sector. To be fair, the storage conditions can be more carefully controlled in the Defense system that throughout society. Though the true numbers are almost mythical, I did find a transcript of a speech given by a medical officer to a civilian audience. In trying to illustrate how much money the DOD is saving the public through this program, he cited one example: At controlled room temperature, ciprofloxacin (generic) tablets had been found to retain potency for 10 years past printed expiration date – he then said that further testing would probably extend the shelf life even further! Now before we all get excited, please remember that this is a highly anecdotal example, and is meant only to underscore the point that with proper storage, most published expiration dates are loose guidelines. Of course, biological drugs, such as insulin and cell growth factors are inherently less stable, and will present a real problem for those dependent on them during an extended SHTF or TEOTWAWKI occurrence.
With regard to Matt’s reference to his dentist writing prescriptions for Tamiflu, don’t be surprised if some pharmacists refuse to fill such prescriptions. In all states with which I have any familiarity, it is illegal for a doctor, or dentist to write prescriptions for drugs outside the scope of their practice. Pharmacists are usually held legally responsible for saying “no” in such cases by their State pharmacy practice act, though it usually takes something pretty obvious to trigger a rejection. Matt’s dentist may be prepared to argue that it’s hard to work on teeth when his patient’s nose is running like Niagara Falls, so it is within his scope of practice to treat influenza! Also, if you’re using insurance to pay for “stockpile meds”, just be aware that the practice may be misinterpreted as fraud by some insurance companies. I’m sure a sudden high volume of claims for unrelated medications would probably prompt an investigation or claim rejection.
Just my two cents worth – I will put more thought and research into specifics, and try to help out more in the future. Best Wishes, and thanks to all who share their knowledge and insight on your terrific blog! – S.H. in Georgia