Here's a treat for you. Too long to be a single blog post, this essay by a family physician addresses prescription medications after societal collapse. He is working on a website (which needs work but promises to be a fabulous resource) at Post Peak Medicine.
POST PEAK MEDICINE
- Peter Gray
A subject which comes
up fairly regularly in collapse-oriented discussions is “after a
societal collapse or TEOTWAWKI, what will happen to people who take
prescription medications?” As a family physician, this is
something which I’ve been thinking about for some time, not because
I think a sudden and dramatic societal collapse is particularly
likely, but because it’s within the range of things which might
occur in the wake of peak oil and other looming disasters of the 21st
century. I feel I have an obligation to consider what it might look
like from a medical perspective, and what the options might be for
dealing with it, because if it happens, I’m likely to be one of the
front line responders. It’s rather like, you don’t expect the
guy at the next table in the restaurant to have a heart attack, but
if he does, it’s good idea to know how to use the defibrillator.
There are some
medications which are so critical that if patients don’t get them
they are going to die within days or weeks: insulin, for example. If
you are an insulin dependent diabetic and you are worried about a
societal collapse, the best advice I can give you is to go and live
within walking distance of an insulin-producing facility and hope for
the best.
However, only a very
small percentage of the population are critically dependent on
life-saving medications, so I’m not going to say much more about
them. What is of more interest to me, and will have a much larger
impact on society generally, is how the average person on common
medications is going to manage. With that in mind, I would like to
introduce you to one of my patients, Average Joe. Or let’s just
call him Joe for short. Joe is a fictitious patient, but I have
hundreds of patients on my roster just like him, and I see several of
them every day in my office.
Joe is in his late
fifties and works a sedentary job at a call centre. His height is 5
feet 9 inches, he weighs 237 pounds and he has a Body Mass Index
(BMI) of 35, putting him in the middle of the “obese” range. He
doesn’t have any rare or immediately life-threatening diseases, but
he does take the following regular medications:
Vitamin B12 injection
once monthly
Zantac ( for acid
reflux / indigestion)
Coversyl (a blood
pressure lowering medication)
Metformin and Glyburide
(pills to lower blood sugar in diabetics)
Lipitor (to lower
cholesterol)
Low dose asprin (to
protect against heart attacks and strokes)
Celexa (an
antidepressant)
Ativan (a
tranquilliser)
Temazepam (a sleeping
pill)
Arthrotec (a
painkiller, for arthritis)
He also has sleep apnea
and uses a Continuous Positive Airways Pressure (CPAP) machine to
help him breathe at night, which is electrically operated.
Because of his multiple
medical conditions and medications, Joe comes to see me about once a
month. Regardless of what he is coming to see me about, the fact
that he seeks medical attention so often makes me concerned about his
lack of resiliency in the event of a sudden collapse. If I were Joe,
I wouldn’t want to come and see me every month. I’ve got better
things to do with my time, and I would make every effort to cut down
the frequency of my visits to the absolute minimum. But Joe seems to
quite enjoy his visits here, even if I keep him waiting. It makes
him feel cared for, and it’s part of the routine of his life. If
his medications go away, or the Government is no longer able to pay
for his visits, Joe is likely to feel disorientated, upset and angry.
So now let’s look at
each of Joe’s medications and try to imagine what will happen if
they suddenly become unavailable. We’ll start with the least
important first.
Joe gets an injection
of Vitamin B12 every month, but he really doesn’t need it and he is
unlikely to suffer any ill effects if it goes away. Before starting
the injections he had a borderline low B12 level, but that was
probably partly due to his diet which consisted mainly of pizza,
chicken wings and pop and was deficient in fresh vegetables and dairy
produce, and partly due to an unrealistically high laboratory
reference range for what constitutes a “normal” Vitamin B12
level. Correcting his diet will correct the deficiency (if any).
The injections were started by a predecessor of mine, who decided
that as he got paid $6.75 for each injection, but nothing for giving
dietary advice, he would give the injections instead of the dietary
advice. I suppose I could stop them, but I know Joe would be very
disappointed, so I continue giving them and claiming the monthly
$6.75 just like my predecessor.
Joe has acid reflux
mainly because of his obesity. Slim down, and the unpleasant burning
sensations will go away and he won’t need the Zantac. Joe finds it
difficult to lose weight on a diet of pizza and chicken wings, but he
will find it much easier once he starts growing his own food or
walking to the farm gate
The same can be said of
his sleep apnea machine. Sleep apnea is mainly a disease of obese
people, where the fatty tissue at the back of the throat obstructs
breathing during the night. Slim down, and he won’t need the
machine.
Losing weight and
reducing the amount of fat and salt in his diet will also help his
blood pressure and cholesterol levels. Slim down, and he won’t
need his Coversyl or his Lipitor.
Joe has difficulty
getting to sleep at night, and a few years ago his physician put him
on Temazepam sleeping pills which he has taken ever since. However,
insomnia isn’t a medical illness but a lifestyle problem, caused by
a combination of stress, poor sleep hygiene, lack of exercise and
possibly a secondary effect of other medical conditions such as sleep
apnea (see above). If his sleeping pills go away, Joe will suffer a
few weeks of withdrawal symptoms which may be unpleasant but not
fatal, and eventually he will settle back into a natural sleep rhythm
and feel better for it.
Tomorrow: Part 2
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I commented on this on the day it was posted but it's not here :-(
ReplyDeleteIt didn't show up on Disqus, in Blogger, or in my email. :( Seems to have been one of those "lost in cyberspace" things. I *think* that Blogger has been doing some maintenance, which I really hope is over.
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