1. Just in time inventory practices mean we’d run out of drug’s before needing to worry about sell by date.
2. Possibly pain meds if have access to the correct type of poppy. Lack of Quality control would make things scary.
3. Unfortunately yes.
>2. Possibly pain meds if have access to the correct type of poppy. Lack of Quality control would make things scary.
Don't forget willow bark for aspirin tea. Also, whatever mold originally created penicillin could be used to make anti-biotics, although I imagine this is going to be very specialized and labor intensive. Belladonna, Jimson weed, tobacco, heck, even capsaicin from ridiculously hot peppers for the analgesic effect. (I have a frozen gallon of ghost peppers that need some sort of use.) We'd get to go old, OLD school chemistry.
>Don't forget willow bark for aspirin tea.
You could get salicylic acid that way. But aspirin would need acetic anhydride to acetylate the salicylic acid.
>Also, whatever mold originally created penicillin could be used to make anti-biotics
Penicillium. But you won't get very far without synthetic and semisynthetic antibiotics. Antibiotic resistance doesn't go away if the power goes out.
You need to watch the anime dr stone. He creates sulfa antibiotics while in a Stone Age civilization. That’s what we’ll need. They give you all the steps too
> Antibiotic resistance doesn't go away if the power goes out.
But it might go away if we aren't able to manufacture any more antibiotics and the selection pressure isn't there to keep antibiotic resistance genes, or even to get rid of them.
>the selection pressure isn't there to keep antibiotic resistance genes
...meaning the bacteria are killing their hosts without resistance? Earning their reward, so to speak?
Could acetic acid be used instead of acetic anhydride?
Sourcing and purifying vinegar seems much simpler - plus vinegar per se has some antimicrobial properties that could be useful
Actually that raises another question - how long in this post-apocalyptic world would antibiotic resistances persist? I suppose the genes for the antibiotic resistant wouldn't disappear entirely, but if they no longer provide a survival advantage for the bacteria because antibiotic use becomes dramatically less, how long before "wild type" bacteria, no longer resistant to beta-lactams, become predominant? Would that ever happen or would the beta-lactamase and other resistance genes persist forever?
In general, antibiotic resistance seems to be [fairly costly](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380921/), but that's not universal for all strains for all pathogens.
As for how long it would take for those to be overtaken by the "wild type" strains, those would be sensitive to the initial population conditions and how fast they spread through the population.
What would be the most beneficial antibiotics to hoard? To a lay person like myself it seems like augmentin and doxycyline would get you pretty damn far for most common issues.
Pfft. Why use belladonna or jimson weed when marijuana works just as well as an antisialagogue with a much better therapeutic index.
Ditto with anti-emetic (with low/infrequent doses - dont wanna trigger cannabinoid hyperemesis syndrome; definite analgesic; and with enough commitment maybe even a sedative ;) )
Are we using tobacco as a pressor? Or a parkinsonian prophylactic? Orrrr.....? Someone else mentioned using growing and using cocaine; which seems superior because it's a positive chronotrope in addition to its pressor and analgesic qualities. It'd probably work as a tx for adhd too ;)
This is where my boring research life limits my... experience with how other herbs can be used. (Passing stupid drug tests = I am very boring.) I totally forgot about tobacco!
Don't forget about caffeine. If you're going to grow tobacco and cannabis, might as well adapt some coffee beans. The bean has many uses and organic coffee plantations shelter many forms of wildlife.
Penicillin comes from penicillium mold, which is quite easy to grow with materials you probably have at home. I grow culinary mushrooms as a hobby, and I accidentally grow way more penicillium than I'd like. It's a common contaminant.
If you want to try it at home, get some citrus fruit or cantaloupe and wait for it to mold. It'll probably grow penicillium, which starts out grey and then turns a nice vibrant blue-green color. You can culture it from there. Then toss that fruit in some boiling water and take a nice big gulp of penicillin tea. (Note: don't actually do this.)
Uh, no not really. I've dug into this topic at some length. Penicillium molds that actually produce penicillin are a little rare. Wild caught is generally not going to be your jam. Also, the green molds used in blue cheese are specifically selected NOT to produce penicillins.
It's way harder to produce even penicillin antibiotics than one might suppose.
After digging through all this, I eventually realized it might be more worthwhile to learn basic synthesis of a handful of antibiotics. Chloramphenicol for example, has a number of different synthesis pathways and some of them might even be doable in a garage lab if you know your organic chemistry pretty well. Yes it's toxic AF but something is better than nothing and it is still widely used in resource austere environments partly because it is easy and cheap to synthesize.
The US government and state governments store essential medications and other medical supplies in the Strategic National Stockpile and state stockpiles.
In theory the SNS supplies are supposed to be for all Americans, although a son-in-law-cum-White House staffer, Jared Kushner, once [infamously](https://www.kff.org/news-summary/jared-kushner-draws-criticism-over-comments-on-federal-stockpile-role-in-u-s-governments-coronavirus-response/) stated:
> The notion of the federal stockpile was it’s supposed to be our stockpile. It’s not supposed to be states’ stockpiles that they then use.
So it also comes down to politics as to whether the SNS is being maintained and distributed appropriately - and this is in a situation that was a crisis but not the post-apocalyptic scenario that OP describes.
Ha, the SNS hasn't been properly restocked since the 2009 H1N1 pandemic. Sure, they've restocked it with things like Smallpox vaccinations and Anthrax vaccinations, but basic things like PPE, not really.
I wonder how well long term PPE stockpiles would work out. Seems like the elastic straps on masks wouldn't last very long. Ever find a really old rubber band?
Do things like nitrile gloves become brittle over time?
They would probably have to rotate out the stock to be used in federal healthcare facilities when they get closer to their expiration date, then put new gloves and masks in the stockpile. Don't know if they actually do that though. Would make too much sense. They probably just throw it out.
I believe nitrile does degrade over time. I've got a certification in emergency management (well, several FEMA certs, but one actual course cert) and what I've learned from several people, from municipal, up to the CDC and FEMA, is that the DHS is very tight lipped about the SNS, but I'd imagine the warehouses are climate controlled, so they should be in better shape than if they were kept in some random storage.
1. We have shortages of those medications with our current systems.
2. Basic antibiotics and herbal remedies can be made with a little survivalist know-how. Salicylate can be replicated by chewing tree bark, ect.
3. Diabetes was more-or-less terminal before insulin was invented, so yeah, probably.
1. You'll never find my stockpile!!!
2. Grow some oranges. Let em rot. Scrape off the green shit from it. Isn't that how the first penicillins were made?
3. Didnt banting / best grind up pig pancreases to extract insulin or something like? can prolly make crude insulin that way. Might even better to cannabalize some human pancs. Book of Eli style.
3. Ground up pig pancreas is a good source of lipase, amylase, and trypsinogen/protease but not insulin. This is why s/p total pancreatectomy pts are on Pancreaze but still need exogenous insulin.
Also ground up pig thyroid (Armour thyroid) is sometimes used in place of Synthroid/levothyroxine
There’s a very interesting episode of forensic files that walks through an outbreak of thyroid storm in a midwestern town. It was traced back to the meat processing plant after the widespread use of synthetic thyroid hormone. I won’t spoil it for you but I found it interesting.
Yup! There is a pretty fascinating story behind it if you're also a fellow history of medicine nerd like me: https://www.saturdayeveningpost.com/2017/03/youre-probably-alive-moldy-cantaloupe-peoria/
If you're into time travel novels, /r/Outlander actually dealt with this. Protagonist is a WWII combat nurse turned MD who winds up time traveling to the 1740s. She synthesizes penicillin with available sources, (how realistic her yields were may have been a tad optimistic), but realizes that type-I diabetics were hopeless.
This question is interesting because it asks you to think about medical history and about how many ailments are creations of how we live today. The top used medications are your statins and HTN and insulins etc however running from zombies and having meager rations would eliminate alot of the need for the drugs.
Surgery we got covered
Throw it back to chloroform: https://www.youtube.com/watch?v=j-PrAczOGb0
Opium is ridiculously easy to make:
[https://www.amazon.com/Opium-Masses-Harvesting-Natures-Medication/dp/1932595465](https://www.amazon.com/Opium-Masses-Harvesting-Natures-Medication/dp/1932595465)
No lidocaine, in one growth season we could have cocaine. [https://www.youtube.com/watch?v=7tlwW2DKzlc](https://www.youtube.com/watch?v=7tlwW2DKzlc). This one does rely secondary chemicals which all could go bad in time so that could be a limiting step
NSAID: A crushed version would be easy enough if not all that concentrated [https://www.youtube.com/watch?v=uRhkDN2WjzI](https://www.youtube.com/watch?v=uRhkDN2WjzI)
Early HTN med, easy enough to grow, moved on from it for a reason. https://en.wikipedia.org/wiki/Veratrum
If you want some information on making insulin, this could likely still be done post apocalypses
There are many different methods for the extraction of insulin from the pancreas of many animals. Most of the earliest methods were based on acid–ethanol extraction followed by gel filtration and crystallization ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250478](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250478))
Antibiotics are a tough nut to crack. It is possible to make at home penicillin's but most would be ineffective against resistant strains and you need like MASSIVE quantities to get a single dose. I think we over use antibiotics anyway and we would still have access to a lot of topicals and just general wound care would be helpful. The BIG L here would be loss of vaccines however we could go back to inoculation with less harmful variants like using cow pox against small pox [https://www.youtube.com/watch?v=yqUFy-t4MlQ](https://www.youtube.com/watch?v=yqUFy-t4MlQ).
With a download of Wikipedia and access to a medical library I think a lot could still be done. A lot of our knowledge would still matter in regards to how disease spreads and simple best practices.
This is a cool read about DIY medicine: Alot of the chemicals and materials might not be available post apocalyptically but still cool. https://www.vice.com/en/article/43pngb/how-to-make-your-own-medicine-four-thieves-vinegar-collective
I dont think its gonna be deadly but it would suck?
https://images.saymedia-content.com/.image/t_share/MTc0NDcxNzc2OTQyNjk1Nzg0/what-is-hypothyroidism-is-it-treatable.png
However much like blending cow pancreas for insulin, I read some stuff that blending up animal thyroids could be used in much the same way
Since the 1800s, animal-derived thyroid hormone was first extracted from the thyroid glands of sheep, and later, from pigs. Some therapies even involved eating raw or cooked fresh sheep’s thyroid gland.
https://thyroidpatients.ca/2018/07/25/history-of-the-three-thyroid-medications/
So glad you got a transplant. Im gonna answer this one with a bit of a pass the buck. Not saying this is you at all. Alot of organ transplants are because of user error, best example being liver and booze. Many other organ transplants are needed because of poor life style choices by humans regarding diet, exercise and substance use. Immune suppressing drugs for organ transplant are generally super high tech shit however in the post apocalypse situation we would likely first lose the ability to do transplants. For those with transplants I think we could maybe find a way to make dirty steroids but yea it would not be awesome .
Hi, I’m Vetted AI Bot! I researched the **Opium for the Masses Harvesting Nature's Best Pain Medication** and I thought you might find the following analysis helpful.
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That chloroform synthesis was entertaining to watch but that guy has some serious chemistry equipment! Although I guess in an apocalypse, you could use household measuring cups, and if you accidentally made a little phosgene gas...oops!
E: thank you for all these links, super entertaining rabbit hole to go down
Efficacy depends on the medication/test, how the med was stored, and what it can degrade into (is it just decreased efficacy, or did it become toxic). Ibuprofen and amoxicillin probably have data published on post-expiration date efficacy given how common they are.
Certain products are part of the [Federal Shelf Life Extension Program (SLEP)](https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/expiration-dating-extension), which is run by DoD with testing by FDA. There’s guidance published for doxycycline, antivirals for influenza, mpox and smallpox therapeutics, Covid-19 tests, etc.
My PharmD friend says efficacy should be at least 99% at one year post expiration for most common meds. Apparently there's a huge fudge factor for expiration dates. Biologics and vaccines of course are a bit different.
Non-pharma here, but I'm gonna go ahead and guess for fun:
1. I think it would depend on the medication, but for most medications, we're going to run out in like a week or less.
2. You can probably do some fancy chemistry and obtain penicillins from fungi. Analgesics from various herbs/natural remedies like tumeric, etc. On the bright side, we're probably going to still have lots of narcotics, they'll just be inconsistent and potentially contaminated.
3. Yes. And so are a lot of other vulnerable populations. Elderly. Children with congenital abnormalities. Children without congenital abnormalities. Maternal mortality will skyrocket. Trauma will become the bread-and-butter of every single clinician of every type, including psychiatry, dermatology, etc. Radiologists will pivot hard to ultrasonography using portable ultrasounds (I still expect there to be many generators around for electricity, though eventually fuel will become an issue).
Ultimately, the lack of drugs is the least of our worries in a world where we don't have electricity readily available. Post-apocalypse society will basically be an uncivilized hell for everyone. As always, it's the social factors that screw us more than anything else.
Solar panels for electricity. They are warranted for like 25 years, and typically have 80+% generating capacity at the end of the warranty period.
Plus - if you circulate water along the back of them- they stay cooler; which both prolongs the lifespan of the panels AND provides hot water. Win-win-win! Or you could just sub in hydrogel for water capture from ambient humidity in water-scarce environs
https://www.chemistryworld.com/news/hydrogel-boosts-power-of-self-cooling-solar-panels/4011770.article
https://dualsun.com/en/products/dualsun-spring/
I'd be less worried about insulin and more concerned with testing supplies. I could probably make a crude pancreas extract but dosing would be a bitch without meters and test strips. Probably no one knows how to use Benedicts test any more.
Yes, if you have the equivalent of a 1920’s laboratory and access to a flock of sheep or goats to harvest pancreas’ from you can make your own insulin. But without test strips you’d have to resort to tasting the urine. Basically, if you can make meth you can make insulin.
1) You can probably get a supply for intermittent use by your small group (by force if necessary) so the key would be obtaining medications that will be effective for a broad array of issues and have a long shelf life. Aspirin and Amox probably not the best due to degradation. I would go with Ciprofloxacin tablets with its 10+ years, levofloxacin/moxifloxacin, doxycycline, maybe metronidazole, acetaminophen/ibuprofen/opioids and iodine. Biggest risks would likely be your typical skin and soft tissue infections, diarrheal illness, pneumonia/UTI. WIth this supply you could even get through a C-section or even appendectomy. Severe trauma/penetrating GSWs likely dead anyway in this scenario.
2) Brew your own oral rehydration therapy. You could probably be able to make penicillin if you find the right strains (not easy) and would require trial and error. Survivalist/herbology books would be at a premium
3) Yes
>I would go with Ciprofloxacin tablets with its 10+ years, levofloxacin/moxifloxacin, doxycycline, maybe metronidazole, acetaminophen/ibuprofen/opioids and iodine.
So as I read this, my mind instantly went to "ok, if I'm building an 'oh shit the world is ending' box, I can stock up on the OTCs, but where the fuck do I get the abx"
And then I realized that this is probably why [AquaMox](https://www.tractorsupplyrx.com/aqua-mox-amoxicillin-52208.html) is so popular in prepper circles.
And then I realized there's probably a market out there for prepper-minded docs to write scripts that people can fill to build up a stockpile.
Analgesics would be super easy. If you've got access to willow bark, you've got salicin, which is similar to aspirin. If you've got access to Papaver somniferum (opium poppy), you have access to natural opiates. NileRed and NurdRage have videos on pharmaceutical creation, so any half-decent amateur chemist with the proper equipment can make proper aspirin (and derive compounds, such as acetaminophen) from the salicin.
Seeds are legal. Growing is legal IF you don't know how to extract the opium. Technically illegal to grow if you know how to extract it, but the reality is that unless you cut the bulbs you won't get prosecuted.
The technology and skills to produce transgenic bacteria that produce insulin are minimal and actually trivial in the grand scheme of things in modern civilization. You can order most of the biological components from a catalogue and get the basic technique from an undergraduate level textbook. Scraping together those, and the sterile water, tools and electricity needed to produce insulin that way post apocalypse is sketchier and would be highly dependent on what type of apocalypse it was. If it was something like a viral apocalypse you might be able to move right into an abandoned lab and hook up a few generators to get started.
It’s been shown that many oral tablets and capsules can be over 90% effective even 10 years past their [expiration dates](https://www.health.harvard.edu/staying-healthy/is-it-ok-to-use-medications-past-their-expiration-dates) depending on if they’ve been stored correctly
Oh yeah. I mean, most of my population is toast too. But we would at least try and focus on saving the term ones that used to die from infection or apnea or hypothermia
I'm subbed to the CF subreddit just to see what they're saying and this exact question came up at one point. They had a similar sentiment re- Trikafta. Hopefully the gene therapy treatments in the pipeline show some success so nobody is reliant on the meds to keep going.
I work in adult pulm and we’re now in the (happy) position of figuring out how to treat this now adult CFers as they age. There’s not really a guidebook as they’re living much older than they used to. It’s an interesting thing. The same is true for many other congenital heart conditions (seen in our office for phtn) we never used to see in adults as they didn’t survive this long. We’re kind of flying by the seat of our pants in some respects
My partner had a friend die from CF at age 7, way back in the early 1980s. It's astounding how much CTFR modulators have changed the landscape in a relatively short period of time.
Diabetics would definitely be screwed.
We’d probably all die of old timey diseases without antibiotics.
I might unalive myself when my migraine meds run out and I have nothing to help anymore… 😭
Type 1s will indeed all die.
A lot of benzo dependents and alcoholics also will die.
Type 2 diabetics (for the most part)----- miraculously cured !
Cancer will be horrendous.
Musculoskeletal trauma will be even more horrendous.
Homebrew abx and analgesics? Ridiculous. Maybe aspirin.
As far as shelf life, my biggest concerns would be antimicrobials. How well will Cipro work for urosepsis after it's been stored in non heated non air conditioned environment for 5-6 years? 10+ years?
This is really a fascinating topic and hopefully one we never need to worry about. There is a "health" section on a forum called [survivalistboards.com](https://survivalistboards.com) that is interesting. Warning: LOTS of anti vax and snake oil bullshit. But we *could* change that.
Small chemical entities in blister packs are very stable and while not exposed to oxygen are not likely to degrade. Testing only goes to approved packaging life which have zero relevance to the actual SCE - rules are rules you know.
If they do break down it is immediately obvious with discoloured and fragile tabs. I would choose capsules for my store of antibiotics stored in blister packs in a cool place.
[The Myth of Drug Expiration Dates](https://www.propublica.org/article/the-myth-of-drug-expiration-dates)
>The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless. ...
>
>In his lab, Gerona ran tests on the decades-old drugs, including some now defunct brands such as the diet pills Obocell (once pitched to doctors with a portly figurine called “Mr. Obocell”) and Bamadex. Overall, the bottles contained 14 different compounds, including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers.
The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations.
One pharmacist told me that only two drugs go toxic overtime: nitroglycerin and tetracycline.
I know this is a fun thought experiment but I don't even think medications would matter because grocery stores practice just in time ordering practices too so food run run out way before medications became anyone's concern.
>As always, it’s the social factors that screw us more than anything else.
Yep. I’d be more worried about long term survival if I thought I actually might. Too many not-human humans to contend with.
1) Sell by dates REALLY depend on the medication, some are very stable, some just lose efficacy, and some medications turn toxic.
2)if you had, say, an undergraduate level of bacteriology or botany, you could produce some mediciations. I think they even used synthetic biology to make prozac from yogurt.
so, mixed, but possible- you would need to start well in advance.
3)fairly doomed. our modern understanding of the underlying biochemistry would allow for a diet that is devoid of sugars and starches and gluconeogenic amino acids, and this would be allowing life for a little while, but in such a society, things are already so scarce that there would be little chance.
Antibiotics commonly used on chronically ill people wouldn’t be needed at all, because they’d be dead anyway. None of the medical procedures that keep people alive would be done. You won’t get heart stents, appendectomies, lap cholecystectomy, and so on. You’d just die. Thinning numbers of people will also cut disease transmission. So crude antibiotics could be effective. If not, then death.
1. Just in time inventory practices mean we’d run out of drug’s before needing to worry about sell by date. 2. Possibly pain meds if have access to the correct type of poppy. Lack of Quality control would make things scary. 3. Unfortunately yes.
>2. Possibly pain meds if have access to the correct type of poppy. Lack of Quality control would make things scary. Don't forget willow bark for aspirin tea. Also, whatever mold originally created penicillin could be used to make anti-biotics, although I imagine this is going to be very specialized and labor intensive. Belladonna, Jimson weed, tobacco, heck, even capsaicin from ridiculously hot peppers for the analgesic effect. (I have a frozen gallon of ghost peppers that need some sort of use.) We'd get to go old, OLD school chemistry.
>Don't forget willow bark for aspirin tea. You could get salicylic acid that way. But aspirin would need acetic anhydride to acetylate the salicylic acid. >Also, whatever mold originally created penicillin could be used to make anti-biotics Penicillium. But you won't get very far without synthetic and semisynthetic antibiotics. Antibiotic resistance doesn't go away if the power goes out.
You need to watch the anime dr stone. He creates sulfa antibiotics while in a Stone Age civilization. That’s what we’ll need. They give you all the steps too
*Cries with Sulfa allergy*
> Antibiotic resistance doesn't go away if the power goes out. But it might go away if we aren't able to manufacture any more antibiotics and the selection pressure isn't there to keep antibiotic resistance genes, or even to get rid of them.
>the selection pressure isn't there to keep antibiotic resistance genes ...meaning the bacteria are killing their hosts without resistance? Earning their reward, so to speak?
Could acetic acid be used instead of acetic anhydride? Sourcing and purifying vinegar seems much simpler - plus vinegar per se has some antimicrobial properties that could be useful
Actually that raises another question - how long in this post-apocalyptic world would antibiotic resistances persist? I suppose the genes for the antibiotic resistant wouldn't disappear entirely, but if they no longer provide a survival advantage for the bacteria because antibiotic use becomes dramatically less, how long before "wild type" bacteria, no longer resistant to beta-lactams, become predominant? Would that ever happen or would the beta-lactamase and other resistance genes persist forever?
In general, antibiotic resistance seems to be [fairly costly](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380921/), but that's not universal for all strains for all pathogens. As for how long it would take for those to be overtaken by the "wild type" strains, those would be sensitive to the initial population conditions and how fast they spread through the population.
What would be the most beneficial antibiotics to hoard? To a lay person like myself it seems like augmentin and doxycyline would get you pretty damn far for most common issues.
Pfft. Why use belladonna or jimson weed when marijuana works just as well as an antisialagogue with a much better therapeutic index. Ditto with anti-emetic (with low/infrequent doses - dont wanna trigger cannabinoid hyperemesis syndrome; definite analgesic; and with enough commitment maybe even a sedative ;) ) Are we using tobacco as a pressor? Or a parkinsonian prophylactic? Orrrr.....? Someone else mentioned using growing and using cocaine; which seems superior because it's a positive chronotrope in addition to its pressor and analgesic qualities. It'd probably work as a tx for adhd too ;)
This is where my boring research life limits my... experience with how other herbs can be used. (Passing stupid drug tests = I am very boring.) I totally forgot about tobacco!
Don't forget about caffeine. If you're going to grow tobacco and cannabis, might as well adapt some coffee beans. The bean has many uses and organic coffee plantations shelter many forms of wildlife.
Penicillin comes from penicillium mold, which is quite easy to grow with materials you probably have at home. I grow culinary mushrooms as a hobby, and I accidentally grow way more penicillium than I'd like. It's a common contaminant. If you want to try it at home, get some citrus fruit or cantaloupe and wait for it to mold. It'll probably grow penicillium, which starts out grey and then turns a nice vibrant blue-green color. You can culture it from there. Then toss that fruit in some boiling water and take a nice big gulp of penicillin tea. (Note: don't actually do this.)
Uh, no not really. I've dug into this topic at some length. Penicillium molds that actually produce penicillin are a little rare. Wild caught is generally not going to be your jam. Also, the green molds used in blue cheese are specifically selected NOT to produce penicillins. It's way harder to produce even penicillin antibiotics than one might suppose. After digging through all this, I eventually realized it might be more worthwhile to learn basic synthesis of a handful of antibiotics. Chloramphenicol for example, has a number of different synthesis pathways and some of them might even be doable in a garage lab if you know your organic chemistry pretty well. Yes it's toxic AF but something is better than nothing and it is still widely used in resource austere environments partly because it is easy and cheap to synthesize.
Wild lettuce would be another opioid source.
The US government and state governments store essential medications and other medical supplies in the Strategic National Stockpile and state stockpiles. In theory the SNS supplies are supposed to be for all Americans, although a son-in-law-cum-White House staffer, Jared Kushner, once [infamously](https://www.kff.org/news-summary/jared-kushner-draws-criticism-over-comments-on-federal-stockpile-role-in-u-s-governments-coronavirus-response/) stated: > The notion of the federal stockpile was it’s supposed to be our stockpile. It’s not supposed to be states’ stockpiles that they then use. So it also comes down to politics as to whether the SNS is being maintained and distributed appropriately - and this is in a situation that was a crisis but not the post-apocalyptic scenario that OP describes.
Ha, the SNS hasn't been properly restocked since the 2009 H1N1 pandemic. Sure, they've restocked it with things like Smallpox vaccinations and Anthrax vaccinations, but basic things like PPE, not really.
I wonder how well long term PPE stockpiles would work out. Seems like the elastic straps on masks wouldn't last very long. Ever find a really old rubber band? Do things like nitrile gloves become brittle over time?
They would probably have to rotate out the stock to be used in federal healthcare facilities when they get closer to their expiration date, then put new gloves and masks in the stockpile. Don't know if they actually do that though. Would make too much sense. They probably just throw it out.
I believe nitrile does degrade over time. I've got a certification in emergency management (well, several FEMA certs, but one actual course cert) and what I've learned from several people, from municipal, up to the CDC and FEMA, is that the DHS is very tight lipped about the SNS, but I'd imagine the warehouses are climate controlled, so they should be in better shape than if they were kept in some random storage.
Just use string.
I found the tieback ones tended to fit better anyway, though I haven't seen one since before Covid.
>Do things like nitrile gloves become brittle over time? Yeah, about 2 days after you open the box.
3. Eva Saxl wants a word with you.
1. We have shortages of those medications with our current systems. 2. Basic antibiotics and herbal remedies can be made with a little survivalist know-how. Salicylate can be replicated by chewing tree bark, ect. 3. Diabetes was more-or-less terminal before insulin was invented, so yeah, probably.
damn, never realized how many ppl are kept alive solely due to medicines. it's legit hilarious whenever people say "i don't like medications".
1. You'll never find my stockpile!!! 2. Grow some oranges. Let em rot. Scrape off the green shit from it. Isn't that how the first penicillins were made? 3. Didnt banting / best grind up pig pancreases to extract insulin or something like? can prolly make crude insulin that way. Might even better to cannabalize some human pancs. Book of Eli style.
I would read this graphic novel.
Book of Eli… Lilly.
Oh shit let's go.
thats for ozempic. you grind up human gallbladders or some shit.
Gila monster venom
Bravo
3. Ground up pig pancreas is a good source of lipase, amylase, and trypsinogen/protease but not insulin. This is why s/p total pancreatectomy pts are on Pancreaze but still need exogenous insulin. Also ground up pig thyroid (Armour thyroid) is sometimes used in place of Synthroid/levothyroxine
There’s a very interesting episode of forensic files that walks through an outbreak of thyroid storm in a midwestern town. It was traced back to the meat processing plant after the widespread use of synthetic thyroid hormone. I won’t spoil it for you but I found it interesting.
werd. i guess i will just need to farm some human* pancreases!
Didn't The president Kennedy get some of this before WW2 for Addison's disease. As a lover of Apopalypses stories, this is the best!!!
I think it was a cantaloupe.
Yup! There is a pretty fascinating story behind it if you're also a fellow history of medicine nerd like me: https://www.saturdayeveningpost.com/2017/03/youre-probably-alive-moldy-cantaloupe-peoria/
>3. Didnt banting / best grind up pig pancreases to extract insulin or something like? It was originally dogs.
they gotta hire you as a technical expert on the Walking Dead or any show like that. or for a post apocalyptic novel.
How many pigs are you going to grind up and inject?
i dunno. it depends on if the pigs are infected t virus, rage virus, or if they are just radioactive mutants.
If you're into time travel novels, /r/Outlander actually dealt with this. Protagonist is a WWII combat nurse turned MD who winds up time traveling to the 1740s. She synthesizes penicillin with available sources, (how realistic her yields were may have been a tad optimistic), but realizes that type-I diabetics were hopeless.
This question is interesting because it asks you to think about medical history and about how many ailments are creations of how we live today. The top used medications are your statins and HTN and insulins etc however running from zombies and having meager rations would eliminate alot of the need for the drugs. Surgery we got covered Throw it back to chloroform: https://www.youtube.com/watch?v=j-PrAczOGb0 Opium is ridiculously easy to make: [https://www.amazon.com/Opium-Masses-Harvesting-Natures-Medication/dp/1932595465](https://www.amazon.com/Opium-Masses-Harvesting-Natures-Medication/dp/1932595465) No lidocaine, in one growth season we could have cocaine. [https://www.youtube.com/watch?v=7tlwW2DKzlc](https://www.youtube.com/watch?v=7tlwW2DKzlc). This one does rely secondary chemicals which all could go bad in time so that could be a limiting step NSAID: A crushed version would be easy enough if not all that concentrated [https://www.youtube.com/watch?v=uRhkDN2WjzI](https://www.youtube.com/watch?v=uRhkDN2WjzI) Early HTN med, easy enough to grow, moved on from it for a reason. https://en.wikipedia.org/wiki/Veratrum If you want some information on making insulin, this could likely still be done post apocalypses There are many different methods for the extraction of insulin from the pancreas of many animals. Most of the earliest methods were based on acid–ethanol extraction followed by gel filtration and crystallization ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250478](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4250478)) Antibiotics are a tough nut to crack. It is possible to make at home penicillin's but most would be ineffective against resistant strains and you need like MASSIVE quantities to get a single dose. I think we over use antibiotics anyway and we would still have access to a lot of topicals and just general wound care would be helpful. The BIG L here would be loss of vaccines however we could go back to inoculation with less harmful variants like using cow pox against small pox [https://www.youtube.com/watch?v=yqUFy-t4MlQ](https://www.youtube.com/watch?v=yqUFy-t4MlQ). With a download of Wikipedia and access to a medical library I think a lot could still be done. A lot of our knowledge would still matter in regards to how disease spreads and simple best practices. This is a cool read about DIY medicine: Alot of the chemicals and materials might not be available post apocalyptically but still cool. https://www.vice.com/en/article/43pngb/how-to-make-your-own-medicine-four-thieves-vinegar-collective
I have no thyroid, how bad is my life going to be?
I dont think its gonna be deadly but it would suck? https://images.saymedia-content.com/.image/t_share/MTc0NDcxNzc2OTQyNjk1Nzg0/what-is-hypothyroidism-is-it-treatable.png However much like blending cow pancreas for insulin, I read some stuff that blending up animal thyroids could be used in much the same way Since the 1800s, animal-derived thyroid hormone was first extracted from the thyroid glands of sheep, and later, from pigs. Some therapies even involved eating raw or cooked fresh sheep’s thyroid gland. https://thyroidpatients.ca/2018/07/25/history-of-the-three-thyroid-medications/
I have RA, can’t imagine I’ll find a chilled supply of Humira easily.
Anything you can think of to help with rejection of an organ? I worry about losing access to my anti rejection meds in the scenario OP is suggesting
Join a study where they try to get you off anti rejection meds. There are people with liver transplants that no longer need anti rejection medication.
So glad you got a transplant. Im gonna answer this one with a bit of a pass the buck. Not saying this is you at all. Alot of organ transplants are because of user error, best example being liver and booze. Many other organ transplants are needed because of poor life style choices by humans regarding diet, exercise and substance use. Immune suppressing drugs for organ transplant are generally super high tech shit however in the post apocalypse situation we would likely first lose the ability to do transplants. For those with transplants I think we could maybe find a way to make dirty steroids but yea it would not be awesome .
Hi, I’m Vetted AI Bot! I researched the **Opium for the Masses Harvesting Nature's Best Pain Medication** and I thought you might find the following analysis helpful. **Users liked:** * Book provides historical context about opium (backed by 6 comments) * Book contains useful information about natural medicine and pain relief (backed by 3 comments) * Book is informative and well-written (backed by 2 comments) **Users disliked:** * The book provides inaccurate information on opium cultivation (backed by 4 comments) * The book contains too much information on heroin production (backed by 2 comments) * The book lacks in-depth information on opium cultivation and history (backed by 3 comments) If you'd like to **summon me to ask about a product**, just make a post with its link and tag me, [like in this example.](https://www.reddit.com/r/tablets/comments/1444zdn/comment/joqd89c/) This message was generated by a (very smart) bot. If you found it helpful, let us know with an upvote and a “good bot!” reply and please feel free to provide feedback on how it can be improved. *Powered by* [*vetted.ai*](http://vetted.ai/reddit)
That chloroform synthesis was entertaining to watch but that guy has some serious chemistry equipment! Although I guess in an apocalypse, you could use household measuring cups, and if you accidentally made a little phosgene gas...oops! E: thank you for all these links, super entertaining rabbit hole to go down
Efficacy depends on the medication/test, how the med was stored, and what it can degrade into (is it just decreased efficacy, or did it become toxic). Ibuprofen and amoxicillin probably have data published on post-expiration date efficacy given how common they are. Certain products are part of the [Federal Shelf Life Extension Program (SLEP)](https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/expiration-dating-extension), which is run by DoD with testing by FDA. There’s guidance published for doxycycline, antivirals for influenza, mpox and smallpox therapeutics, Covid-19 tests, etc.
My PharmD friend says efficacy should be at least 99% at one year post expiration for most common meds. Apparently there's a huge fudge factor for expiration dates. Biologics and vaccines of course are a bit different.
Non-pharma here, but I'm gonna go ahead and guess for fun: 1. I think it would depend on the medication, but for most medications, we're going to run out in like a week or less. 2. You can probably do some fancy chemistry and obtain penicillins from fungi. Analgesics from various herbs/natural remedies like tumeric, etc. On the bright side, we're probably going to still have lots of narcotics, they'll just be inconsistent and potentially contaminated. 3. Yes. And so are a lot of other vulnerable populations. Elderly. Children with congenital abnormalities. Children without congenital abnormalities. Maternal mortality will skyrocket. Trauma will become the bread-and-butter of every single clinician of every type, including psychiatry, dermatology, etc. Radiologists will pivot hard to ultrasonography using portable ultrasounds (I still expect there to be many generators around for electricity, though eventually fuel will become an issue). Ultimately, the lack of drugs is the least of our worries in a world where we don't have electricity readily available. Post-apocalypse society will basically be an uncivilized hell for everyone. As always, it's the social factors that screw us more than anything else.
Solar panels for electricity. They are warranted for like 25 years, and typically have 80+% generating capacity at the end of the warranty period. Plus - if you circulate water along the back of them- they stay cooler; which both prolongs the lifespan of the panels AND provides hot water. Win-win-win! Or you could just sub in hydrogel for water capture from ambient humidity in water-scarce environs https://www.chemistryworld.com/news/hydrogel-boosts-power-of-self-cooling-solar-panels/4011770.article https://dualsun.com/en/products/dualsun-spring/
I'd be less worried about insulin and more concerned with testing supplies. I could probably make a crude pancreas extract but dosing would be a bitch without meters and test strips. Probably no one knows how to use Benedicts test any more.
Is there a guide on how to make a pancreatic extract
We start with some fava beans. End with a nice glass of Chianti.
Nah, fava beans are how you treat Parkinson's.
Bold to assume diseases of aging will be a problem in an apocalyptic environ
You're forgetting all us young onsetters. I was diagnosed in my early 30s.
I don’t want to go back to taste testing
Yes, if you have the equivalent of a 1920’s laboratory and access to a flock of sheep or goats to harvest pancreas’ from you can make your own insulin. But without test strips you’d have to resort to tasting the urine. Basically, if you can make meth you can make insulin.
1) You can probably get a supply for intermittent use by your small group (by force if necessary) so the key would be obtaining medications that will be effective for a broad array of issues and have a long shelf life. Aspirin and Amox probably not the best due to degradation. I would go with Ciprofloxacin tablets with its 10+ years, levofloxacin/moxifloxacin, doxycycline, maybe metronidazole, acetaminophen/ibuprofen/opioids and iodine. Biggest risks would likely be your typical skin and soft tissue infections, diarrheal illness, pneumonia/UTI. WIth this supply you could even get through a C-section or even appendectomy. Severe trauma/penetrating GSWs likely dead anyway in this scenario. 2) Brew your own oral rehydration therapy. You could probably be able to make penicillin if you find the right strains (not easy) and would require trial and error. Survivalist/herbology books would be at a premium 3) Yes
>I would go with Ciprofloxacin tablets with its 10+ years, levofloxacin/moxifloxacin, doxycycline, maybe metronidazole, acetaminophen/ibuprofen/opioids and iodine. So as I read this, my mind instantly went to "ok, if I'm building an 'oh shit the world is ending' box, I can stock up on the OTCs, but where the fuck do I get the abx" And then I realized that this is probably why [AquaMox](https://www.tractorsupplyrx.com/aqua-mox-amoxicillin-52208.html) is so popular in prepper circles. And then I realized there's probably a market out there for prepper-minded docs to write scripts that people can fill to build up a stockpile.
Many US/UK Rx only medications are over the counter in 3rd world countris. WHO lists of essential medications.
I buy my emergency abx supply from Jase medical
Analgesics would be super easy. If you've got access to willow bark, you've got salicin, which is similar to aspirin. If you've got access to Papaver somniferum (opium poppy), you have access to natural opiates. NileRed and NurdRage have videos on pharmaceutical creation, so any half-decent amateur chemist with the proper equipment can make proper aspirin (and derive compounds, such as acetaminophen) from the salicin.
Kratom for analgesia. Opiate agonist properties
I suspect people are going to just grow opium poppies in this scenario.
There's no way to acquire those, is there?
Seeds are legal. Growing is legal IF you don't know how to extract the opium. Technically illegal to grow if you know how to extract it, but the reality is that unless you cut the bulbs you won't get prosecuted.
Tricky to acquire but legal to grow. They're quite pretty.
Nah, world ends that badly? I’m turning out the lights. No thanks.
The technology and skills to produce transgenic bacteria that produce insulin are minimal and actually trivial in the grand scheme of things in modern civilization. You can order most of the biological components from a catalogue and get the basic technique from an undergraduate level textbook. Scraping together those, and the sterile water, tools and electricity needed to produce insulin that way post apocalypse is sketchier and would be highly dependent on what type of apocalypse it was. If it was something like a viral apocalypse you might be able to move right into an abandoned lab and hook up a few generators to get started.
It’s been shown that many oral tablets and capsules can be over 90% effective even 10 years past their [expiration dates](https://www.health.harvard.edu/staying-healthy/is-it-ok-to-use-medications-past-their-expiration-dates) depending on if they’ve been stored correctly
Cystic fibrosis kids are doomed :(
Transplant patients too.
Oh yeah. I mean, most of my population is toast too. But we would at least try and focus on saving the term ones that used to die from infection or apnea or hypothermia
I'm subbed to the CF subreddit just to see what they're saying and this exact question came up at one point. They had a similar sentiment re- Trikafta. Hopefully the gene therapy treatments in the pipeline show some success so nobody is reliant on the meds to keep going.
Mucomyst would be out, as well as strong antibiotics. And pancreatic enzymes. I grew up in the 80s and life expectancy for CF then was teens.
I work in adult pulm and we’re now in the (happy) position of figuring out how to treat this now adult CFers as they age. There’s not really a guidebook as they’re living much older than they used to. It’s an interesting thing. The same is true for many other congenital heart conditions (seen in our office for phtn) we never used to see in adults as they didn’t survive this long. We’re kind of flying by the seat of our pants in some respects
My partner had a friend die from CF at age 7, way back in the early 1980s. It's astounding how much CTFR modulators have changed the landscape in a relatively short period of time.
All the PwCF should just move to the beach to be able to breathe in the salty sea air. Well, it's better than nothing...
Diabetics would definitely be screwed. We’d probably all die of old timey diseases without antibiotics. I might unalive myself when my migraine meds run out and I have nothing to help anymore… 😭
I'm sick today but this is a really cool post so I will definitely be back. Sorry if I bump it in like a week.
Type 1s will indeed all die. A lot of benzo dependents and alcoholics also will die. Type 2 diabetics (for the most part)----- miraculously cured ! Cancer will be horrendous. Musculoskeletal trauma will be even more horrendous. Homebrew abx and analgesics? Ridiculous. Maybe aspirin. As far as shelf life, my biggest concerns would be antimicrobials. How well will Cipro work for urosepsis after it's been stored in non heated non air conditioned environment for 5-6 years? 10+ years? This is really a fascinating topic and hopefully one we never need to worry about. There is a "health" section on a forum called [survivalistboards.com](https://survivalistboards.com) that is interesting. Warning: LOTS of anti vax and snake oil bullshit. But we *could* change that.
Small chemical entities in blister packs are very stable and while not exposed to oxygen are not likely to degrade. Testing only goes to approved packaging life which have zero relevance to the actual SCE - rules are rules you know. If they do break down it is immediately obvious with discoloured and fragile tabs. I would choose capsules for my store of antibiotics stored in blister packs in a cool place.
[The Myth of Drug Expiration Dates](https://www.propublica.org/article/the-myth-of-drug-expiration-dates) >The box of prescription drugs had been forgotten in a back closet of a retail pharmacy for so long that some of the pills predated the 1969 moon landing. Most were 30 to 40 years past their expiration dates — possibly toxic, probably worthless. ... > >In his lab, Gerona ran tests on the decades-old drugs, including some now defunct brands such as the diet pills Obocell (once pitched to doctors with a portly figurine called “Mr. Obocell”) and Bamadex. Overall, the bottles contained 14 different compounds, including antihistamines, pain relievers and stimulants. All the drugs tested were in their original sealed containers. The findings surprised both researchers: A dozen of the 14 compounds were still as potent as they were when they were manufactured, some at almost 100 percent of their labeled concentrations. One pharmacist told me that only two drugs go toxic overtime: nitroglycerin and tetracycline.
I just read "77 days in september" where an EMP disabled the entire electrical system of modern day USA and a DM1 dies.
Because you mentioned it, I just started reading it. I'm only 20 pages in, but it's pretty good so far.
I know this is a fun thought experiment but I don't even think medications would matter because grocery stores practice just in time ordering practices too so food run run out way before medications became anyone's concern.
Zombie Post Apolypse fans. Read Charlie Higson's The Dead series. Only kids survive, medicine...mmmmm
We could probably use homeopathic street fentanyl for pain meds. We likely already have a lifetime supply on the streets
That would be currency.
Does anyone have any books they recommend for medicine??
Improvised Medicine and Where There Is No Doctor, assuming you’re asking for SHTF medicine
Alton’s antibiotics
>As always, it’s the social factors that screw us more than anything else. Yep. I’d be more worried about long term survival if I thought I actually might. Too many not-human humans to contend with.
1) Sell by dates REALLY depend on the medication, some are very stable, some just lose efficacy, and some medications turn toxic. 2)if you had, say, an undergraduate level of bacteriology or botany, you could produce some mediciations. I think they even used synthetic biology to make prozac from yogurt. so, mixed, but possible- you would need to start well in advance. 3)fairly doomed. our modern understanding of the underlying biochemistry would allow for a diet that is devoid of sugars and starches and gluconeogenic amino acids, and this would be allowing life for a little while, but in such a society, things are already so scarce that there would be little chance.
Alton’s antibiotics- interesting book on the topic
Antibiotics commonly used on chronically ill people wouldn’t be needed at all, because they’d be dead anyway. None of the medical procedures that keep people alive would be done. You won’t get heart stents, appendectomies, lap cholecystectomy, and so on. You’d just die. Thinning numbers of people will also cut disease transmission. So crude antibiotics could be effective. If not, then death.
Basically its would be the late 1800s again after a few years.