Hurricane Harvey and Other Emergency Situations

 

Hurricane Harvey

 

 

 

 

 

We all felt heartbroken as we watched the plight of citizens of Houston and other locations deal with the latest weather emergency. I worry most about debilitated senior citizens, children, and animals, all of whom won’t understand what’s happening. I’ve prayed for all people affected by the storm, but that didn’t feel like enough, so I donated to an emergency relief fund.

I said special prayers for patients on medicated assisted treatment. By that I mean any patient who can’t get much needed medications during the flood for serious illnesses. That includes patients with diabetes, heart disease, depression, asthma, opioid use disorder, and many other illnesses.

After Katrina, my state pushed for all opioid treatment programs (OTPs) to formulate emergency planning for their patients for these situations. In New Orleans, patients on methadone (there weren’t many patients on buprenorphine in 2005) had no way to get their medication, and no way to contact their home clinic for confirmation of their dose if they were re-located to a new area with a new OTP. It was only one aspect of the giant disaster that was Katrina.

I thought about what our OTP would do if struck by weather so bad that the facility shut down.

We have a disaster plan, and we just updated it a few weeks ago, coincidently. It’s easier now, since we have a sister OTP located about an hour away. Since both are owned by the same company, sharing data should be simple. We use a server that stores data off-site and can be accessed off-site. Obviously, electronic data retrieval has grown much more sophisticated since Katrina in 2005.

Since my OTP has about nine times the number of patients as our newer sister program, we would need to transport medication to meet the needs of the extra patients routed there for their dose. I feel like that could be easily accomplished, though we’d have to get the approval of the DEA and follow protocols already arranged for these situations.

There are several other OTPs, all about forty-five to ninety minutes’ drive away, surrounding my work site. Patients living closer to those programs could be easily dosed at those facilities as well, if needed. I have a good relationship with the medical directors of those programs, and I feel sure they would go out of their way to help in an emergency. I know I would do the same if they suffered an emergency.

Office-based buprenorphine patients are a little easier. There’s a number of ways to accommodate these patients, since prescriptions could be called in to pharmacies in a pinch. I have records of my office-based patients’ phone numbers both on paper an stored electronically, so if my office can’t open I can still communicate with them for alternative arrangements, assuming phone systems are operable.

Several weeks ago, my fiancé (who also provides counseling for my office-based patients) and I drove to my office practice but forgot the keys to the front door. No problem, we thought, our health services manager, Daniel, will have his keys. Nope. He forgot too. OK, we thought, we can get the landlord, who has an office at the front of our building, will have a master key. Nope. She was out of the country.

It was a pleasant day, not too hot and still shady on the bench in front of my office door where I was sitting. While the other two went in search of another person who may have a master key, my first patient arrived. I explained the situation and asked him if he minded if we conducted the session outside. He thought that was a splendid idea, so we had a very nice fifteen-minute chat. He was doing well, as he has been for about ten years. I couldn’t do a drug screen, but I didn’t make that into an obstacle. At the end of our visit, he gave me his pharmacy’s phone number and I called in his prescription. By the time my second patient arrived, the others had found a key and we proceeded as usual.

In other words, creative solutions to problems can be easy. However, we do need to plan for how to handle situations such as floods, power outages, and other emergencies.

I spent some time on the internet trying to find something about how OTPs in Houston were handling the storm, and how their patients were faring, but so far, I can’t find anything. I hope someone in that area can tell the rest of the nation what happened, so we can better learn how to handle medical issues during emergencies. 

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