Guides / medicine
Medicine and Health
Keeping prescriptions going when pharmacies close, a first-aid kit and the skills to use it, heat and cold illness, refrigerated medicines like insulin in a power outage, and what the research really says about expired medicines.
Reviewed 2026-09-21 · 6 sections · 40 sources
Your region's section opens first once you choose your region. Every region is listed under each section below.
01 Keep your medicines going
After a disaster, interrupted medical care keeps killing people for months. After Hurricane Maria in 2017, George Washington University researchers estimated 2,975 excess deaths in Puerto Rico between September 2017 and February 2018.[1] A separate Harvard-led household survey, published in the New England Journal of Medicine, found that interruption of medical care was the primary cause of the high death rates that continued in the months after the storm. About one-third of the deaths in those months were caused by delayed or interrupted health care.[2]
About half of all Americans take a prescription medicine every day. An emergency can make it hard to refill a prescription or find an open pharmacy.[3]
- Build an emergency supply. Talk to your doctor or pharmacist about how to create one.[4] Ask whether a 90-day supply or mail order is possible for each regular medicine. General guidance: what is allowed depends on the medicine and your insurance plan.
- Refill on the first day you can, not the day you run out. If you can't get an emergency supply, ask your insurance company to help you keep enough on hand. Rotate your supply so it stays in date.[5]
- Keep a written medication list: the name and strength of each medicine, what it is for, how much you take and when, plus medical conditions, medical supply needs, and allergies. Keep a copy of your prescriptions with your emergency supplies.[6]
- Keep medicines dry. Store bottles in watertight containers, somewhere floodwater is unlikely to reach.[6]
- Before a storm or other expected disruption, get early refills and learn your state's emergency refill law.[6]
- If you depend on dialysis or another life-sustaining treatment, know where more than one facility can help you.[3]
This page is general information, not medical advice. Your doctor and pharmacist know your medicines. Ask them.
By region
Northeast / New England
- Nor'easters and ice storms can close roads and pharmacies for days. Refill when a big storm is forecast, not after it hits. General guidance.
- Ask your pharmacist what your state allows for emergency refills.[6]
Local detail: Southeastern Connecticut
- Connecticut emergency refills: if your pharmacist cannot reach your prescriber, they may use professional judgment to refill a prescription that is not for a controlled drug, once, for up to a 72-hour supply, when running out would interrupt treatment.[7]
- Larger refills: a Connecticut pharmacist may refill a non-controlled drug for more than the first quantity prescribed, up to a 90-day supply and no more than the total the prescriber authorized, if the prescriber has not said no and your plan covers it with no extra cost to you.[7]
- Insulin and diabetes supplies: if you have less than a seven-day supply and could suffer significant harm without more, a Connecticut pharmacist may dispense up to a 30-day supply, generally once in any 12 months.[7]
Mid-Atlantic
- Put medication in your go bag. After a hurricane you may not be able to get supplies for days or even weeks.[8]
- Keep your medication list on paper as well as on your phone, in case the phone dies. General guidance.
Southeast & Gulf Coast
- Evacuate with your medicines. Pack them, your medication list, and copies of your prescriptions in your go bag. After a hurricane you may not be able to get supplies for days or even weeks.[8][6]
- During Hurricane Florence, 31% of storm-related emergency room visits in North Carolina were for prescription refills, even though pharmacists there could give early refills.[4] Refill before the storm.
Midwest / Great Lakes
- Tornadoes and blizzards can keep you at home for days. Keep medical supplies and medication with your shelter supplies.[9]
- Refill before winter storms are forecast. General guidance.
Great Plains
- Keep medical supplies and medication with your tornado shelter supplies in case you have to shelter for a long time.[9]
- Rural pharmacies can be far away, and blizzards close roads. Keep a larger buffer than people in town. General guidance.
Mountain West
- Wildfire evacuations can come fast.[10] Keep a few days of medicine and your medication list in your go bag. General guidance.
- Mountain roads close in winter storms. Refill before snow is forecast. General guidance.
Desert Southwest
Local detail: Tucson, AZ
- Arizona emergency refills: when a state of emergency is declared after a natural disaster or terrorist attack, a pharmacist may dispense a one-time emergency refill of up to a 30-day supply of a medicine that is essential to life or to continuing treatment. If the emergency lasts at least 21 more days, one more 30-day refill is allowed.[11]
- This authority ends when the declared emergency ends.[11] Outside a declared emergency, ask your pharmacist what they can do. General guidance.
Pacific Northwest
California
Alaska
- In a remote community, the nearest pharmacy may be a flight away, and weather can stop flights for days. Order refills early and keep a larger buffer. General guidance.
- Ask your pharmacist or insurer about mail-order refills, and allow extra shipping time in winter. General guidance.
Hawaii
- Stay ahead of your refills. After a disaster, roads may be impassable and pharmacies may not be open.[16]
- Supplies reach the islands by ship and plane. Refill before hurricane season, not during a storm watch. General guidance.
02 A first-aid kit for your household
A first-aid kit belongs in every emergency kit.[17] You can buy one or put one together. The Red Cross recommends that a kit for a family of four include:[18]
- 2 absorbent compress dressings (5 x 9 inches)
- 25 adhesive bandages in assorted sizes
- 1 roll of adhesive cloth tape
- 5 antibiotic ointment packets and 5 antiseptic wipe packets
- 2 packets of aspirin (81 mg each)
- 1 emergency blanket
- 1 breathing barrier with a one-way valve
- 1 instant cold compress
- 2 pairs of nonlatex gloves
- 2 hydrocortisone ointment packets
- Gauze: a 3-inch roller bandage, a 4-inch roller bandage, five 3 x 3 inch pads, and five 4 x 4 inch pads
- An oral thermometer (not mercury, not glass)
- 2 triangular bandages
- Tweezers
- Emergency first aid instructions
Add what your household needs: your medicines, emergency phone numbers, and anything your health care provider suggests. Check the kit regularly and replace anything used or out of date.[18]
Also keep: nonprescription medicines such as pain relievers, anti-diarrhea medicine, antacids, and laxatives; and spare prescription glasses and contact lens solution.[17] If anyone uses hearing aids, oxygen, or medical devices, add extra hearing aids and batteries, a backup oxygen supply, and a list of each device's style and serial number.[3]
By region
Northeast / New England
- Know how to treat frostbite. Warning signs: numbness, white or grayish-yellow skin[19].
- Add hand warmers and a wool blanket to the kit you keep for winter outages. General guidance.
Local detail: Southeastern Connecticut
- Keep the kit with your warm-room supplies for winter outages. General guidance.
Mid-Atlantic
- Keep the kit and your medicines in watertight containers if you live where it floods.[6]
- Keep a small kit in the car as well as at home. General guidance.
Southeast & Gulf Coast
- Medicines that touch floodwater are unsafe. Throw them out, even in their original containers.[6]
- Keep the kit in a waterproof container in your go bag. General guidance.
Midwest / Great Lakes
Great Plains
- Keep a first-aid kit with your tornado shelter supplies.[9]
- Ambulances can take much longer to reach rural homes. Build a fuller kit than the basic list. General guidance.
Mountain West
Desert Southwest
- Heat damages medicines. Keep the kit in a cool, dry place in the house, not in a hot car or garage.[12]
- Add extra water and an instant cold compress for heat illness. General guidance.
Local detail: Tucson, AZ
- Tucson summers can cook a car or garage. Keep medicines and the first-aid kit in an interior room.[12]
Pacific Northwest
- After a big earthquake, help may be delayed. Learn how to treat common injuries so you can be the help until help arrives.[13]
- Keep a first-aid kit with your earthquake supplies. General guidance.
California
Alaska
- Help can be far away. Build a fuller kit and take first-aid training. General guidance.
- Know the signs of frostbite: numbness, white or grayish-yellow skin[19].
Hawaii
- Hawaii's emergency agency says to keep a fully stocked first-aid kit with tape, bandages, gauze, scissors, tweezers, and a thermometer, plus basic medicines such as antihistamines, pain relievers, and anti-diarrheal medicine.[16]
- Keep the kit in a waterproof container. General guidance.
03 Skills: bleeding control, CPR, and first aid
A kit only helps if someone knows how to use it. After a disaster, emergency medical services will be in high demand and help may be delayed. You are the help until help arrives.[13]
- Stop the Bleed. Bleeding is the number one cause of preventable death after injury. The American College of Surgeons' Stop the Bleed course teaches anyone three basic actions to control severe bleeding. Find a course at stopthebleed.org.[20]
- CPR. CPR, especially if it is done right away, can double or triple a person's chance of surviving cardiac arrest.[21] The American Heart Association and the American Red Cross both teach CPR, AED, and first aid, including online courses.[21][22]
- Good Samaritan laws exist in every state to protect people who give life-saving help in an emergency.[23]
- Train more than one person in each household, so help does not depend on one person being home. General guidance.
- CERT training includes disaster medical operations. See the Family and Community guide.[24]
By region
Northeast / New England
- Learn cold-injury first aid: hypothermia and frostbite. General guidance.
- Winter is a good time for an indoor CPR or first-aid class. General guidance.
Local detail: Southeastern Connecticut
- Connecticut has 23 Medical Reserve Corps units. Volunteers include medical and public health professionals and people with no health care background.[25]
Mid-Atlantic
- Take a CPR and first-aid class before hurricane season.[22]
- Storm cleanup with chainsaws and debris causes serious cuts. Learn to control bleeding. General guidance.
Southeast & Gulf Coast
Midwest / Great Lakes
Great Plains
- Ambulances may take a long time to reach rural homes. Train at least two people in each household. General guidance.
- Learn bleeding control, for tornado and farm injuries alike.[20]
Mountain West
Pacific Northwest
California
Alaska
- In remote communities, help may be hours or days away. A wilderness first-aid course teaches care for longer waits. General guidance.
- Learn cold-injury first aid and CPR.[21]
Hawaii
- Neighbor islands may have fewer hospital resources. Train more than one person per household. General guidance.
- Take CPR and first-aid training.[22]
04 Heat illness, hypothermia, and smoke
Heat exhaustion signs: heavy sweating; weakness or tiredness; cool, pale, clammy skin; a fast, weak pulse; muscle cramps; dizziness, nausea or vomiting; headache; fainting. Move the person somewhere cooler, loosen clothing, apply cool wet cloths, and offer sips of water. Get medical help right away if they vomit, or if symptoms get worse or last more than an hour.[26]
Heat stroke is a medical emergency. call 911. Do not give fluids.[26]
Hypothermia: below 95°F.[28]
Medicines and heat: some medicines interfere with the body's ability to cool itself. Read your medicines' side effects and ask your doctor how heat affects them. People with spinal cord injuries may not be able to cool down by sweating.[3]
Wildfire smoke can make anyone sick. People with asthma, COPD, diabetes, chronic kidney disease, or heart disease are at higher risk.[29] Check air quality on AirNow.[30]
More on staying warm and cool: Temperature guide.
By region
Northeast / New England
- Hypothermia can happen indoors in a cold house. Know the signs: below 95°F[28].
- Check on anyone who lives alone during a winter outage. General guidance.
Local detail: Southeastern Connecticut
- In a winter outage, a cold house can cause hypothermia, especially for people who live alone. Check on neighbors. General guidance.
Mid-Atlantic
Southeast & Gulf Coast
Midwest / Great Lakes
Great Plains
Mountain West
Desert Southwest
Pacific Northwest
California
Alaska
05 Insulin and refrigerated medicines in a power outage
Plan before the power goes out. Talk to your medical provider about a power outage plan for refrigerated medicines and for medical devices that need electricity. Find out how long each medicine can be stored at higher temperatures.[38]
- Have a cooler and ice or frozen gel packs ready for medicines that must stay cold, and follow each medicine's label.[6]
- If refrigerated medicine got warm, check its storage instructions or ask a pharmacist, your health care provider, or the maker whether it can still be used.[6]
- In a long outage: power out more than a day.[38][6]
Insulin: 59°F to 86°F for up to 28 days.[37]
- Insulin loses some strength when it gets very hot, and the longer it stays hot, the weaker it gets. In an emergency you may still need to use it.[37]
- If you use ice, wrap the insulin so it does not freeze.[37]
- When you can store insulin properly again, replace vials that were exposed to extreme heat or cold as soon as you can.[37]
- Never switch insulin types without a doctor unless there is no other choice. FDA publishes emergency switching guidance, and it requires close blood sugar monitoring.[37]
Power-dependent medical devices: talk to your doctor about keeping them running, and ask your power company to put you on its priority restoration list.[3]
By region
Northeast / New England
- In a winter outage, don't let insulin freeze in a cold house or car.[37]
- A cooler set in the coldest room is not a refrigerator. Check its temperature with a thermometer. General guidance.
Local detail: Southeastern Connecticut
- Insulin running short? A Connecticut pharmacist may dispense up to a 30-day emergency supply of insulin and diabetes supplies in some cases. See the refill section above.[7]
Mid-Atlantic
Southeast & Gulf Coast
- After a hurricane, the power can stay off for days in extreme heat. Keep insulin as cool as possible, out of direct sun.[37]
- Pack a cooler for medicines in your evacuation plan. General guidance.
Midwest / Great Lakes
Great Plains
- Long rural outages are common after blizzards and ice storms. Plan backup power for medical devices. General guidance.
- Keep insulin from freezing in winter outages.[37]
Mountain West
- Winter outages in cold homes can freeze insulin. Keep it in an insulated bag in the warmest room. General guidance.
- Talk to your provider about a power outage plan for medical devices.[38]
Desert Southwest
- Desert summer heat runs well above insulin's safe range, so a house without air conditioning is not safe storage. General guidance.
- Keep insulin as cool as possible, out of direct heat and sun, and wrapped so ice doesn't freeze it.[37] If the heat is extreme and the power is out, go somewhere that has power.[38]
- Never leave insulin or other medicines in a parked car. General guidance.
Pacific Northwest
California
Alaska
- In a cold outage, keep insulin from freezing. Do not use insulin that has frozen.[37]
- Plan backup power for powered medical devices. General guidance.
06 Expired medicines: what the research says, and what it doesn't
FDA's advice to the public is clear: if your medicine has expired, do not use it. Once the expiration date has passed, there is no guarantee that the medicine is safe and effective. Expired medicines can be weaker or can change chemically. Some can grow bacteria, and weak antibiotics can fail to treat infections.[12]
What the military research found. The federal Shelf Life Extension Program (SLEP), run by the Department of Defense with FDA testing, has extended the shelf life of certain federally stockpiled medicines after testing showed some stayed stable past their dates when properly stored. The program is limited to federal stockpiles.[39] An FDA review of SLEP data covered 122 drug products (3,005 lots). 88% of the lots were extended at least a year past their original date, for an average extension of 66 months. But stability varied widely from lot to lot, and the authors said the quality of an extended medicine can only be assured by testing each lot.[40]
Why that does not apply to your medicine cabinet:
- Stockpiles are stored under controlled conditions and tested lot by lot. Your medicines are not. General guidance.
- Heat, humidity, and damp bathroom cabinets can weaken medicines even before their dates.[12]
- Medicines that need refrigeration, such as insulin and some liquid antibiotics, can lose strength when they are not kept at the right temperature.[6]
- Medicines exposed to fire, floodwater, or unsafe water can be unsafe. If a life-saving medicine was exposed and there is no replacement, FDA says it may be used if it looks unchanged, then replaced as soon as possible.[6]
What to do instead: store medicines in a cool, dry place such as a dresser drawer or closet shelf, away from children.[12] Rotate your emergency supply so it stays in date.[5] Take old medicines to a drug take-back site.[12] If you are ever forced to choose, ask a pharmacist first. General guidance.
By region
Northeast / New England
- Don't store medicines in a bathroom cabinet. Damp air weakens them.[12]
- Don't let medicines freeze in an unheated room or car. General guidance.
Local detail: Southeastern Connecticut
- Shoreline flooding can reach basements. Keep medicines on an upper floor in a watertight container.[6]
Mid-Atlantic
Southeast & Gulf Coast
- Throw out medicines that touched floodwater, even in sealed original containers.[6]
- Heat and humidity shorten medicine life. Store medicines in a cool, dry room. General guidance.
Midwest / Great Lakes
Great Plains
- Barns, trucks, and sheds get too hot and too cold for medicines. Keep them in the house. General guidance.
- Rotate your emergency supply so it stays in date.[5]
Mountain West
Desert Southwest
Local detail: Tucson, AZ
- Tucson garages, sheds, and cars get far too hot for medicines. Store them in an interior room.[12]
Pacific Northwest
California
Alaska
- Keep medicines from freezing in cold storage or vehicles. General guidance.
- With resupply far away, rotate your stock: use the oldest first and replace it. General guidance.
Sources for this guide
Numbers in brackets in the text link here. Items marked General guidance are widely accepted practice rather than a figure from one source.
- GW Researchers: 2,975 Excess Deaths Linked to Hurricane Maria · GW Today (George Washington University) · checked 2026-09-21
- Study Puts Puerto Rico Death Toll From Hurricane Maria Near 5,000 · NPR · checked 2026-09-21
- People with Disabilities · Ready.gov (FEMA) · checked 2026-09-21
- Prescriptions (Prepare Your Health) · CDC · checked 2026-09-21
- Medications in an emergency kit? · FEMA · checked 2026-09-21
- Safe Drug Use After a Natural Disaster · U.S. FDA · checked 2026-09-21
- Connecticut General Statutes, Chapter 400j (Pharmacy), Sec. 20-616 and 20-616a · Connecticut General Assembly · checked 2026-09-21
- Hurricanes · Ready.gov (FEMA) · checked 2026-09-21
- Tornadoes · Ready.gov (FEMA) · checked 2026-09-21
- Wildfires · Ready.gov (FEMA) · checked 2026-09-21
- Arizona Revised Statutes 32-1910: Emergencies; continued provision of services · Arizona State Legislature · checked 2026-09-21
- Don't Be Tempted to Use Expired Medicines · U.S. FDA · checked 2026-09-21
- Be 2 Weeks Ready · Oregon Department of Emergency Management · checked 2026-09-21
- Public Safety Power Shutoffs (PSPS) · California Public Utilities Commission · checked 2026-09-21
- Earthquakes · Ready.gov (FEMA) · checked 2026-09-21
- 2-Weeks Ready in Hawaiʻi · Hawaiʻi Emergency Management Agency · checked 2026-09-21
- Build a Kit · Ready.gov (FEMA) · checked 2026-09-21
- Anatomy of a First Aid Kit · American Red Cross · checked 2026-09-21
- Winter Weather · Ready.gov (FEMA) · checked 2026-09-21
- Stop the Bleed · American College of Surgeons · checked 2026-09-21
- CPR and First Aid Training · American Heart Association · checked 2026-09-21
- CPR Classes · American Red Cross · checked 2026-09-21
- Care for Each Other (Prepare Your Health) · CDC · checked 2026-09-21
- Community Emergency Response Team (CERT) · FEMA · checked 2026-09-21
- Community Emergency Response Teams (Citizen Corps) · CT Division of Emergency Management and Homeland Security · checked 2026-09-21
- Heat Cramps, Exhaustion, Stroke · National Weather Service · checked 2026-09-21
- Community Emergency Response Team (CERT) · Pima County Office of Emergency Management · checked 2026-09-21
- Preventing Hypothermia · CDC · checked 2026-09-21
- How Wildfire Smoke Affects Your Body · CDC · checked 2026-09-21
- AirNow air quality · AirNow (EPA and partners) · checked 2026-09-21
- Heat Forecast Tools (heat index) · National Weather Service · checked 2026-09-21
- Understanding Wind Chill · National Weather Service · checked 2026-09-21
- Pima County heat-related deaths surpass last year's total · KOLD News 13 · checked 2026-09-21
- Cooling Centers (Heat Relief Network) · Pima County Health Department · checked 2026-09-21
- Hot Weather Precautions · Washington State Department of Health · checked 2026-09-21
- Volcanoes · Ready.gov (FEMA) · checked 2026-09-21
- Information Regarding Insulin Storage and Switching Between Products in an Emergency · U.S. FDA · checked 2026-09-21
- Power Outages · Ready.gov (FEMA) · checked 2026-09-21
- Expiration Dating Extension · U.S. FDA · checked 2026-09-21
- Stability profiles of drug products extended beyond labeled expiration dates (Lyon et al., Journal of Pharmaceutical Sciences, 2006) · PubMed (National Library of Medicine) · checked 2026-09-21