Ishita Kent takes two prescriptions to manage her bipolar disorder, both that ever since the pandemic, she chooses to get by mail. Every month, her antidepressant and mood stabilizer show up at her door like clockwork. But in late July, as Kent took her last pills, the next refill…wasn’t there. It had never been late before and she’d ordered it nearly two weeks prior, plenty of time to arrive before her final dose.
“I was frantically checking the mail, completely freaked out because I didn’t know when I’d get my medication again,” she says. “I was terrified that without it, I’d go into a manic episode—I’m a danger to myself when that happens.”
She phoned her doctor but couldn’t reach him at his office. She was forced to wait. But two days later, she was still waiting. Now off her meds, she began to get a “buzzy” feeling in her limbs, an uncomfortable symptom that Kent recognized: withdrawal. Her mood kept changing. “I was talking louder and faster without being able to control it,” she says. When her husband pointed out the shift in her behavior, she snapped at him, causing a fight. “Normally there are things that irritate me but I’m able to moderate my response,” she says. “But I’m so much more reckless without medication.”
Then two more days passed. She began experiencing “brain zaps” and insomnia. “I was just lying on the couch at 4 a.m. with my brain buzzing, cursing because everything in my body hurt,” she says. By day five, her pills were still MIA and she wasn’t sleeping at all.
Although it may sound like the typical lost package, it’s not. Ever since Republican businessman and Trump appointee Louis DeJoy took over as postmaster general in June, USPS deliveries have been lagging across the country. The delays are a direct result of DeJoy eliminating overtime pay for postal workers, which meant many USPS employees had to reduce their hours. That created a growing backlog of mail. Under pressure, this Saturday, the U.S. House of Representatives will reconvene from a summer recess to vote on a proposed $25 billion stimulus package meant to fund the USPS and restore regular service.
But it’s not clear whether the bill will garner enough support to pass in the Republican-led Senate. And given that 4 million shipments of prescription medications pass through the postal service every day, according to the National Association of Letter Carriers, that means many people are being forced to wait for the drugs they desperately need.
Especially, perhaps, millennials who have been fast adopters of medication by mail. During COVID-19, even more so. Nurx, a service that allows you to order birth control online and have it delivered to your door, had more than 250,000 new patient requests during the pandemic, according to Allison Hoffman, the company’s director of brand and communications.
Reilly Golden receives her 90-day birth-control prescription by mail. That way, she doesn’t forget to pick it up at the pharmacy and risk missing a dose. Except in August, the delivery was late. By the time it finally arrived, Golden had been forced off the pill for nearly a week. While a delay in birth control might seem like a minor inconvenience, it’s actually a significant cause of unintended pregnancy in the U.S., says Julie Graves, MD, a public health doctor and associate director of clinical services at Nurx. (Uh, yeah.) Not to mention the women who use it to manage health issues, like the debilitating symptoms caused by endometriosis.
But it’s not just birth control. Sarah Jeney, MD, a doctor based in Irvine, California, says the majority of her patients opt to get their prescriptions by mail—STI drugs, anti-anxiety and other mental health pills, diabetes meds—and a delay in taking them can cause serious issues. If you aren’t taking your prescription when you’re meant to or are hoarding what you’ve got left and not taking the right dosage, the medication just isn’t as effective, and in some cases, it isn’t effective at all, says Dr. Jeney. Other meds, like insulin, are temperature sensitive and lose efficacy when left languishing in transit; other drugs can become completely ineffective without proper refrigeration, making them worthless whenever they do arrive.
And although, in many cases, doctors can write a prescription for an emergency supply of meds, it’s not always easy. Insurance companies often won’t cover a duplicate prescription, meaning if your meds were “filled” but you didn’t receive them, you’ll likely have to pay out of pocket to get more. That’s what happened to Kent. After finally connecting with her doctor, he wrote her a new prescription she could pick up in person at her local pharmacy, but it cost her an extra $200.
Ultimately, the package of pills Kent was waiting for arrived: nearly two weeks later and one day before her emergency prescription ran out. Had it not, she would have needed to reconnect with her doctor for another emergency prescription and likely paid out of pocket again, an option not everyone can afford. She knows that next month could bring the same saga all over again, and that makes her nervous. But depending on what happens with Congress on Saturday, she—along with millions of others—may have no choice.
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