Your Medications Don’t Tolerate Heat the Way You Do: A Summer Storage Guide

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Your Medications Don’t Tolerate Heat the Way You Do: A Summer Storage Guide

By Cayla McGrath

Summer is hard on a lot of things.

Car batteries die. Chocolate melts in the grocery bag. Ice cream doesn’t survive the drive home. Most of us instinctively adjust for those inconveniences, but medications are different. They often sit quietly in a medicine cabinet, dresser drawer, carry-on bag, or parked car without much thought about what heat, humidity, and sunlight are doing behind the scenes.

The problem is that most medication-storage advice isn’t especially helpful. You’ve probably heard some version of, “Store medications in a cool, dry place,” or “Don’t keep them in the bathroom.” Those recommendations aren’t wrong, but they also don’t tell you what actually matters during a July heat wave, a beach vacation, or a cross-country road trip.

A car parked in direct sunlight on a 100°F day reaches an average interior temperature of 116°F within an hour. Dashboards can exceed 150°F. Even on a mild 72°F day, the inside of a parked car can climb to roughly 117°F within sixty minutes. The question isn’t whether summer affects medications. It’s understanding which exposures matter, which don’t, and how to make a few thoughtful adjustments so your medicine cabinet works just as hard as the hottest day of the year asks it to.

Heat Usually Doesn’t Make Medications Dangerous. It Makes Them Weaker.

Heat speeds up chemical reactions, including the slow breakdown of medications. Over time, prolonged exposure can reduce potency, meaning the medication simply does less of what it’s supposed to do.

For tablets and capsules, sustained heat can affect the active ingredient itself, soften capsule shells, and damage stabilizing ingredients designed to preserve effectiveness. For biologics and protein-based medications such as insulin, heat can cause proteins to unfold and lose activity in ways that aren’t easily reversed.

Fortunately, most summer storage questions can be answered by considering two simple factors:

How hot did it get?

And for how long?

Pharmacists often think about medication exposure as either an excursion or sustained exposure. Brief excursions happen. A bottle sits in a warm car while you run into the grocery store. A mail-order package spends an afternoon on the porch before you bring it inside. For many solid oral medications stored in their original packaging, those occasional exposures are unlikely to cause meaningful problems.

A glove compartment from June through August is a different story.

Most medications are designed to live at room temperature, typically between 68°F and 77°F, with brief excursions up to 86°F explicitly tolerated. Once temperatures remain above that range for prolonged periods, stability concerns begin to increase. Sustained temperatures above 104°F move into territory where degradation becomes a realistic concern.

Summer medications don’t need perfection. They simply need a better address.

The Best Place in Your House Is Probably Not Where You Think

The two most common places people store medications also happen to be two of the least ideal.

Bathrooms experience significant swings in both temperature and humidity. A hot shower can briefly push humidity close to 100%, creating conditions that encourage tablets to absorb moisture and capsule shells to soften. Kitchens present a different challenge. Cooking, dishwashers, and sinks introduce heat and humidity spikes that may seem insignificant to us but can add up for medications stored there month after month.

Garages and glove compartments are even more problematic during summer. In many parts of the country, they can remain above 100°F for days at a time.

Perhaps unsurprisingly, one of the least exciting locations tends to perform the best.

A bedroom dresser drawer.

It’s cool, dry, dark, and generally protected from the temperature swings common elsewhere in the house. It also happens to be an excellent home for a JaseCase. The medications inside are designed to remain stable at room temperature, making the same dresser drawer a practical location for both the medications your family already depends on and the contingency medications you hope you’ll never need.

Original Packaging Matters More Than Most People Realize

Prescription bottles aren’t orange because pharmacists have a favorite color.

Many medications, particularly certain antibiotics, are sensitive to ultraviolet light. Ciprofloxacin, metronidazole, and doxycycline all carry recommendations to protect the medication from excessive light exposure. Doxycycline adds another layer of concern because it can increase a person’s sensitivity to sunlight as well.

Keeping antibiotics in their original amber bottles or blister packs provides an extra layer of protection that weekly pill organizers simply don’t offer. For medications taken every morning, organizers can make sense. For antibiotics that may sit unused for months until needed, the manufacturer’s packaging usually remains the better option.

Mail-Order Medications and the Summer Porch Problem

Mail-order pharmacies have become routine for millions of Americans, which means medications now spend more time in delivery trucks and on front porches than ever before.

It’s reasonable to wonder whether medications sitting outside on a 95°F afternoon have been ruined.

For most tablets and capsules shipped in original packaging, a single hot transit is usually better thought of as an excursion than sustained exposure. Bringing packages inside promptly once they arrive is generally enough to address the concern.

Refrigerated medications deserve more attention because they rely on an intact cold chain. But for room-temperature stable medications, including products like JaseCase, the biggest takeaway is fairly simple: once the package arrives, bring it inside and let your dresser drawer take over from there.

Traveling With Refrigerated Medications Doesn’t Have to Be Stressful

This is where summer medication questions become more complicated.

Insulin, biologics, GLP-1 medications, and injectable therapies understandably make people nervous. They’re expensive, often labeled “keep refrigerated,” and many travelers assume they become unusable the moment they leave the fridge.

Fortunately, most manufacturers publish room-temperature stability windows that are more generous than many people realize.

Some commonly prescribed examples include:

  • NovoLog (insulin aspart): 28 days at room temperature
  • Levemir (insulin detemir): 42 days
  • Toujeo (insulin glargine U-300): 56 days
  • Humira (adalimumab): 14 days
  • Dupixent (dupilumab): 14 days
  • Enbrel (etanercept): 30 days when kept in its original carton

These windows generally assume temperatures remain at or below 86°F.

Interestingly, refrigeration itself isn’t always perfect. Research has found that nearly one-quarter of household refrigerators expose insulin to subfreezing temperatures at some point, usually because medications are stored against the back wall or near the freezer compartment. The middle shelf of the refrigerator often provides the most stable environment.

Travel introduces another challenge: keeping medications cool while you’re moving between airports, hotels, and destinations.

Several tools can help:

Frio cooling wallets remain one of the most affordable and widely recommended options. They use evaporative cooling and don’t require electricity, making them particularly attractive for international travel or outdoor activities.

Vivi Cap devices provide a more automated approach by monitoring and maintaining temperatures with minimal effort, which appeals to travelers looking for a “set it and forget it” solution.

MedAngel One isn’t a cooler at all. Instead, it’s a sensor that tracks temperatures and alerts users through a smartphone app if medications drift outside their preferred range. For people who simply want reassurance that their hotel refrigerator didn’t accidentally freeze their medication overnight, it can provide helpful peace of mind.

Another travel tip surprises many people: If you’re flying with insulin or other refrigerated medications, your gel ice pack does not have to be confiscated at airport security simply because it’s partially melted. TSA specifically allows medically necessary cooling packs, including slushy or thawed gel packs, provided they’re declared during screening. Medically necessary liquids are also exempt from the standard 3.4-ounce carry-on restriction.

Many travelers surrender cooling supplies because they don’t realize they can simply say, “These are medically necessary.”

Declaring them is often all that’s required.

Did You Ruin Your EpiPen by Leaving It in the Car?

Probably not.

A 2016 review examining epinephrine stability found that brief temperature excursions generally do not cause meaningful degradation and do not automatically warrant replacing an auto-injector.

An EpiPen that spends a few hours in a hot car during a summer soccer tournament and then returns to a dresser drawer is likely still functioning appropriately.

An EpiPen living in a glove compartment from Memorial Day through Labor Day is a different story.

Once again, the distinction comes back to duration. A brief excursion is rarely the same thing as a season-long exposure.

Appropriate Medical Preparation Includes the Drawer

Preparedness conversations often focus on generators, bottled water, batteries, and flashlights. Those things matter.

But preparedness also includes the less glamorous details.

Knowing your insulin is stored properly. Understanding that your gel ice pack can travel through TSA. Recognizing that your antibiotics are better protected in an amber bottle than a humid bathroom cabinet.

Appropriate medical preparation isn’t only about acquiring medications. It’s about making sure the medications you already depend on are ready to work when you need them.

For most families, that doesn’t require a complete overhaul of their medicine cabinet. More often, it means moving a few bottles into a dresser drawer, bringing deliveries inside a little sooner, and understanding which summer exposures matter—and which ones simply make for good internet myths.

We’re a family team of medical doctors, PAs, and pharmacists who use these medications in the field and at home. Our goal isn’t to make summer feel fragile. It’s to help families make informed decisions so that when the hottest day of the year arrives, their medicine cabinet is prepared for it.

Cayla McGrath is a content strategist with Jase Medical. This post is for informational purposes only and does not constitute medical advice. Always consult a licensed healthcare provider before using any prescription medication.

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You Don’t Have to Be a Prepper to Be Prepared

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You Don’t Have to Be a Prepper to Be Prepared

By Cayla McGrath

Medical preparation has a branding problem.

On one end of the conversation, you have disaster medicine — the world of field manuals, off-grid clinical decision trees, and preparation for scenarios where help is genuinely not coming. On the other end, you have FEMA and the Red Cross: the 72-hour kit, the written medication list, the floor every household is told to clear. Both ends of that spectrum have been well-served for years. Both address real situations.

Neither one is where most families actually live.

The real disruptions — the ones that land on ordinary households with frustrating regularity — don’t make the news. They don’t require a doomsday frame, and they don’t fit in a three-day kit. They look like this: a UTI that starts on the third night of a cruise. An 11pm fever in a country where nobody at the hotel front desk speaks English. A refill that didn’t come through before your flight. A weekend storm that knocks out the only pharmacy in town. A rural ER three hours away, and urgent care already closed when you checked.

These aren’t outliers. They’re the predictable, recurring, quiet failures that happen to prepared people who simply didn’t have the right thing on the shelf when they needed it. And for a long time, nobody had a name for the category of preparation that addresses them.

That category has a name now: appropriate medical preparation.

What it is

Appropriate medical preparation is a clinically grounded buffer — built to get you through to your primary care team, not around it.

At Jase, the team building this category is a family of medical doctors, physician assistants, and pharmacists. The pharmacist integration isn’t cosmetic: drug interactions, storage conditions, expiration, and access logistics are pharmacy questions. The clinical standards we hold ourselves to are the same ones that apply in any legitimate medical practice.

What we’re building is not a one-size-fits-all kit and not a subscription to whatever online pharmacy will approve a checkout without reviewing your health history. It’s a physician-prescribed, pharmacist-guided supply — matched to the disruptions families actually face, reviewed by the right credentials, and sized to the gap that exists between when a problem starts and when your regular provider is reachable.

That gap is real. A family with a solid primary care relationship is still vulnerable to the 11pm fever, the backordered medication, the Sunday infection. Appropriate medical preparation is what it looks like to be ready for those moments — not as a workaround for your doctor, but as a buffer that holds until your doctor is available.

What it isn’t

It isn’t a replacement for your primary care relationship. That relationship belongs in the exam room — complex diagnoses, chronic conditions, anything that requires an in-person exam and an ongoing clinical history. We are not competing with that, and we would never frame it that way.

It isn’t fear-based hoarding dressed in clinical language. The disruptions this category is built for are boring and statistical: they happen to people who live normal lives and travel normally and fill their prescriptions normally, until one week they can’t. Preparation for those moments is calm, not alarmist. It doesn’t require believing anything catastrophic is coming.

And it isn’t the fringe. There are legitimate, credentialed, evidence-grounded reasons to have physician-prescribed medications on your shelf. Travel medicine has practiced standby prescribing for decades. Disaster medicine has long recognized that the patient’s own medicine cabinet is the primary line of care — not the federal stockpile. We are extending that logic to the everyday disruptions that don’t make the national news.

The calm middle

You do not have to be paranoid to be prepared. You do not have to choose between an empty medicine cabinet and a doomsday bunker.

There is a sensible, clinical middle — built by doctors and pharmacists, reviewed to the highest standards, sized to the moments most families will actually face. JasePrep is the home of that middle. Your doctor and pharmacy, already on your shelf, there before life gets weird.

If you’ve been curious about what appropriate medical preparation actually looks like — and whether it’s the right fit for your family — you can start at jase.com/products/jase-case or explore specific scenarios at jase.com/collections/symptoms-and-scenarios.

Cayla McGrath is a content strategist with Jase Medical. This post is for informational purposes only and does not constitute medical advice. Always consult a licensed healthcare provider before using any prescription medication.

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When the Ebola Headline Hits: What I’m Actually Watching

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When the Ebola Headline Hits: What I’m Actually Watching

By Aaron Asay, PA-C, DMSc

You saw the headline. Maybe it came up in your news feed this morning, or someone in a group chat sent it with a string of question marks. WHO has declared a public health emergency. JFK is screening flights from affected countries. And the question running through your head, whether you say it out loud or not, is: Is this going to be like COVID?

I understand that feeling. I’ve spent 25 years responding to outbreaks, disasters, and health crises, and I’ve watched what the first wave of media coverage does to people — it creates anxiety without context, and anxiety without context is where bad decisions get made. So let me give you what most of those headlines are leaving out.

What’s actually happening in 2026

WHO declared a public health emergency of international concern in May. Major US airports including JFK have begun screening travelers arriving from affected regions in the DRC. The outbreak is real, it is serious, and international responders are working on it.

The strain driving the 2026 outbreak is Bundibugyo virus — a distinct Ebola species from Zaire ebolavirus, which is the strain most people picture when they hear “Ebola.” That distinction matters more than it might seem. The vaccine you may have heard about — Ervebo, licensed in the US in 2019 — works against Zaire ebolavirus. It does not work against Bundibugyo. There is no licensed vaccine for Bundibugyo, no approved monoclonal antibody product, and no specific antiviral. The international response looks different this time, and understanding why helps you hold the news accurately rather than just anxiously.

Bundibugyo has caused two previous outbreaks: Uganda in 2007 and DRC in 2012. Neither received significant US media coverage, and neither crossed into the United States. That track record is relevant context for what you’re deciding to pay attention to right now.

What CDC is and isn’t saying

CDC currently assesses the risk to Americans as low. But the part most headlines skip is the next sentence: travel from an affected country is not by itself an epidemiologic risk factor.

That phrase is doing a lot of work. If a coworker traveled to the DRC last month, that travel alone doesn’t place you at risk. If your kid’s friend has a parent who just returned from an affected region, that also doesn’t create exposure. The Ebola transmission pathway is specific: direct contact with the body fluids of a symptomatic person, or with surfaces and objects contaminated by them. The groups who carry real exposure risk are healthcare workers, burial team members, laboratory workers, and household caregivers of sick patients — not casual contacts, not fellow plane passengers, not the neighbor whose cousin lives near Kinshasa.

Knowing this doesn’t mean you dismiss the outbreak. It means you hold an accurate model of what’s happening rather than a generalized one. There is a difference between “there is an active Ebola outbreak with real mortality” and “I am at risk of Ebola.” Both can exist at the same time. The first one is true. The second one, for most people reading this, isn’t.

Why “calm down, you’ll be fine” isn’t the answer

When people feel anxious about something like this, the worst thing a trusted source can do is wave it off. It tells the worried person that their feeling is wrong. It signals that you’re not engaging seriously with something real. And it sends them somewhere else to find answers — usually somewhere without clinical grounding.

I’ve seen this in disaster response. The communities that come through crises best are not the ones who weren’t scared. They’re the ones who had accurate information early and used it to make decisions. Fear plus facts is manageable. Fear without facts isn’t.

If the Ebola coverage is unsettling you this week, that’s not irrational. There’s a real outbreak. The vaccine that worked before doesn’t apply here. International response is more complicated because of it. All of that is true. What that feeling is telling you, if you’re willing to listen carefully, isn’t “panic.” It’s “pay attention.” And there’s something constructive to do with that.

What preparation actually looks like

When I work with families on emergency readiness, I start with the same question: what does your household do when the system doesn’t work?

That question applies whether the disruption is an active outbreak, a hurricane, a supply chain failure, or a routine illness that hits on a Sunday when urgent care is closed. The households that navigate disruptions best aren’t the ones who panicked when headlines got scary. They’re the ones who had already built a baseline: medications on hand, documentation in order, a clinical resource they trust.

Ebola doesn’t directly threaten most American households right now. What does threaten households — every week, quietly, without a news cycle behind it — is the absence of preparation for disruptions that are coming regardless of what’s happening in the DRC.

That’s what I think about when I see a headline like this. Not fear. Inventory.

If you want to build that baseline with clinical oversight from a team that takes this seriously, Jase Response is where we do that work. Appropriate medical preparation — before you need it.

👉 Support Jase Response

Aaron Asay, PA-C, DMSc, is a physician assistant with 25+ years of frontline emergency response experience, former firefighter and paramedic, military disaster rescue officer, and founder of Jase Response.

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When the Ebola Headline Hits: What I’m Actually Watching

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When the Ebola Headline Hits: What I'm Actually Watching By Aaron Asay, PA-C, DMSc You saw the headline. Maybe it came up in your news feed this morning, or someone in a group chat sent it with a string of question marks. WHO has declared a public health emergency....

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The FDA’s BPC-157 Briefing Document Says Less Than It Sounds Like

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No, FDA Isn’t Banning BPC-157

The July 2026 briefing document says less than it sounds like it says

By Dr. Shawn Rowland, MD, Founder and CEO of Jase

Every week a patient brings up BPC-157. Sometimes it’s a gym client asking about tendon healing, sometimes it’s someone who found it through a peptide forum for gut issues. So when FDA posted a nearly 70-page briefing document ahead of the Pharmacy Compounding Advisory Committee meeting on July 23 and 24, 2026, I read the whole thing.¹ It’s worth unpacking, because the headline version that will circulate (“FDA moves to ban BPC-157”) is not actually what the document says.

It also helps to know BPC-157 was not singled out. FDA reviewed seven peptides at this meeting, and its scientists recommended against adding all seven to the compounding list.² This is a document about how thin the evidence base is across a whole category, not a verdict aimed at one molecule.

What’s actually being decided

Two compounders, Wells Pharmacy Network and LDT Health Solutions, nominated BPC-157 (and its acetate salt form) for the 503A Bulks List, the list of substances a compounding pharmacy can legally use to make individualized prescriptions. Both nominations were withdrawn. FDA decided to evaluate the peptide anyway, on its own initiative, but narrowed the efficacy review to one specific use: ulcerative colitis. That narrowing matters. The agency explicitly did not evaluate BPC-157 for tendonitis, Crohn’s, or Celiac disease, because the nominators never submitted enough information for those uses to be reviewed at all.¹ So the efficacy question in front of the committee is about ulcerative colitis, not about everything patients are actually using the peptide for.

This is also not happening in a vacuum. BPC-157 spent two years on FDA’s Category 2 list of substances that raise significant safety concerns, came off that list in April 2026 as part of a broader reconsideration of restricted peptides, and now lands in front of this committee.³ The July meeting is one technical step inside a much larger, very public back-and-forth over peptide access.

What FDA actually found

Strip away the regulatory language and the case is this. There is no USP monograph for BPC-157 in either form. The two nominators couldn’t even agree with their own paperwork on whether they were nominating the free base or the acetate salt, and their certificates of analysis didn’t match what they wrote in the nomination¹. For efficacy, FDA found exactly one trial in UC patients, a 53 person rectal enema study that exists only as a conference abstract, with no real detail on inclusion criteria or statistical methods, and no statistically significant benefit over placebo¹. For human safety, the FAERS database returned three case reports, all involving injectable BPC-157. One was confounded by a second peptide the patient was also injecting, one could not be interpreted because almost no information was reported, and one involved a product that also contained TB-500, where the reaction returned when the patient restarted it but could not be pinned to either peptide.¹ Nobody has run a human pharmacokinetic study for oral, subcutaneous, nasal, or transdermal delivery, despite those being the four routes patients are actually using¹.

On the animal side, the picture is more reassuring than the headline suggests. BPC-157 wasn’t mutagenic in Ames assays, didn’t cause birth defects in pregnant rats at any tested dose, and produced no clearly drug-attributable serious events in the small human record that exists.The toxicology read is closer to “we don’t have enough information to rule out risk” than “we found a dangerous compound.”

Where I land on this

I built a telemedicine practice around the idea that patients deserve more access to care, not less. So I want to be precise about where I agree with FDA and where I do not.

The part FDA gets right is the quality question. A substance sold under one name while carrying two different chemical identities, with no monograph and no agreed impurity-testing standard, is a real problem, especially for injectable and nasal products where endotoxin and aggregation risk are genuine. FDA’s recommendation rests mostly here: its scientists call BPC-157 “not well-characterized” and point to missing data on impurities, aggregates, and sterility, not to a finding that the peptide failed.¹ That is a legitimate concern, and I am not going to pretend otherwise.

Here is where I part ways. A quality problem calls for a higher quality bar, not for pushing the substance out of the one channel where quality can be controlled. BPC-157 has been studied since 1993⁴ and has millions of views across social media and peptide forums. That demand is not waiting on a committee vote.

If BPC-157 comes off the 503A list, that demand doesn’t disappear. It moves to the channels FDA isn’t even discussing in this document: direct-to-consumer peptide sellers shipping vials labeled “research use only,” med spas with no physician oversight, and telehealth operations cutting corners on the very COA and purity testing that legitimate compounders are required to provide. The exact impurity and aggregation risk the agency is worried about gets worse, not better, once you push the substance out of a regulated pharmacy and into a supply chain with zero accountability.

If the goal is patient safety, the better path is tightening the quality bar inside the regulated channel: require validated impurity testing, require a real CoA before listing approval, and build a post-market surveillance mechanism through the outsourcing facility reporting structure that already exists. Pulling the substance off the list without a parallel path for legitimate use doesn’t solve the underlying problem. It just moves it somewhere nobody is watching.

What patients and prescribers can actually do:

The committee meets July 23 and 24. If you want your experience on the record, be clear-eyed about the calendar. The window to register to speak at the meeting has closed, and the deadline for written comments to reach the committee before it votes has passed. What is still open: FDA is accepting written comments through July 22 under docket FDA-2025-N-6895 at regulations.gov, and those comments go to the agency as it finalizes its decision after the meeting.⁵ A committee recommendation is not a final rule. The decision is not closed yet, and prescribers with real case experience, along with patients treated through licensed pharmacies, are exactly the input this record is thin on.

Sources:

  1. FDA Briefing Document, Pharmacy Compounding Advisory Committee Meeting, July 23-24, 2026 (BPC-157 free base and acetate). Docket FDA-2025-N-6895. https://www.fda.gov/media/193343/download
  2. FDA, 2026 Meeting Materials, Pharmacy Compounding Advisory Committee. https://www.fda.gov/advisory-committees/pharmacy-compounding-advisory-committee/2026-meeting-materials-pharmacy-compounding-advisory-committee
  3. FDA interim policy on compounding using bulk drug substances; removal of BPC-157 from the Category 2 list, April 2026. https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks
  4. Sikiric P, et al. First description of BPC-157 (gastric pentadecapeptide), 1993; subsequent preclinical literature 1993-2024.
  5. Federal Register, Pharmacy Compounding Advisory Committee; Notice of Meeting; docket FDA-2025-N-6895 (comment and registration deadlines). https://www.federalregister.gov/documents/2026/04/16/2026-07361/

 

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For Clinicians | Protest First Aid: Tear Gas, Pepper Spray, and Crowd Injury Basics

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For Clinicians | Protest First Aid 


Tear Gas, Pepper Spray, and Crowd Injury Basics

By Dr. Jamie Wilkey, PharmD — Director of Clinical Strategy, Jase
Medically reviewed and edited by Aaron Asay, PA-C, DMSc, FIBODM, FAWM

Protests are a part of life around the world, and this summer they are a large part of life here: on single days this year, organizer estimates put several million Americans in the streets. That means our patients are in those crowds, near those crowds, or raising kids who are headed to one. Whether someone marches on purpose or catches a drift of tear gas at a bus stop, the medicine is identical. And I don’t know about you, but this is medicine I never actually learned in my professional program. Pepper spray, tear gas, rubber bullets, crush injuries, and heat all have first aid, and right now the best available guidance is written by street medics and tactical gear companies instead of by us. Today we’re covering the clinical version: what actually works, what is myth, which injuries need real evaluation, and the two-minute pep talk worth giving any patient who brings up that they will be near a protest anytime soon.

What actually treats tear gas and pepper spray exposure?

Before we talk treatment, scene safety comes first. If crowd movement, violence, or ongoing deployment of crowd-control agents makes the area unsafe, leaving the scene is the first intervention. Trauma priorities come next: serious bleeding or trouble breathing outranks any chemical exposure. And anyone providing aid should use appropriate PPE for the anticipated environment: nitrile gloves for providing aid, eye protection when feasible, sturdy closed-toe footwear, and hearing protection in situations where crowd-control munitions or explosive noise are possible.

Once the patient is somewhere safe, the short answer is: fresh air and water, in that order. The first move is out of the cloud, upwind, somewhere air is moving, and no rubbing: the agent is on their hands, and eyes are where it wants to go. Contact lenses come out and go in the trash. They trap the agent against the cornea, and rinsing over the top of them accomplishes very little. Then irrigation, 15 to 20 minutes with water or normal saline, per the American Academy of Ophthalmology’s clinical statement on ocular exposure to pepper spray and tear gas from February of this year.¹ Exposed skin gets soap and water; skip the lotions and creams afterward, since they trap residue against the skin. Refer anyone with persistent symptoms, reduced visual acuity, or anything that suggests corneal damage.The eyes get the headlines, but these agents are respiratory irritants too. Most exposures cause cough, chest tightness, and burning in the nose and throat that settle within about half an hour of reaching fresh air.⁶ The exception is reactive airway disease: patients with asthma, COPD, or chronic bronchitis can tip into a true exacerbation. Most clinicians will never see a severe riot control agent exposure, so the escalation criteria are worth committing to memory: persistent hypoxia, worsening bronchospasm despite rescue medication, inability to speak normally, stridor, or altered mental status. Those distinguish a routine irritant exposure from a patient who needs a higher level of care.

Now the myths, because your patients have seen the photos of people getting milk poured across their faces, and a lot of them believe that’s the treatment.

  • Milk: comparative trials show no advantage over water for pepper spray pain, and milk is not sterile.² It has no business in anyone’s eye.
  • Baby shampoo mixes: a randomized trial found no benefit over water alone, and the AAO explicitly declines to endorse it.³
  • Antacid solutions (the half-Maalox, half-water spray bottles from the street medic playbook): same story, no demonstrated advantage over plain water.²
  • Vinegar: this one comes with a story from this article’s reviewer. Aaron was tear gassed countless times as a bystander at protests while living in Venezuela several years ago, and resorted to carrying a small bottle of vinegar everywhere because it took the sting out of breathing (he and his companions doused their ties in it). No change to morbidity or mortality, but it sure felt like it made the symptoms tolerable. That’s the right frame for most folk remedies: comfort, maybe, but not treatment, and no substitute for fresh air and irrigation.

And remember, tear gas is not a gas. CS and OC agents are aerosolized particulates that settle into hair, skin, and clothing and keep re-exposing the patient, and everyone who hugs them at home, until the clothes come off and the shower happens.⁴ Rinsing the eyes at the scene treats the eyes. It does not decontaminate the person. The home half of the advice is simple: clothes off at the door and washed separately, shower with soap, hair included.

And one decontamination note for our side of the counter: a contaminated patient who walks into a pharmacy, clinic, or emergency department brings the agent along, and staff can develop symptoms from clothing residue alone. If someone arrives straight from an exposure, decontamination comes before the waiting room, not after.

The two-minute pep talk for a patient headed to a protest

Here’s what’s strange about this topic: the information exists, it just wasn’t written for us. On one side are the street medics: volunteers who train each other, sometimes through twenty-hour courses, and who genuinely know their decontamination and scene safety.⁵ Their material is solid, but it’s written by activists, for activists. On the other side are tactical gear companies selling trauma kits with a side of fear. When your patient searches “protest first aid kit” tonight, those are the two voices they will find. What’s missing is the neutral clinical layer, the version a family clinician or a pharmacist would actually give. So here is one.

We already have the muscle for this. It’s anticipatory guidance, the same thing we do for international travel: we don’t weigh in on whether the trip is a good idea, we make sure the patient comes home healthy. A patient who mentions an upcoming protest is handing you the same opening. The whole talk fits in two minutes:

  • Bring your critical medications, especially the rescue inhaler. Crowd-control agents are respiratory irritants, and reactive airway disease is the one condition that can turn a self-limiting exposure into something dangerous.⁶ Add glucose for anyone on insulin or a sulfonylurea, and a dose of anything critical in case getting home takes hours longer than planned.
  • Carry a medication list on paper. Phones die on long days, and a card in a pocket answers the questions a stranger or a medic will need answered.
  • Wear glasses, not contact lenses. Lenses trap chemical agents against the cornea, and nobody wants to be doing lens removal with contaminated fingers on a sidewalk.
  • Carry more water than seems reasonable. It covers heat and dehydration, and it doubles as eye irrigation, which as we just covered is the actual treatment.

And we’ve got to talk about the blazing heat, because at any large summer gathering it causes more medical trouble than anything else on this list. A demonstration is a long outdoor event with dense crowds, limited shade, adrenaline, and no easy way to leave, which is a reasonable recipe for heat exhaustion. The advice here is pretty simple: water before thirst, shade breaks, and treat dizziness, nausea, or confusion as a reason to get out of the crowd now rather than after the speeches. One clinical layer worth adding: patients on diuretics, stimulants, anticholinergics, or antipsychotics run hotter than they realize, and they are exactly the ones who won’t connect their med list to the weather forecast.

The pharmacology refresher here for the ‘why’ these meds promote hyperthermia is this: diuretics start the day volume-depleted, anticholinergics switch off sweating, which is the body’s main radiator, stimulants generate extra metabolic heat, and antipsychotics blunt the hypothalamic thermostat that would normally sound the alarm. Less sweat, more heat, and a later warning.

One final consideration is risk stratification, because the crowds this summer are not all twenty-five-year-olds. Patients with significant cardiopulmonary disease, pregnancy, advanced age, or limited mobility may require more individualized counseling based on their ability to tolerate respiratory irritants, heat, prolonged standing, or rapidly changing crowd conditions. For some, the discussion may shift from what to bring to whether attending is medically advisable at all.

How dangerous are rubber bullets, really?

More dangerous than the name wants you to think. “Less lethal” is a comparison to live ammunition, not a safety rating. The best evidence we have is a 2017 systematic review in BMJ Open covering kinetic impact projectiles (rubber bullets, beanbag rounds, and their cousins) in crowd-control settings from 1990 to 2017: at least 53 deaths, some 300 people left with permanent disability, and 71% of the 2,135 documented survivor injuries were severe.⁷ Head and neck strikes did the worst of it, accounting for roughly half the deaths and more than 80% of the permanent disabilities.

Our smarty pants exam-room translation: location is the triage. A projectile impact to the head, neck, chest, or abdomen deserves prompt medical evaluation, with imaging guided by the clinical examination and mechanism of injury. Anything near the eye goes to ophthalmology the same day. The bruise on the thigh can usually be a bruise on the thigh. 

Crowd compression deserves its own section, because it is often overlooked. People die all the time in mob crushes, and it’s likely a significant injury if a patient comes out of a stampede alive. Patients who have been pinned or compressed may develop occult thoracic injuries, delayed respiratory compromise, compartment syndrome, rhabdomyolysis, or crush syndrome after prolonged entrapment. None of those announce themselves at the scene: chest pain, worsening shortness of breath, escalating limb pain or swelling, or dark urine in the hours or days afterward means evaluation, not watchful waiting. And the advice Aaron gives his own patients is worth two sentences of anyone’s pep talk: consider a crowd like a river. Go with the flow, and angle to a side to find an avenue of escape, like a doorway, alley, or street, then get as far from the mob as possible.

Bleeding is the one place where the layperson layer already exists, and it’s good. Stop the Bleed came out of the American College of Surgeons’ Hartford Consensus work and teaches direct pressure, wound packing, and tourniquet use in a course that takes about an hour.⁸ It treats bystanders as immediate responders instead of spectators, which is exactly the right frame. If a patient wants one concrete thing to do beyond the pep talk, point them there. It’s the only part of this whole topic that already comes in an ordinary-citizen version.

Quick reference

  • Scene safety first: if the area is unsafe, leaving is the first intervention. Trauma priorities before decontamination.
  • Chemical exposure (tear gas, pepper spray): fresh air first, no eye rubbing, contact lenses out and discarded, irrigate eyes 15 to 20 minutes with water or saline, soap and water for skin. Refer for persistent symptoms, reduced acuity, or suspected corneal damage. Emergency evaluation for persistent hypoxia, worsening bronchospasm despite rescue medication, inability to speak normally, stridor, or altered mental status.
  • Projectile impact: head, neck, chest, abdomen, or eye means prompt medical evaluation, with imaging guided by the clinical examination and mechanism of injury. Eye strikes go to ophthalmology.
  • Crowd compression: pinned or caught in a surge means evaluation, not watchful waiting. Watch for delayed chest pain, breathing trouble, limb pain or swelling, or dark urine in the hours to days afterward.
  • Heat: dizziness, nausea, or confusion means out of the crowd, cooling, and fluids.
  • Bleeding: direct pressure, wound packing, tourniquet if trained. Stop the Bleed courses teach all three in about an hour.
  • At home afterward: clothes off at the door and washed separately, shower with soap, hair included. Contaminated patients decontaminate before the waiting room, not after.

The missing middle layer

Notice where everything in this article came from. The eye protocol is from a statement written for ophthalmologists. The projectile numbers are from a review written for policy researchers. The decontamination habits are from street medics. All of it useful, none of it written for the exam room, the pharmacy counter, or the patient standing at either one. That’s the pattern we keep running into at Jase: when the question is how to get ready for predictable medical trouble, care today is all or none. Either your patient reaches a professional in time, or they’re on their own with whatever the search results serve up, milk bottles and all.

Appropriate medical preparation is the name we’ve given that missing middle layer: the bounded, clinician-built work of getting ready before the bad day instead of during it. Most of our work is on the medication side, and if the pep talk surfaces that a patient has no plan for their critical medications, that part you can hand to us at Jase.com. The rest we publish in the open, every week, articles like this one included, so the neutral clinical version of these answers exists and none of us has to improvise it. None of it replaces anyone’s doctor, and it isn’t meant to. A water bottle, a paper med list, and a two-minute conversation are complements to care, not substitutes for it.

The bottom line

Protests are not going away, and neither is the medicine around them. Water and time for the chemical agents. Location as triage for the impacts. Clothes off and a shower at home. A rescue inhaler in the pocket where it belongs, and a pep talk that takes two minutes to give. None of this requires new training or a single piece of gear, just someone in the room who thought about it ahead of time. As of today, that’s you.

Sources

  1. American Academy of Ophthalmology. Ocular Exposure to Pepper Spray and Tear Gas: Evaluation and Management. Clinical statement, February 2026. https://www.aao.org/education/clinical-statement/ocular-exposure-to-pepper-spray-tear-gas-evaluatio
  2. A randomized controlled trial comparing treatment regimens for acute pain for topical oleoresin capsaicin (pepper spray) exposure in adult volunteers. Prehospital Emergency Care. 2008;12(4). Compared Maalox, 2% lidocaine gel, baby shampoo, milk, and water; no significant difference between regimens. https://pubmed.ncbi.nlm.nih.gov/18924005/
  3. Baby Shampoo to Relieve the Discomfort of Tear Gas and Pepper Spray Exposure: A Randomized Controlled Trial. Western Journal of Emergency Medicine. 2018;19(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5851502/
  4. Centers for Disease Control and Prevention. Facts About Riot Control Agents. https://www.cdc.gov/chemical-emergencies/chemical-fact-sheets/riot-control-agents.html. See also: Tear Gas and Pepper Spray Toxicity. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK544263/
  5. Atlanta Resistance Medics. How to Organize a 20-Hour Street Medic Training. https://www.atlantaresistancemedics.org/street-medic-training/
  6. Tear Gas and Pepper Spray Toxicity. StatPearls. Respiratory symptoms are mostly self-limited; patients with asthma, emphysema, or bronchitis may present with acute exacerbation. https://www.ncbi.nlm.nih.gov/books/NBK544263/
  7. Haar RJ, et al. Death, injury and disability from kinetic impact projectiles in crowd-control settings: a systematic review. BMJ Open. 2017;7(12):e018154. https://pubmed.ncbi.nlm.nih.gov/29255079/
  8. American College of Surgeons. STOP THE BLEED. https://www.stopthebleed.org/
  9. No Kings protests. Britannica. Organizer-estimated 8 to 9 million participants across roughly 3,300 events, March 28, 2026. https://www.britannica.com/event/No-Kings-protests

 

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