US hospitals struggle with opioid shortage during epidemic

Hospitals are running out of pain medication for patients as the opioid crisis continues to claim more than 100 lives each day.

Manufacturing issues have led to a shortage of injectable opioids in hospitals and medical facilities around the country that need them for patients with severe pain.

These injectables are different from the prescription pills that are fueling the opioid epidemic but both categories are highly controlled, highly addictive substances.

The shortage is just one facet of the medical system’s struggle to strike a balance with opiates as there are too many in the wrong hands and not enough in the right ones. 

Medical facilities are running low on injectable opioids for patient pain management because of manufacturing problems as America’s opioid crisis claims the lives of 115 people each day

Opioids have been making headlines on a nearly daily basis in the past several years as overdoses have become the leading cause of death for adults under 50 in the US, claiming the lives of more than 115 Americans each day and more than 64,000 annually.

Beginning last summer, medical treatment facilities started to see issues with orders for injectable opioids, which are used for patients recovering from surgery, undergoing cancer treatment or those who have sustained significant trauma.

Unlike the prescription pills at the center of the opioid crisis, these injectable pain products are exclusively administered by medical professionals while a patient is directly monitored. 

In response to the shortage, hospitals have had to pay extra close attention to what injectables they do have to make sure they’re providing the best possible care given the limited resources.

At the Cleveland Clinic in Ohio, doctors have been increasingly using alternative treatments such as oral opioid medications pills or in less severe cases, IV Tylenol.

The shortage of injectables has put a strain on hospital staff who have had to work longer hours and go through additional training for alternative methods.

Several hospice centers across the US have reportedly run out of the opioids they rely on to perform their primary function of keeping dying patients comfortable, according to the National Hospice and Palliative Care Organization.

‘Any shortage of these medicines has the potential to impact the ability to provide adequate pain management to patients admitted with painful conditions or patients undergoing surgeries,’ Dr Charles Morris, associate chief medical officer at Brigham and Women’s, told STAT.

Last month pharmaceutical company Pfizer began notifying customers that it had paused production of some pain medicines and orders would likely not be back to normal until the first quarter of 2019 – nine months from now.

Pfizer, which controls more than half of the US market for opioid injectables, blamed the production interruption on problems with a third-party supplier for pre-filled syringes.

‘We recognize the importance of these medicines to patients and physicians and are committed to resolving these shortages as quickly as possible,’ a company spokesperson said.

‘To that end, we are exploring the feasibility of increasing capacity within the global Pfizer manufacturing network and potential third party suppliers.’ 

Although the shortage wasn’t directly caused by the opioid epidemic, the Drug Enforcement Administration has been limited in what it can do to address the shortage because of the strict regulations surrounding opiates.

Before smaller manufacturers can increase production of injectables to alleviate the shortage, the DEA has to raise quotas – which it has been slow to do.

Earlier this week a bill was introduced in the Senate that would make it easier for the DEA to respond to both under-production and over-production of opioids.

Scott Knoer, chief of pharmacy at the Cleveland Clinic, said he sees shortages all the time.

‘There is a real cost to drug shortages,’ Knoer told STAT. ‘This month it’s opiates. It’s going to be something else next month. This revolving door means something is always going to be short. You’re never over it.’



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