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It’s ironic that even while the country is confronting a dangerous opioid epidemic, providers report that they are having trouble getting their hands on the powerful pain killers — a situation that is dangerous as well. The shortage, which primarily involves injectable opioid painkillers, is reportedly caused by drug manufacturing difficulties as well as the government’s efforts to address addiction by clamping down on drug production. However, the problem is resulting in adverse consequences for clinicians and patients.
For instance, in some cases, physicians and nurses are scrambling for alternative pain relievers, some of which require different doses or delivery mechanisms — a recipe for errors. Indeed, the Institute for Safe Medication Practices (ISMP) reports that there already have been some cases in which patients received potentially harmful doses as a result of this practice.
For instance, in the ISMP’s survey of hospital pharmacists conducted in 2017, a provider reported that in one case a patient received five times the appropriate amount of morphine because the vial containing a smaller dose was not in stock. Some physicians report they are forced to preserve the supply of injectable opioids for the highest priority cases, leaving some patients suffering with less potent alternatives such as acetaminophen or muscle relaxants. Meanwhile, the American Society of Anesthesiologists reports that the shortage has resulted in the postponement of some elective surgeries.
In a letter to the U.S. Drug Enforcement Administration (DEA) in late February, the American Hospital Association, the American Society of Clinical Oncology, the American Society of Health-System Pharmacists, the ISMP, and other groups called the drug shortages potentially life-threatening. The groups urged the DEA to temporarily adjust the aggregate production quotas for the injectable opioids in short supply to enable alternative manufacturers to supply these drugs until the shortage eases.
Financial Disclosure: Physician Editor Robert Bitterman, MD, JD, FACEP, Manager of Accreditations Amy Johnson, MSN, RN, Author Dorothy Brooks, Editor Jonathan Springston, Executive Editor Shelly Morrow Mark, and Editorial Group Manager Terrey L. Hatcher report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study.