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national shortage of morphine and dilautid

I have a low pain tolerance and tend to me on the wimpy side. I'm having a TLIF at L4/L5 this coming Friday, July 20th.  

I'm wondering if I should hold off until this gets restocked.  Apparently, the DEA sets controls on the raw materials these drugs are made of, which happens to be the same as the drugs for the "opioid crisis".  They thought by limiting the amount of raw materials used to make these drugs, fewer people would use them.  The problem is cancer patients and burn patients aren't getting enough of them so I'm guessing surgery patients aren't getting them either.  My friend's husband had a kidney stone 2 weeks ago and went to the E.R., they couldn't give him anything.  I'm not talking outpatient, he was an inpatient.  The DEA didn't think of that happening, imagine that.  Meanwhile, the FDA has gotten involved because other sources of pain medication has been used ,such as ketamine, and there have been bad outcomes.  I read this from some articles on-line.  Chicago has been out of morphine for 7 months.  Why is it that we can never reach a happy medium in this country?  When something happens that people don't like, we go to the far end of the opposite direction.  Limit the amount prescribed and monitor it but don't stop manufacturing it in case it is needed.  What if we had some kind of crisis where a lot of people got injured in some kind of disaster?  Are we going to make them all use bio-feedback?   

Should I run for congress??



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  • dilauroddilauro ConnecticutPosts: 12,099

    I would agree, in the several hospitals within 90 miles radius, I am not aware of any morphine or other opioid shortage.

    DEA has never set out to prevent the required medications at hospitals when needed. 

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  • Here is just one article on the internet which discusses the DEA LIMITING the raw materials to make opioids.  There is also a WEBMD article I read which also addresses this issue so I'm not dreaming this up.  Additionally, I called my doctors office who also confirmed of the storage.  I was told they had other "options"  for pain.  This program won't allow me to paste the URL but it is a UPI article titled " Hospitals in US experience shortage of critical opioid drugs".  

    Quote taken from the article:

    Other drug companies have tried to fill the gap, but they have been hampered by the U.S. Drug Enforcement Administration's (DEA) efforts to reduce availability of prescription opioids by cutting back on the raw materials used for the painkillers.

    Please understand, I'm afraid enough about this surgery, I shouldn't have to be afraid of pain relief also.  I had a knee replacement in 2008 and was in so much pain I couldn't wait for the next pill time.  Conversely, I had a hysterectomy in 2016 and was given pain meds which I didn't need for very long, but they were there if I needed them.   

    It is wrong thinking to put limits on a drug that IS needed by people who are suffering because of other people abusing it.  There are other ways to control abuse.  

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  • I know that my area hospitals are all having issues.  They say it is due to several things including the hurricane in Puerto rico, the consolidation of pharmaceutical companies, and the stricter federal guidelines.

    They are short on morphine, fentanyl, dilaudid, atropine and even bags of saline solution are hard to get.  One of our hospitals says they have several pharmacy techs that now spend several hours a day breaking saline bags down to smaller bags just so they won't run out.  They also at times have to order a more expensive product as well.  Running out of atropine is scary because that's what they use on crash carts in case of a code blue.

    If I understand correctly most of the issue is with injectable meds right now.  But if the feds keep making cuts to what the pharmaceutical companies can produce, it inevitably will affect oral meds as well.

    I guess the injectable morphine is so low right now that hospitals here are having pharmacy techs compounding the drug.  

    The articles I read say that the hospitals administrators and medical staff are complaining to government officials and trying to get this turned around as quickly as possible.  I sure hope they are able to get something done.  This is getting really scary.


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  • More and more medications are becoming unavailable.  Valium is another med that is extremely difficult to get.  Our EMS service has been out of Valium since May 1st and suppliers cannot give us a date when it will be available again.  We use a substitute benzo, but it doesn't work as well as Valium.  Throughout my career, we have gone through shortages, but the last couple years has been downright ridiculous.  Hurricanes are one reason, but more importantly, labs don't want to spend time making medications that are inexpensive.  They want to produce the money making drugs that costs thousands of dollars a month.  The worst decision ever made in healthcare was to remove the ban from profiting on healthcare back in the 1970's.  If healthcare was a "cost only" model, we would still have affordable care in the United States.  On the flipside, people's 401K's wouldn't be so funded!  It's amazing how many medical related products are tied up in the stock market. 

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Full disclosure, I'm a retired research scientist who worked for a major pharmaceutical company.  You are correct on several points EMS guy but there are also several moving parts to drug costs and manufacturing issues.  Drug companies are not going to make generic drugs, for example, for drugs used by a small amount of people, like an interferon.  It would be too expensive.  However, drugs which are already approved by governing bodies, which are used in mass are still cost effective to produce, no matter how cheap they are.  This is not the forum to debate this right now.  Just know this:  There is much more to setting the cost of drugs besides the drug companies.  Research is very expensive and time consuming with no guarantee of the end result being a useable drug.   Consider what might happen if there was no profit, and I'm just asking here, what would be the incentive to research new drugs?  It would be interesting to see data on the development rates of drugs before and after 1970s.  Another aspect worth considering is the effect of insurance on medical cost.  My father likes to tell of the change in cost of going to the dentist after dental care was insured.   Dental care was really cheap until General Motors started providing dental insurance.  I'm not dissing GM for taking care of their people but there was a consequence to the cost after insurance was available.

  • n2braves, your news about the saline bags is alarming.  I would be very concerned about the process being sterile.  geez

  • I understand there needs to be an incentive for companies to do research, but when I see drug rep after drug rep bringing free meals to doctor's offices, doctor's taking free trips to exotic locations because of the number of scripts they write for a specific drug along with the FDA fast tracking meds while ignoring safety data, it's pretty evident what's going on.  A high ranking FDA executive recently admitted a new non-opioid pain medication doesn't show much value (medically speaking), but since the company invested so much money that they "deserve" to make that money up by approving the drug.  Pharmaceutical costs in my humble opinion are one part of the health equation that is making healthcare unaffordable.  This is one of my favorite lines, "ask your doctor about (insert drug name here)".  There are healthy people asking doctors for medications they have no need to take just because a benefit touted in the ad is something the patient wants but is not medically indicated.

    Please understand I'm not begrudging research or innovation, but when you see the profit margins along with price breaks other countries receive, it's hard not to have a bias against the parent companies.  We have regular patients we transport frequently and one of the biggest reasons is because they cannot afford the drugs they've been prescribed.  COPD medications right now are insanely marked up.  One albuterol inhaler costs close to $200.00.  Albuterol has been around a pretty long time and is widely prescribed.  I can't see for the life of me why a medication that is one of the most prescribed for COPD has to be so expensive.  It is literally costing some people their life savings just to get what they need to breathe. Even though some drug companies say they can give price breaks to those who cant afford it, many of those who need it don't have access to the Internet or even know how to turn the computer on.  There has got to be a "meeting place" in the middle on costs.   Thanks for indulging my rant!  I hope everyone has a safe "relatively" pain free day!  

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • I'm supposed to have my surgery in the morning.  I hope they have compounded some pain meds for me, this part makes me very nervous.  "

    Do you all remember when we'd hear "take you pain medicine, get ahead of your pain, your pain medicine will make your physical therapy go better"?  Now I'm reading "we need to stop relying on pain medications and let your bodies natural pain fighting chemicals kick in".  HA!  I guess this is where the old business adage:  "If you can't fix it, feature it" comes in to play.....  I don't trust our government any more.

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