Injectable opioids scarce in hospitals and hospices despite the U.S. being awash in pills

Injectable opioids are essential in healthcare environments, and pills are often inappropriate for the same use. (iStock/Thinkstock)

Amid the opioid crisis in the U.S., physicians and pharmacists in hospitals and hospices are having increasing difficulty finding injectable painkillers like morphine, hydromorphone (Dilaudid) and fentanyl for easing pain or sedating patients.

Injectable opioids are essential in healthcare environments, and pills are often inappropriate for the same use. 

Some hospitals, like Penn Presbyterian Medical Center, have reported having to use more expensive alternatives for an extra cost of $30,000 in the past three months, The Philadelphia Inquirer reported. The hospital said three months ago they were getting 20% to 30% less of injectable painkillers than they needed. Those percentages have since increased to 50% to 60% less of the drugs they require.

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The shortage has led the American Society of Health-System Pharmacists, American Society of Anesthesiologists, Institute for Safe Medication Practices and the American Society of Clinical Oncology to urge the Drug Enforcement Administration to temporarily adjust the aggregate production quotas for certain injectable opioid medications in short supply that would allow other manufacturers to provide product until the shortage is resolved.

“We understand and share the DEA’s concern that these medications need to be well‐managed and used judiciously to help stem the nation’s opioid epidemic,” the organizations wrote. “We fully support and use advances in pain management, such as multimodal analgesia, that enable patients to undergo procedures with fewer opioids and less reliance on opioids after surgery.

“Nonetheless, injectable opioids remain a crucial component of patient management during and immediately after many operations. With no appropriate opioids available, operations would have to be postponed or cancelled. In some cases, this could prove life‐threatening to the patient.”

The cause of the shortage stems from manufacturing issues that have been magnified by government regulations aimed at preventing the illegal sale of the addictive drugs.

Pfizer, a major manufacturer of small syringes and vials of the painkillers, has said some of the products may not be available until July. However, it expects a “full recovery date” for supplies in early 2019, the newspaper reported.


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