Hospitals nationwide now dealing with opioid shortage

HORRY COUNTY, SC (WMBF) - As the country is dealing with widespread opioid addiction, hospitals are now dealing with an opioid crisis of their own, including in our own area. According to experts, the IV form of opioid painkillers such as fentanyl, ketamine and hydromorphone have been in short supply. They say patients who require significant pain control after traumatic injuries, undergoing surgery or fighting cancer desperately need these drugs.

According to the Food and Drug Administration, Pfizer, the dominant manufacture of injectable opioids, had to stop production of the medications after the FDA found problems at one of its third-party manufacturing facilities in Kansas.

Conway Medical Center's pharmacy director, Robert Gajewski, said one of the main reasons for this shortage is the fact that manufacturers are unable to meet the hospitals needs for the narcotics, and says because the marketplace is so small, when one manufacturer leaves, it leaves a tremendous impact.

Pfizer wrote a letter to its customers in November, stating the work to upgrade the facility took longer than expected and will not be able to fully restore its capacity until the first quarter of 2019.

Gajewski said although the shortage was not directly caused by the opioid addiction crisis, the response to it is being impaired by some of the legal controls surrounding these drugs. He said the Drug Enforcement Administration has put tougher restrictions on the amount manufacturers can make.

Gajewski said this is something that's been happening for quite some time now.

"This has been going on for a long time. With hydromorphone, I think it started back in 2001 and then it eased up for quite some time and then we had another shortage back in - I think it was 2011 - and then here we are in 2018 once again experiencing it. So, it's sort of like a roller coaster. We have plenty of product and then all of a sudden, we don't have enough. So, we work through those shortages the best we can," said Gajewski.

Now, it's causing hospitals to improvise. Gajewski said right now, the hospital has either very limited supply or no hydromorphone at all, and have had to switch to another strength for Ketamine.

As a result, hospital pharmacists, including the staff at Conway Medical Center, are working long hours to try to maintain the drug supply and finding alternatives. Gajewski said such few companies make the certain injectable drugs, which in turn, raises the risk of mistakes.

"That's always a risk, anytime we change a product especially if it has a similar name, it can often get confused with the original product that we had. So, a similar name or a similar dosage strength can often lead to a dosage error, which could be problematic for patients. That's why we try to be very careful. We try to alert the staff when we change our products to make sure that they are well aware of the changes that we are making," said Gajewski.

He also hopes for more manufacturers in the future.

"Well, I hope that we can get more manufactures to help boost up our market and we won't be faced with having severe consequences when one manufacture is being closed by the FDA… or possibly even a hurricane. We saw that with saline shortages and how the hurricane took out manufacturing facilities in Puerto Rico. So, it would be nice to have manufacturers that have more than one facility and multiple manufactures that are making this product to help maintain the supply and demand," said Gajewski.

Both Tidelands Health and Grand Strand Medical Center said they are also experiencing tightened supplies of some medication, but the shortage has not affected patient care.

Tidelands Health spokesperson, Carl Lindquist, said that the system is dealing with shortages by shuffling drug inventory.

"At Tidelands Health hospitals, we continue to provide the same, high-quality level of care to our patients. Our team has responded to tightened supplies of some medications in a variety of ways, including through more refined inventory management. For example, we've more closely aligned the amount of medication stored on some units with historical use. As a result, more of the medication is available in other areas where it tends to be in higher demand," said Lindquist.

Pharmacy director for Grand Strand Health, Connie Williams, said, "Our health system is experiencing a shortage of these drugs. The shortage has not affected patient care."

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