Hampton Roads hospitals dealing with empty shelves as national IV narcotic shortage rages on

Posted at 10:39 PM, Apr 05, 2018
and last updated 2018-04-06 09:22:58-04

HAMPTON ROADS, Va. - Hospitals around Hampton Roads are facing a shortage that could impact you the next time you are in pain and seeking medical help.

There is currently a shortage of IV (intravenous) narcotics in our region and across the country.

The opioid epidemic is part of the reason for the issues.

Sentara Healthcare officials took News 3 inside the room where they keep the heavy duty drugs used for patients with serious medical problems earlier this week.

It is where they hold IV narcotics like morphine and fentanyl.

“You can see how many of our shelves are bare,” said Julie Scott, team coordinator for Sentara Norfolk General pharmacy.

Sentara Vice President of Pharmacy Services Tim Jennings said they’ve been impacted by this since November. However, the lack of IV narcotics has gotten worse in recent weeks.

“It's a national shortage and we really need to reserve it [IV narcotics] for patients for whom, frankly, there's no other alternative,” said Jennings.

One of the causes is tight restrictions by the Drug Enforcement Agency on drug manufacturing companies.

The stricter rules are a direct response to the opioid epidemic plaguing our country and killing Americans every day.

Several medical groups like the American Hospital Association and American Society of Health-Systems Pharmacists issued a joint letter to the DEA urging them to lift some of the restrictions.

“These medications are also frequently used in intensive care units for surgical, trauma, burn, or oncology patients, when it is not clinically appropriate to use oral opioids," the letter reads in part. "Having diminished supply of these critical drugs, or no supply at all, can cause suboptimal pain control or sedation for patients in addition to creating burdensome workarounds for healthcare staff.”

The letter also explained the other issue causing the shortage.

“Shortages of these injectable medications are largely attributable to manufacturing delays affecting Pfizer, the primary maker of these products, following its acquisition of Hospira.”

We reached out to several area hospitals about the problem, and here's what they said:

Sentara Healthcare: 

"A nationwide shortage of intravenous (IV) narcotics for pain is causing hospitals to take urgent steps to control IV narcotic usage and find alternatives for pain control in emergency room patients, post-surgery patients, cancer patients and those with chronic painful conditions such as Sickle Cell disease. Efforts include using oral opioids for patients who are able to swallow them and non-narcotic IV analgesics where safe and appropriate. Foremost is a commitment to keep patients in pain as comfortable as possible and save IV narcotics for the worst inpatient pain.

All Sentara hospitals in all regions are taking immediate steps to conserve IV narcotics in stock and devise creative, safe solutions to help patients control pain using other methods such as the ones described above. Sentara is engaging the public in this discussion so they are aware of the nationwide nature of the production capacity issue, which is being aggravated by U.S. government (DEA) restrictions on production quotas for all opiate medications in 2018.

The supply crisis is expected to extend into mid-2019. The current changes in pain control methods could be a first step toward a permanent shift in how hospitals control pain, using fewer IV narcotics and reserving their use for trauma patients, surgery patients and others in the most acute pain.​"

Riverside Regional Medical Center:

“…we are experiencing shortages for all opioid injectable products as well as non-opioid pain management injectable medications as usage shifts to other agents. The shortage is significant, requiring daily strategy meetings with pharmacy and medical staff members. We are moving patients to non-opioid medications and/or oral dosage firms when possible.  We are working with our medical staff members, including anesthesia, to revise treatment protocols in order to reserve medications for those most in need. Additionally, we are seeing shortages of injectable anesthetic agents which are also used in conjunction with opioid injectable medications in procedural areas.”

Bon Secours Health System:

“Bon Secours Health System is responding to the national shortage of IV narcotics by implementing an aggressive approach by converting to alternative medications and treatment methods to ensure our patients have access to appropriate pain control.

Some of those actions include:

Converting to oral narcotic therapy for patients needing pain management,

Identifying alternative non-narcotic drug and non-drug treatment methods for pain management where clinical appropriate,

Communicating with our clinical staff about the conservation efforts and our approach to providing safe, effective alternatives,

Implementing guidance tips and equivalencies in our clinical information system to support pain management,

Shifting inventory within Bon Secours facilities to meet critical demands,

Implementing conservation techniques to ensure we do not waste any products.”

Chesapeake Regional:

“Chesapeake Regional is also experiencing a shortage of IV narcotics. To meet the needs of our patients while we respond to this shortage, we have altered some of our procedures. When possible, physicians are prescribing non-opioid products and pharmacists are providing other alternative therapies as appropriate.”

"We are all feeling that shortage much more than we did a couple of months ago," said Jennings.

The shortage is expected to continue until March 2019.