Drug Shortages Persist in U.S., Harming Care

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From the NEW YORK TIMES:

…From rural ambulance squads to prestigious hospitals, health care workers are struggling to keep vital medicines in stock because of a drug shortage crisis that is proving to be stubbornly difficult to fix. Rationing is just one example of the extraordinary lengths being taken to address the shortage, which health care workers say has ceased to be a temporary emergency and is now a fact of life. In desperation, they are resorting to treating patients with less effective alternative medicines and using expired drugs. The Cleveland Clinic has hired a pharmacist whose only job is to track down hard-to-find drugs…

Caused largely by an array of manufacturing problems, the shortage has prompted Congressional hearings, a presidential order and pledges by generic drug makers to communicate better with federal regulators…A law passed this summer contains several provisions aimed at improving the situation, including expediting approval of new generic medicines and requiring the agency’s enforcement unit to better coordinate with its drug-shortage officials before it takes action against a manufacturer…

Click here to read the full article.

EDITOR: Physicians have long been intimidated by the threat of prosecution should they prescribe stronger drugs to a patients than is considered average, even though metabolism so varies from individual to individual that some require multiple amounts than others.   Those knowledgeable and courageous doctors tend to attract pain patients and then look all the more suspect.  (Please see below.)

We wonder if the fear of diversion of drugs and potential bad publicity and even prosecution has discouraged manufacturers from competing in the field.

From Drug War Facts:

(American Medical Association position on controlled substances and pain) “The AMA [American Medical Association] supports the position that:

“1. physicians who appropriately prescribe and/or administer controlled substances to relieve intractable pain should not be subject to the burdens of excessive regulatory scrutiny, inappropriate disciplinary action, or criminal prosecution. It is the policy of the AMA that state medical societies and boards of medicine develop or adopt mutually acceptable guidelines protecting physicians who appropriately prescribe and/or administer controlled substances to relieve intractable pain before seeking the implementation of legislation to provide that protection;

“2. education of medical students and physicians to recognize addictive disorders in patients, minimize diversion of opioid preparations, and appropriately treat or refer patients with such disorders; and

“3. the prevention and treatment of pain disorders through aggressive and appropriate means, including the continued education of physicians in the use of opioid preparations.”

Source:

American Medical Association, “About the AMA Position on Pain Management Using Opioid Analgesics,” 2010.
http://www.ama-assn.org/go/painpolicy

( American Medical Association position on the undertreatment of pain) “Unbalanced and misleading media coverage on the abuse of opioid analgesics not only perpetuates misconceptions about pain management; it also compromises the access to adequate pain relief sought by over 75 million Americans living with pain.

“In the past several years, there has been growing recognition on the part of health care providers, government regulators, and the public that the undertreatment of pain is a major societal problem.

“Pain of all types is undertreated in our society. The pediatric and geriatric populations are especially at risk for undertreatment. Physicians’ fears of using opioid therapy, and the fears of other health professionals, contribute to the barriers to effective pain management.”

Source:

American Medical Association, “About the AMA Position on Pain Management Using Opioid Analgesics,” 2010.
http://www.ama-assn.org/go/painpolicy
Editor’s Note: Although this report has disappeared from the AMA’s website, its content still remains relevant and is discussed here:
http://www.ama-assn.org/amednews/2004/09/13/prl10913.htm

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