Summary: New reports show that opioids are in short supply, and things are unlikely to improve. DEA has been cutting down production quotas, and manufacturers have also been hesitant to produce these drugs due to rising litigation costs.
The US has been going through an era of drug shortages for quite some time. This problem has been especially acute during the last few years. However, as the COVID-19 problems eased, so did the drug supply. But, this did not change things for patients living with chronic pain, as the shortage of opioids persists. Thus, drugs like oxycodone, hydrocodone, and many other painkillers or opioids are in tight supply.
Surely, the latest report by the American Society of Health-System Pharmacists (ASHP) shows that things are improving, and thus, drug shortages have declined from a peak of 323 to 277. However, as one can see, there is still not much improvement.
These shortages are affecting many essential medications, and not just opioids or painkillers. Thus, there is a significant shortage of various IV fluids, dialysis fluids, or sterile fluids. Such acute is this shortage that the American College of Emergency Physicians is asking specialists to use tap water for cleaning wounds instead of sterile irrigation fluid.
There are some other worrisome facts. Despite the information, it appears that not enough is being done. Thus, for example, industry stakeholders have not been able to explain the reason for the deficit of many drugs. However, they do say that it is due to multiple reasons like increased demand, manufacturing problems, raw material shortages, and business decisions.
When it comes to opioids, surely, regulatory changes are among the significant reasons. DEA production quota is insufficient to meet the requirements of opioids, leading to rationing of these drugs. Therefore, surveys show that 90% of patients have difficulty getting their opioid prescriptions filled by the pharmacy.
In fact, some of the drugs, like Transmucosal Immediate-Release Fentanyl Medicines (TIRF), have been discontinued by the manufacturer. This drug is used in a small number of patients to manage severe pain in cancer patients, and those patients have now been left without any options.
Although manufacturers are not saying why they have discontinued producing certain opioids, industry experts think that it is not difficult to understand. Many of the manufacturers have been experiencing losses and legal issues, so they decided to discontinue producing certain opioids.
As per ASHP, oxycodone, hydrocodone, hydromorphone, fentanyl patches and solutions, and morphine solutions are some of the opioids that are in short supply. These are some of the most potent painkillers and widely used opioids, and their short supply means that a significant number of patients have to seek other options.
Some industry experts warn that things are unlikely to get better since, in 2025, the DEA would further reduce the quota for producing opioids. If the quota is implemented, it will only make things worse.
These shortages are not only making it difficult to manage severe and chronic pain but also causing other health issues. Thus, many patients are experiencing higher levels of anxiety, and they have to struggle a lot to get their prescriptions filled.
Doctors are already raising the alarm, and some of them have written to the regulatory agencies that any cut down in the production of opioids will cause significant harm to their patients. In fact, these shortages are also causing stress and burnout in physicians, as they feel helpless and unable to help their patients. Doctors say it is regretful to see that patients must call 10-20 pharmacies and often travel hundreds of miles to get their medications.
Further, if those living with chronic pain do not get these medications, they are more likely to consider other ways to manage their pain, which may include using illicit drugs, which may further make things worse. This creates an added concern for doctors specialising in opioid addiction treatment, as it may lead to a rise in illicit drug use and related complications.
