EDs run out of vital drugs, and patients are feeling it

Emergency departments (EDs) across the country have been struggling with shortages of essential drugs, including pain and heart medications. As a result, some patients end up suffering through their pain, while others risk reactions to alternative medications that may not be the best option.

Emergency departments (EDs) across the country have been struggling with shortages of essential drugs, including pain and heart medications. As a result, some patients end up suffering through their pain, while others risk reactions to alternative medications that may not be the best option. "So many substances are short, and we're dancing every shift," said James Augustine, MD, a doctor in Cincinnati who works for US Acute Care Solutions, which employs doctors who work in EDs for hospitals around the country. While previous drug shortages were often dealt with behind the scenes by pharmacists, physicians, and nurses, doctors say the current shortages are more directly affecting care for patients. According to a May survey of emergency doctors by the American College of Emergency Physicians, 90% said they lacked access to vital drugs, and almost 40% said patients had been negatively impacted. Benjamin Savitch, MD, who oversees the ED at Norwegian American Hospital in Chicago for US Acute Care Solutions, notes the difficulty in explaining the situation to patients. "They are often disappointed and frustrated that the system is not functioning at the level it should," he said. Drug giant Pfizer has said that manufacturing problems at some of its facilities will reduce supplies of many of its products, including morphine, until 2019. Meanwhile, the company's competitors are struggling to keep up with demand and are depleting their own supplies. Additionally, the shortage of opioids such as morphine has been affected by federal quotas that limit the amount of narcotics any one company can produce. While the FDA has made some progress, says Commissioner Scott Gottlieb, the agency is working to address the underlying issue in which drug companies earn a narrow margin on products that are difficult to make. "Today it's one drug, tomorrow is going to be another drug," Gottlieb said. "We've got to think of something more holistic and comprehensive."