Fentanyl shortages or DEA policing healthcare?

[Polskijames]

Hey guys. I'm a travel nurse in the cath lab. Up until my most recent contract I've been giving versed and fentanyl to my hearts content. But, suddenly I'm at a lab that isn't allowing fentanyl? I was told at first it was shortages in FL. I thought, no, because I just left a contract in south FL and we had plenty of fentanyl. Then just this week we were all told it's because the DEA is regulating the amount of fentanyl we give. Particularly in the county I'm working in (one of the harder hit by the opioid crisis). While I am sympathetic to the fact that there's millions of people dying because of overdoses and opioids have become a national health crisis, I am incredibly angry that we are doing CARDIAC INTERVENTIONS on patients that are not completely sedated or are in pain while we're doing the procedure. Anesthesia and OR get fentanyl, why are our patients not able to receive the same care? I feel a moral obligation to help the people that are on the table! 4 of versed and a lot are still talking, but I could give 2 and 50 and they're peacefully sleeping while we work. Is this going to be an ongoing problem? Anyone else experiencing this? What about peripheral interventions....that dye burns! Pharmacy has told us we can sub with dilaudid but I've found they're harder to wake up and have more respiratory depression with 2 and 1-2...it lasts longer. This is ridiculous. Why is the government interfering with our patient care

[smf0903]

We have zero dilaudid, zero morphine, and limited fentanyl at our facility. We were told it's a nationwide shortage.

[chare]

We have zero dilaudid, zero morphine, and limited fentanyl at our facility. We were told it's a nationwide shortage.

It is, related to decreased production in Puerto Rico as a result of hurricane Maria. Over the last month, we've had shortages of each of these as well.

[Polskijames]

Opioid shortages leave US hospitals scrambling - CNN

I read this article today... it mentions nothing about shortages due to the hurricane. I've been working in Broward County and now in central FL and we didn't have hep saline for the longest time (or Angioseals) because of the effect on the factories in PR. The DEA has called for a reduction in fentanyl and that's why there's a shortage. What i want to know is why its affecting the hospitals directly- do they think drugs are being diverted during shipment or something? From what I was told its foreign carfentanyl that is being laced into other drugs, not the stuff we're giving for procedural sedation and post-op pain. I just think it's unfair that patients who have a need for opioids during a hospital stay can't have them because the current administration thinks limiting their production or getting rid of them altogether will somehow solve it.

[guest769224]

We have zero dilaudid, zero morphine, and limited fentanyl at our facility. We were told it's a nationwide shortage.

Interesting. In my area of the country these meds are all available. I wonder if certain hospital systems pay extra to make sure they are in stock.

[Nurse SMS, MSN, RN]

We are also short, particularly in morphine, due to the situation in Puerto Rico.

[AceOfHearts<3]

No dilaudid at my hospital. We have fentanyl for PCA pumps, but I don't know if we have it for other purposes.

[PeakRN]

We are short on morphine and dilaudid, but we still have it available. We don't have a shortage on fentanyl. Our system certainly has very strong buying power and like ICUman I suspect that our system leverages their size or pays more so that we do not run out. Some of the competing systems around us are begging for all kinds of meds and supplies but we have had very minimal change in the availability of these products.

I have not heard any peep about our medication doses or choices being regulated by the DEA or other agency.

[Lisacar130]

The shortage is government created.

Opioid shortages leave US hospitals scrambling - CNN

[AceOfHearts<3]

The shortage is government created.

Opioid shortages leave US hospitals scrambling - CNN

This makes me so mad, as a nurse and a patient. I was in a car accident and had some massive orthopedic injuries- nothing life threatening, but it left me in a crap load of pain. I had many doses of IV pain medication (Fentanyl and dilaudid) leading up to surgery. I had Percocet once I was home that I took around the clock for a few days until Advil and Tylenol were enough. I needed the pain medication and I stopped taking it as soon as I could. I can't even imagine going through what I did without it.

[mmc51264, BSN, MSN, RN]

We are short of a lot of things, not just opioids. A lot of it has to do with PR. We are good with dilaudid, we don't use a lot of morphine and fentanyl is holding. Very frustrating to be short minibags and having to push meds that need to be diluted. have to teach the newbies how to do this. It is hard to push 1 mL over 2 minutes LOL

[elkpark]

Opioid shortages leave US hospitals scrambling - CNN

I read this article today... it mentions nothing about shortages due to the hurricane.

You're right -- the article doesn't mention the hurricane or PR, but it does say that the shortages are related to Pfizer having to shut down production and modify a plant in Kansas because the plant had significant safety violations in an inspection and was found to be turning out products that were a safety risk for clients, and the other manufacturers haven't been able to make up the shortfall, not that "(T)he DEA has called for a reduction in fentanyl and that's why there's a shortage."

The article does mention that there has also been a call by the government to reduce the overall amounts produced to the amounts that are needed for legitimate healthcare needs (in order to reduce the amounts available for illicit use), instead of the manufacturers just cranking out as much as they are able to and shipping it to whoever wants it. That sounds like a pretty reasonable idea to me.