While opioids are becoming more prominent in American communities and widespread addiction is being attributed to them, hospitals nationwide are facing a shortage of the drugs and other medications for patients.
The shortage, though more severe in different locations, has left many hospitals searching for ways to acclimate and continue to provide patients with quality care.
Hardin Memorial Health Vice President and Chief Medical Officer Dr. John Godfrey said the hospital is holding its own amid the shortage.
“We are continuing to take good care of patients. We haven’t missed a beat,” he said. “But we’ve had to come together with our medical staff, with the pharmacy staff and put our heads together to try to figure out alternative options, because this issue didn’t exist six months ago or a year ago. We’re getting through with some creative thinking.”
Traditionally when hospital physicians write prescriptions, Godfrey said they always have been able to be filled. He said in the last year or so, it increasingly has become difficult for hospitals to acquire certain medications and for a supplier to supply certain medications.
Part of that, he said, is because generic manufacturers have stopped producing certain medications. Godfrey said it’s gotten to the point where some medications are produced by “one manufacturer and that is it.”
He said the 2017 hurricanes that hit Puerto Rico, where Godfrey said about 40 to 50 manufacturing plants operated, also contributed to the shortage. Large U.S. manufacturing plants being shut down by the U.S. Food and Drug Administration for quality concerns also was a contributing factor, he said.
“You add all that together and it is creating, in some situations, critical shortages of medications,” Godfrey said. “I know in some areas of the country, hospitals have had to limit the prescribing of some of these medicines and, in some cases, they have had to go so far as to cancel surgical cases because they don’t have the amount of medicine needed to conduct surgery.”
That is not the situation at Hardin Memorial Hospital, Godfrey said. However, the shortage situation is something its pharmacists and pharmacy staff look at every day to determine what its supplies are.
“Do we have enough to get through the day, get through the week? And so they are keeping us up to date on what they have (and) what they don’t have,” he said.
In working with pharmacists, administration and medical staff, Godfrey said the hospital actually has taken the lead in the Baptist Health system, which manages the local health group, and implemented several restrictions on some of the narcotic medications.
“In the hospital setting, there is somewhat of a shortage of these narcotics that are used very commonly for surgical care as well as just managing post operative pain,” he said.
So, Godfrey said, trying to curb the “very real” opioid epidemic nationwide is creating a dilemma for hospitals. He said they are having to figure out ways to deal with the situation, such as resurrecting old medications that have been used sparingly for several years because newer, better medicines been approved.
“We’re going back to some of the old ones because we don’t have any other options,” he said.
It’s not just narcotics in short supply. Godfrey said some medications for seizure control and medications for controlling rapid heart rhythms also are limited.
Godfrey said HMH is keeping it’s head “above water” as far as maintaining its supply of pain medications and narcotics. He said pharmacists and medical staff have done a good job of trying to limit prescribing narcotics and using alternatives where available.
As a result, they have been able to maintain the hospital’s supply of medicine, such as morphine and fentanyl, which commonly are used for anesthesia and surgical care.
“We’ve really got the doctors and all the staff watching very closely about how much they are prescribing, mainly to conserve things,” he said.
Godfrey said HMH has not had to cancel any surgeries.
“We’ve not even gotten close to that,” he said.
However, Godfrey said the hospital is not out of the woods just yet. He said the estimation is that manufacturing facilities will not be up to full capacity until February or March of 2019.
“We’re keeping our heads above water, but it is not that sort of safety net, security blanket that everybody would like to have,” he said.