Emergency medicine drug shortages likely to increase

Experts in a new article recommend strategies for managing increasing shortages of crucial drugs used in treating medical emergencies. During the past few years, emergency departments have experienced shortages of, for example, naloxone, tetanus toxoid, prochlorperazine, fentanyl, and succinylcholine. In addition, even drugs that can be substituted as alternative treatment also are in short supply. These shortages have impacted how emergency physicians care for their patients, according to the article. (The Challenge of Drug Shortages for Emergency Medicine, p. 598)

The study tracked drug shortages at the University of Utah Health Sciences Center in Salt Lake City since 1995. Drug shortages affecting patients at the hospital grew from three in 1996 to 18 in 2000. In 2001, the hospital experienced a significant jump to 83 drug shortages; 61 of these affected patients and required physician notification. Nationally, the authors tracked 157 shortages from January 2001 through June 2002 and noted that 62 percent of these are still active and unresolved.

"The unprecedented shortages of the past several years may be caused, in part, by industry consolidation, with fewer companies producing raw materials and manufacturing drugs," said E. Martin Caravati, MD, MPH, a co-author of the article. "We are as dependent on foreign sources for our drug supplies as we are for our oil supplies, which is why wars and natural disasters around the world can trigger drug shortages."

The study's authors said solving these shortages will be difficult and will take many years to address, but emergency physicians can take steps to manage these shortages and minimize the impact on patients by opening the lines of communication with their hospitals and with their patients about their options.

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