Question for Steve re: Morphine Shortage--Thanks!

[Eva 14]

Hi Steve,

We all have learned so much from your experience as a pharmacist---thank you!

I dropped off my prescription for morphine injectible 3 days early (on Tuesday), and my pick-up day is always Friday.

Today (Thursday) I got a call from the pharmacist late in the day. She told me that they didn't have the morphine injectible and that they called the manufacturer and were told it was on backorder. I asked her when she thought they'd be getting the morphine in, and she said she had no idea. She seemed to be nice about it, and it really did seem as though she was doing all she could.

This is actually the first time in over 3 years that my pharmacy DID NOT have the morphine injectible on hand. They know I get it every month and specifically order it for me. Somebody must have forgotten to order it ahead of time. They are times when I DON'T drop off my scripts early and the morphine injection has always been there for me.

No other pharmacies in my area have morphine injectible in stock. My pharmacy never stocked it until I became a customer there. My pharmacy has always refused to do partial fills, so I kind of wonder if they don't have at least SOME morphine in stock. But even if I asked, I'm sure they would tell me that partial fills are "illegal", even though I don't believe that they are.

Steve, I just wanted to ask you: Is there REALLY a nationwide backorder on morphine injectible? Do you have any idea when this might be resolved, if there really is a shortage? Even if I were to ask for my prescription back, NO OTHER pharmacy in my area stocks morphine injectible.

The pharmacist said she called my doctor and told him about the shortage. Unfortunately, the pharmacist didn't call me until almost 5 pm on Thursday, and my doctor takes Fridays off.

So I have to wait all the way until Monday to even get to call my doctor's office and see if he can substitute something. The wait seems like an eternity; I don't know why they couldn't have called me earlier. Plus, my doctor's office is almost an hour's drive away. I don't know if my doctor is willing to send a script in the mail, but I'm thinking it had better be registered mail, because our mail carrier mixes up my and my neighbor's mail all the time.

Anyway, I just wondered if this alleged morphine injectible "shortage" is real or just an excuse that my pharmacy is making up. In the past, this pharmacy has told me about Dilaudid "shortages" that really were NOT nationwide, according to your information. Thanks for any advice!

Thanks,
Eva

[Mark N]

Not Steve but reading you post Eva it concerns me that there is a shortage at least in your area. I hope you can get a refill soon and in the mean time have a replacement prescribed for you. I sure hope that companies don't start running into shortages on a regular basis as the sporadic shortages are bad enough.

[Pharmacist.steve]

Unfortunately the shortages are real... last year we had some 260 odd shortages.. a lot of them injectables and this year we are on track to be equal to or greater than last year... According to the FDA list of what is not available there is suppose to be some Morphine Inj available July/Aug this year... but.. that is a guesstimate ...
Two options that you might have .. Morphine 20mg/ml conc soln to be used sublingual (under the tongue).. its onset/duration is similar to IM/SubQ. The other is that they make a Morphine 50mg/ml inj... it is used in ambulatory pumps and IV compounding.. it is not used much.. and there might still be some in the pipeline... I don't know what your dose is.. if not really small .. could use a small insulin syringe (max 30 units) to measure an appropriate dose.

Are there any independents in your area that service nursing homes or hospice.. they MIGHT have some in stock ... I know where I work .. a long term care pharmacy... we have some in stock as of today... but... we only service nursing homes.. and there is not that much in stock at that.

There are some other injectable opiates that may help you manage your pain in the short term until this shortage resolves itself

[Eva 14]

Thanks for your replies, Mark and Steve. Thanks to everyone for reading this! It's too bad about these med shortages, because I've really been suffering.

Here's the latest: I dropped off my scripts a week ago (Tuesday) and wasn't told that there was a problem until the pharmacist called me at the end of the day on Thursday. My doctor is not in the office on Fridays, so I had to wait until Monday to call him.

On Monday, I called my doctor's office. His receptionist told me that my doctor had indeed sent a fax to the pharmacy. His receptionist is really nice. I was just so surprised that it was afternoon and I hadn't heard a word from the pharmacy!

I then called the pharmacy and spoke to the pharmacist. "Did you get a fax from my doctor?" I asked her. Very lackadaisically, the pharmacist replied, "Oh yeah....I think we got something from him". She gets the fax out and tells me that my doctor told them to try to order an alternate strenghth of morphine injectable. Who even knows HOW LONG the pharmacist had had this fax WITHOUT even trying to order the meds! So she tells me that she will try to order the meds.

A bit later in the day, I called the pharmacist again with the intention of providing her with a website I found that actually lists all of the med shortages in the USA, and suggests available alternative strenghths. She told me that wouldn't help her, since Walgreen's only has one (or maybe two?) supplier for C-II meds. Then she tells me, "I was going to call you back after contacting the supplier, but I didn't call until just now (4:35 pm) and the supplier closes at 4:30". Really?? She couldn't have called EARLIER? She's been working there for years; WHY wait until so late in the day anyway??

I asked the pharmacist to PLEASE keep me posted. I really expected to get at least some sort of a call today (Tuesday) but heard NOTHING from the pharmacy. It makes me wonder if she FORGOT again! Or if another pharmacist was working and didn't even know to try to order the morphine.

When I talked to the pharm on Monday, she told me that if she couldn't get an alternate strength of morphine, my doctor said he would mail a script to the pharmacy. (My doctor is an hour's drive away).

So it definitely sounds like my doctor is doing everything HE can; it's the pharmacist who doesn't seem to understand how urgent this matter is. IF my doctor needs to mail a script, that will take time, too. And then the pharmacy will have to special-order that injectable med. This is all going to take TIME, and I was supposed to have gotten my meds last Friday!

I think only a fellow chronic pain patient can relate to just how upsetting this is. I'm having slight withdrawals, and I no longer have my BEST pain med available to me, so my pain levels have been really high. (I usually take 10 mg morphine injection, once daily). I have a couple of vials saved for "emergency" use, but I don't dare use them because I have no idea how long I'll be without my medicine.

I feel weird about having to keep calling the pharmacy about this matter. The pharmacist whom I spoke with has made a few rude comments to me in the past, falsely accusing me of trying to fill scripts "early". Believe me, this was NOT the case. Her math is messed up.

We finally agreed that I could pick up my meds every 28 days, and things have gone pretty smoothly for the past year or so. Although I did have a tech glare at me when I last brought in my scripts, asking me, "You're not trying to fill them EARLY, are you?" That really irked me. I know that the tech got that attitude from what the pharmacist has said about me. I once heard the pharmacist ask the tech, "She's not trying to fill them EARLY, is she?"

I don't know if this pharmacist thinks that pain management is just a game or that every pain patient is an addict or what. I don't understand why she's being so LAZY about this! Why is it so hard for her to pick up the phone and CALL ME to let me know what's going on? (I know no one here can answer that question; I'm just venting.

I really need to know SOMETHING by Thursday, because I don't want to run into another situation where I have to wait until Monday to call my doctor's office. But I almost feel like calling tomorrow (Wednesday) because this wait is gettting ridiculous. I just don't want to be treated like a drug addict, especially after the snide comments I've endured in the past from this pharmacist and one of the techs. I feel rather embarassed to have to call yet AGAIN; I worry what they'll say about me. But I do NEED my medication.

Thanks for reading this! Any advice on how to handle this is greatly appreciated.

Best Wishes,
Eva

[Eva 14]

Now that I look at my past posts on this board, I see that it was only back in February of 2012 that I had yet ANOTHER problem with this pharmacist! How I WISH I didn't have to deal with a pharmacist with this attitude, but I really have no choice. The chain pharmacy is the only pharmacy near me that can get all of my meds. Most months things work out okay, but when things DON'T work out, it's pretty awful. I hope none of you have to go through anything like this.

Eva

[Boxerlover]

Eva, I recently had to change pharmacies, not because of med shortages, but because of issues with the assistant pharmacy manager. The government requires REM's with certain meds. You have to be registered, as well as the pharmacy and your doc for that matter. All that was done but she consistantly had problems putting me through the system even with the pharmacy manager writing it down for her. Then when she couldn't do it she would call the corporate office but this mostly happened on weekends when the corporate office was closed. She never had that "urgency" and I am like uh, I need these soon! After the third time this happened I finally changed pharmacies. I felt horrible as I had been there for 9 years but the first time this happened, I called basically every pharmacy that was registered and there were a whole bunch and no one had my meds. Very few pharmacies have them and I alwasy had them special ordered.

But I totally get it, I would call hours later and she was like oh I called corporate and they're closed. Well what next??? I let her work on it for 3 days then finally picked up my script. I would have been out of meds over a week if I hadn't been careful and had some for an emergency.

I sure hope you get this resolved soon!

[Eva 14]

Thanks, Boxerlover. It takes a fellow chronic pain patient to truly understand just how frustrating this is!

All day today (Wednesday) went by and I heard NOTHING from the pharmacist. My doctor is not in the office on Fridays, so I figured I'd better call the pharmacy today to find out what the heck is going on.

I called at 4:30 and was told by a tech that the pharmacist would call me back. I waited until 6:15, and still no call. So I called back again and asked to please speak with the pharmacist.

I finally got to speak to the pharmacist. I asked her if she had ordered the alternate strenghth of morphine that my doctor had told them to and the pharmacist on Monday had also told me they would order it. Imagine how I felt to hear that they had NOT ordered ANYTHING!!!

This other pharmacist told me they could try to order the alternate strenghth of morphine. I asked her if she had ordered it. No, she replied, because she said that I needed to call my doctor and get a NEW prescription! Wow---how about telling me that a WEEK ago?!

So now I have to wait until tomorrow and call my doctor's office. I don't know if it's better to have the script sent to me or to the pharmacy? (Something tells me WHY would I trust the script to be sent to these fools at the pharmacy!). I actually may just make the hour long drive to my doctor's, because all of this waiting is getting ridiculous! I will still have to wait God only knows how long for them to get the order in AFTER I get the prescription to the pharmacy!

It sounds like I could easily be going 2 WEEKS without meds, and that is NOT acceptable! Especially since NO ONE told me I needed to get a NEW prescription from my doctor! I even asked my doctor's receptionist if a fax was good enough, because I was pretty sure that I would need a new prescription. But it was for the same med, just a different strenghth. The receptionist said that she didn't know. Fair enough, I guess. That's the kind of info that a pharmacist is SUPPOSED to know!

I feel upset enough to file a complaint, but I always seem to chicken out of doing that once I get my meds. I really don't have many options as far as pharmacies go in my area. Usually things go smoothly, but this latest episode has been insane! They've known for a WEEK that I needed a NEW script from my doctor and they never even bothered to tell me that!

Well, there's my vent. I pray that no one else has to go through anything like this. So sorry to the other people who have had problems like this with their pharmacies.

Eva

[Swanton Bomb]

You should contact the (makers of MS Contin) Purdue patient assistance programs and see if they can help (worth a shot).

Purdue Patient Assistance Program
P.O. Box 66547
St. Louis, MO 63166-6547
(800) 599-6070
Hours of Operation:
Monday-Friday, 9:00 a.m. to 5:00 p.m. Central Time

[Mark N]

I went to the pharmacy today and for the first time was told they didn't have a complete order of my MSContin. You have to wonder why shortages are cropping up and I don't want to get into out of bounds territory here but I have a sneaky suspicion of why they are showing up now. I have been promised it will be in by Tuesday so I hope they are right otherwise I will be without my pain medication and have to hope someone else in town has it.

[Tigerlilly50]

Hi Steve,

We all have learned so much from your experience as a pharmacist---thank you!

I dropped off my prescription for morphine injectible 3 days early (on Tuesday), and my pick-up day is always Friday.

Today (Thursday) I got a call from the pharmacist late in the day. She told me that they didn't have the morphine injectible and that they called the manufacturer and were told it was on backorder. I asked her when she thought they'd be getting the morphine in, and she said she had no idea. She seemed to be nice about it, and it really did seem as though she was doing all she could.

This is actually the first time in over 3 years that my pharmacy DID NOT have the morphine injectible on hand. They know I get it every month and specifically order it for me. Somebody must have forgotten to order it ahead of time. They are times when I DON'T drop off my scripts early and the morphine injection has always been there for me.

No other pharmacies in my area have morphine injectible in stock. My pharmacy never stocked it until I became a customer there. My pharmacy has always refused to do partial fills, so I kind of wonder if they don't have at least SOME morphine in stock. But even if I asked, I'm sure they would tell me that partial fills are "illegal", even though I don't believe that they are.

Steve, I just wanted to ask you: Is there REALLY a nationwide backorder on morphine injectible? Do you have any idea when this might be resolved, if there really is a shortage? Even if I were to ask for my prescription back, NO OTHER pharmacy in my area stocks morphine injectible.

The pharmacist said she called my doctor and told him about the shortage. Unfortunately, the pharmacist didn't call me until almost 5 pm on Thursday, and my doctor takes Fridays off.

So I have to wait all the way until Monday to even get to call my doctor's office and see if he can substitute something. The wait seems like an eternity; I don't know why they couldn't have called me earlier. Plus, my doctor's office is almost an hour's drive away. I don't know if my doctor is willing to send a script in the mail, but I'm thinking it had better be registered mail, because our mail carrier mixes up my and my neighbor's mail all the time.

Anyway, I just wondered if this alleged morphine injectible "shortage" is real or just an excuse that my pharmacy is making up. In the past, this pharmacy has told me about Dilaudid "shortages" that really were NOT nationwide, according to your information. Thanks for any advice!

Thanks,
Eva

I have the same issue. I have a brain tumor and have used injectable morphine for several years. Have breathing issues with other narcotics, I have been told there is not a shortage from westward the manufactures of the drug. The issue is with the distributors and the are setting a max of one vial per month. I am in a panic as I am dependent on the medication and without it would just rather die than put up with the excruciating pain that I have. I have a valid script but can't do anything with it. I stay in bed and just pray for it to end. Don't think the government cares about the population that depends on these drugs to have some quality of life. I hope mine ends soon, I don't have a meaningful life anymore