Question for Steve re: Morphine Shortage--Thanks!

[Eva 14]

Mark and Tigerlilly---I am so sorry to hear that both of you are experiences med shortages, too! That is horrible! My heart goes out to both of you.

I have excruciating constant migraine and without the morphine injectable to "tame the pain beast" I have barely been able to get out of bed. I've been in too much pain to even go to the grocery store.

Yes, because of these problems with the distributer an alternate pharmacy probably wouldn't be able to GET the morphine injectable, anyway. Maybe my Walgreen's pharmacist really is doing all she can---I'll never know for sure.

I really am curious as to WHY these med shortages are showing up now? I can't even guess why.

Tigerlilly, I know just how you feel. I saw my doctor 3 WEEKS ago and recieved scripts for the next 2 months. SO I've been waiting 3 weeks and STILL no morphine. I'm so sorry that you can't take an alternate med.

I suppose I'm fortunate that I can take an alternate med, if we need to go to that. But my next doctor's appointment is a long way off. My doctor is an hour away and he already wrote an alternate script for me a couple of weeks ago. I had to go there and pick it up, of course. I used my second-to-last vial of morphine to make the trip. I can't drive in traffic with pain levels this high, so I really worry that the morphine will NEVER come in.

I'm not sure what that means about the distributors setting a max of one vial a month?? That must be for the big multi-dose vials? I usually get 30 of the small 1 ml vials.

I too feel like I don't have a life anymore. I'm panicking, too. I feel like I've missed out on the month of August. Day after day goes by, and all I can do is lie in bed and suffer. This is SO wrong! I've got a great pain management doctor, yet I can't get the relief that he prescribes.

So sorry to the others here who are going through this. This is the worst med shortage that I can remember.

Eva

[Mark N]

Eva, sorry that it feels like you have lost all of August due to the pharmacy issues. I got my meds three days later but within time so I didn't completely run out. My pharmacy could at least order the meds and get them without delay, it sounds like your pharmacy is having trouble getting your meds. I wonder if it is the injectable that is the problem as my testosterone isn't always available from the manufacturers. Usually I can get a different size vial to get what I need but it is a problem.

Have you talked to your doctor about prescribing an oral morphine for the times your vials aren't available? You just shouldn't have to do without and endure pain levels that are so high. I hope you get your meds soon so your problem is solved for now.

[Eva 14]

Thanks, Mark. I do take oral morphine every day, so at least I'm not having withdrawals or anything. With ZERO pain medication I wouldn't even be able to get out of bed! But nothing works as well for my "sky high" pain levels as the morphine injectable. It has been a God send and has enabled me to live a (somewhat) normal life.

I literally have not been in this much pain in YEARS, since I've always had my morphine injectable.

I looked on a website that lists med shortages. The reason the company gives for the morphine injectable shortage is "increased demand". But truly, how many people out there are suddenly needing to take morphine injectable? It's pretty much at the top of the pain med ladder and is reserved for cases of SEVERE and excruciating pain. I really don't think that many people are prescribed it at all.

I'm glad you were able to get the balance of your MSContin in only 3 days. I don't think I saw a med shortage alert for MSContin or any other form of oral morphine. It seems to just be the injetables. I was able to get ALL of my Avinza (oral morphine) with no problem.

I also thank Tigerlilly for posting about her unfortunate problem re: not being able to get morphine injectable from the pharmacy. This leads me to believe that maybe my pharmacists really HAVE been doing all they can to get my morphine injectable. If they can't get it from their distributer, then their hands are tied.

That's why it's helpful to post on a CP board like this. I'm really glad I didn't file a compliant against the pharmacist, because she really might be doing her best to get the morphine injectable. I know she mentioned that there is some sort of problem with the distributer, I think. Or maybe it was the manufacturer? I can get pretty confused when my pain levels are this high.

Thanks for your kind words.

Eva

[Tigerlilly50]

The one vial per month is for the multi use vials. In Florida we have bergin, McKesson, and cardinal as distributers. Cardinal (cvs uses them) as set a one per month limit. Bergin seems to have a little better access but still hard to get. The individual doses are back ordered. Might consider trying to get a bigger vial. I have never had a problem until the beginning of this year. I actually left my front door unlocked as I was certain I was going to need 911 one night last week and didn't want them to break down the door. It's hard to explain the excrutiating pain you are in and the need fr strong c2 drugs. Hope it gets back to normal soon. Good luck.

[Tigerlilly50]

Eva, try small independent pharmacies. I have no luck with Walgreens, cvs, or any major chain. Since January all of mine has come from small pharmacies. I always had a rule of one doctor, one pharmacy but the smaller ones ave been pretty understanding. Someone mentioned the 50 mg multi dose vial. That's a single use vial for use in surgery. Needs to be diluted in 1000 cc. I know because they ordered me one and if I hadn't recognized it (I'm an rn) I might have used it, so far my local small pharmacy has half of my ms in but it's time for my next script. It's crazy. Hope this helps.

[Tigerlilly50]

Right now the manufacturer, west ward, has all in stock in limited quantities except the individual doses. The distributers has to order it but the dea is starting to set limits so the pharmacist can't get what you need. They are probably doing their best. I even called west ward to find out the real issue and some of it had to do with Baxter not making it anymore so it all went to west ward and they changed the NDC numbers which confused everyone.

[Eva 14]

Tigerlilly, thanks for your help. I really do sympathize with the excruciating pain that you are experiencing.

I'd never experienced a morphine shortage until this Summer. My chain pharmacy has actually always been good about ordering it for me ahead of time.

It wasn't until I went 3 and a half weeks without injectable meds that I realized just how severe my pain really is. I've been in pain management for 3.5 years, so I'm used to having my pain well-contolled. I hadn't suffered this much in years!

After 3.5 WEEKS, My pharmacist FINALLY handed me back my prescription, and once I had my script in hand I was able to go to other pharmacies. Within minutes, the OTHER pharmacists were able to tell me 1) The revised dosage of morphine had been written out incorrectly by my doctor. The dosage he wrote doesn't even exist. And 2) They told me that there was a nationwide morphine shortage and NOBODY could get it. (My own pharmacy told me NEITHER of these things. THey promised me they could get a med that doesn't even exist!).

I thank God that MY pharmacist finally gave me my script back---she was actually really reluctant to do so. I had to go there in person and BEG and tell her how much pain I was in.

So on Monday I called my pain doctor and gave him all of the info I'd learned from the OTHER pharmacies/pharmacists. I asked him if he could please substitute Dilaudid injectable AND I asked him to call an indy pharmacy near his office to verify that they have Dilaudid injectable in stock. (My pain doc's receptionist is really nice, but she insisted that *I* make the call to the indy pharmacy).

I'd never been to that pharmacy before and here I was, calling up and asking them if they had injectable Dilaudid in stock! I knew that would be weird. Of course they were kind of suspicious, asking who I was and where I was calling from. The pharmacist confirmed that they had Dilaudid injectable in stock, but that's as much info as HE was comfortable giving out over the phone. I can't say I blame him. My pain doc's receptionist wanted me to ask what dose they had in stock , etc., but the pharmacist just said, "Your doctor needs to call me". I totally understood, because I could have gotten the dosage mixed up. When dealing with mg to milliliters AND total milliliters distributed, it gets VERY confusing.

Fortunately, I was able to see my doctor and bring in the OLD rx from the pharmacy. My doctor had called the indy pharmacy near him and had a script for Dilaudid typed out. I filled it at the indy pharmacy near his office. NONE of the pharmacies near my home stock injectables, but my chain pharmacy had always been able to order them.

I'm so sorry that you can't take a morphine substitute. I hope you're able to get SOMETHING soon. I HATE this new rule about the DEA setting limits on how much a pharmacy can order or have in stock! It makes me so mad, because it's causing so many people so much suffering. I HOPE that they can still order the small single-dose ampules.

P.S. SO glad you noticed that the 50 mg. multi-dose vial needed to be diluted. I'm pretty good with meds and always try to read everything first, but anyone can make a mistake. Surprised your pharmacist didn't mention that info to you.

I hope you get relief soon!

Best Wishes,
Eva

[Mark N]

Eva, I was reading your post and felt really bad that you went 3.5 weeks without your injectables. You commented that it made you realize how bad your pain is and that is what happens to me from time to time. I really don't like taking my meds so I decide it is under control and I can cut back some so I am not taking so much medication. It doesn't last long as my pain kicks in to remind me what my body is dealing with when I don't have my meds to control the pain. It is shocking how strong our pain is without the meds to keep it bearable. I hope the shortages stop soon and you have a regular stream of meds coming into the pharmacy.

[Tigerlilly50]

Hi Eva, the pharmacist didn't realize what she had given me was only used in surgery, not for multiple dose. Even scarier than that was when I called hospira, the manufacturer, their helpline told me that I could safely take it. Wrong, wrong, wrong.. My small pharmacy has been great. Walgreens here won't even or maybe can't order injectable c2 drugs. The big issue with the injectable shortage is on the manufacturing side. It's hard to even get lidocaine now. After Canada recalled ALL their morphine I think we may have helped with some supply. I just deal with it and know the pharmacy is trying their best to get it for me.

[Eva 14]

Mark, thanks for your kind words. Tigerlilly, I hope you're able to get your meds soon. Sorry about your pain. I did read about the Canadian morphine recall, so I'm sure that's effecting the U.S. supply, too.

I was really saddened when I realized just how severe my pain is WITHOUT the proper meds. I always knew my pain was severe, but I'd forgotten that my pain is absolutely excruciating without the injectables. I feel sad that the only way I can have a semi-normal life is to take injectable pain meds, but we all do what we have to do. Sorry about your pain, Mark. Pain IS overwhelming----I feel like I'm locked in a world of pain.

I wistfully think back to when I was able to take vacations. I could wake up early, be on a plane or tour bus for hours, and NEVER have to give a thought to even having to take a pill, let alone an injection. It really limits the activities that one can do. Thanks to everyone for your words of support.

Let's hope these shortages end SOON!

Eva