Dr. Maryann E. Amirshahi was on her way to work at MedStar Washington Hospital Center in Washington, D.C., on Tuesday morning, hoping her eight-hour shift would be filled with all of the medications she needed to do her job.
But she knew better.
As an emergency medicine physician, she knew three of the most common injectable opioid painkillers — morphine, hydromorphone, and fentanyl — would be in short supply.
Those are first-line choices and vital to her job, especially when treating things such as ruptured appendixes or broken femurs.
“We’ve seen a variety of shortages over time,” Amirshahi said. “What’s been challenging is that second-line drugs are out, too.”
As a researcher who has studied drug shortages, Amirshahi also knew it’s quite common for medically important drugs to be in short supply.
Research she led, published last year in the Journal of Critical Care, found that half of the medications in drug shortages were for critical care.
While the majority of the drugs involved in nearly 2,000 drug shortages from 2001 to 2016 had an alternative available, a quarter of the time those alternatives were also on the short list.
The most common drugs in those shortages were for infectious diseases.
This affects not just Amirshahi’s emergency department, but other hospital workers, medical specialists, and paramedics in ambulances all over the country.
“It’s a problem we need to be aware of, but the public should also know drug shortages are a real problem,” Amirshahi said. “But I don’t want people to be scared to come to the ER. Most people are getting the care they need.”
Not more than nine miles from where Amirshahi practices emergency medicine is the headquarters of the U.S. Food and Drug Administration (FDA).
Officials there recently announced those injectable painkillers and other commonly used drugs are currently available in limited amounts.
That includes even the most basic of medications.