Ramona VNA and Hopsice Press Release:
The Current Morphine Shortage Crisis

As a result of the recent actions taken by the Federal Drug Administration (FDA) regarding morphine, hydromorphone and oxycodone there has been a great deal of concern and many questions raised by hospice and palliative care organizations and more importantly by hospice and palliative care patients and their families who we serve.

In early March of this year the FDA ordered the Ethex Pharmaceutical Company to stop manufacturing immediate release morphine and by the end of March had extended this order to nine other pharmaceutical companies and expanded the list to include immediate release hydromorhone and oxycodone in addition to the morphine. This action by the FDA severely limited our ability at Ramona VNA & Hospice to provide the highest quality pain management to our patients.

Fortunately there was a swift, concerted and professional response by individual hospice and palliative care organizations, the National Hospice and Palliative Care Organization (NHPCO), the American Academy of Hospice and Palliative Medicine (AAHPM), the Center for the Advancement of Palliative Care (CAPC), the Hospice and Palliative Nurses Association (HPNA) and ProCare HospiceCare (our pharmacy consulting group) to the FDA asking for reconsideration of these stop orders. Due to this overwhelming response the FDA amended its March stop order on April 9th allowing those companies currently manufacturing immediate release morphine to continue to do so on an interim basis “until and FDA-approved version of this product or other acceptable alternative therapy becomes available for this patient population.”

Unfortunately throughout the United States there continues to be an acute shortage of concentrated morphine solution as well as several oxycodone products. Just as in other economic models the rule of supply and demand applies to the Pharmaceutical industry. As a result of this FDA action and resultant product shortage, the cost of morphine concentrated solution, oxyodone concentrated solution, tablets and capsules is certain to significantly increase. We at Ramona VNA & Hospice find this particularly concerning during this difficult economic time in our country.

Immediate release morphine has been used to manage pain in hospice and palliative care patients for many years in a very safe and effective manner. The physicians, nurses and pharmacists at Ramona VNA & Hospice are well educated, highly trained and bring a wealth of experience in pain management to our patients. We at Ramona VNA & Hospice are dedicated to assuring that our standards for the management of pain, which includes the use of immediate release morphine, remains at the highest level of safety, efficacy and quality.

Ramona VNA & Hospice along with ProCare HospiceCare will continue to work with our state and national organizations to assist the FDA and the pharmaceutical companies to bring these products through the approval process in a safe and timely manner. If you have any questions or concerns about this very important issue please contact Lynmarie Hoover, Hospice Program Director, at 951-658-9288.

(We have available an excellent recent podcast by one of our board certified palliative physicians - Dr. Stevens, on The Myths of Morphine. You can access it by going to our Podcast Page.)