Q&A with Dr. Sahar Swidan - Why there are prescription drug shortages
If you take prescription medication, you may be experiencing difficulty obtaining your prescriptions because of a nationwide shortage of some drugs.
There were 267 new prescription drug shortages last year, an increase from 211 reported in 2010. In 2004 there were only 58. These figures were recently compiled by the University of Utah Drug Information Services, which tracks national drug shortages. We talked about the shortage and other prescription drug issues on 1290 WLBY this past week with Dr. Sahar Swidan, owner of Pharmacy Solutions on Ann Arbor’s Jackson Road.
Lucy Ann: Why has there has been an uptick in shortages of certain prescription drugs recently?
Lucy Ann: You have become known as an expert in pain management, and were featured in on ABC’s 20/20. I think a big problem we have in this country is an addiction to pain medications, like Vicodin. What happens? Why do some people get hooked?
Dr. Swidan: There are a lot of different reasons. We use the term addiction very loosely. These medications you become physically dependent on, meaning if you abruptly stop them you can get really sick. But we become physically dependent on heart medications, where if you abruptly stop them you can get really sick. Addiction is a disease. Not every patient who uses Vicodin is forging prescriptions, doctor-shopping, pharmacy-shopping, and breaking into pharmacies. Obviously that’s more of a disease, an illegal disease if you will. Addiction verses physical dependence are very different terms. Most patients become physically dependent on them, but they’re not necessarily addicted.
Lucy Ann: But what happens when it starts to impact your life and others around you in a negative way?
Dr. Swidan: The way these medications work is that you become physically dependent on them and if you stop them abruptly you’ll go through physical withdrawal and probably psychological withdrawal, so you can get really sick. People become physically dependent and, in the extreme cases, addicted. Most patients use these medications for legitimate pain uses, but definitely there are a few where it’s abused and it’s not used only for pain management. Some of these medications do make people feel good and give them a high so they like the feeling and in that setting, it becomes used for a different reason. It’s not for their pain. And sometimes, most of the patients will tell you, “They don’t even help me that much.” They don’t like them. They make them sleepy, they make them tired, they’re fatigued, they’re not thinking straight, and so a lot of times they don’t like to be on them. It’s just that they don’t know what else they can do to manage their pain because they’re miserable from the pain.
Lucy Ann: There are other things they can do?
Dr. Swidan: Physical therapy has shown to be helpful, water aerobics, some of the supplements and vitamins have been shown to hugely help with increasing pain management. Diet is very important for pain management. Topical pain medications that we use where some of the medications can be applied directly to the area of pain versus taking a pill and having it go everywhere and maybe get to the site of the pain. There are a lot of integrative methods of pain management. Looking at hormones and optimizing people’s hormones sometimes can really help with their pain management also. Opiates patients use can cause a lot of hormonal deregulation in the body, so sometimes fixing the hormones, fixing the diet, some of the supplements in vitamins, some of the topical pain medications, physical therapy, and occupational therapy all in a comprehensive approach, can help patients achieve the best pain management.
Lucy Ann Lance co-owns Lance & Erskine Communications, which produces “The Lucy Ann Lance Business Insider” (M-F, 8 a.m.-11 a.m.) and “The Lucy Ann Lance Show” (Saturdays, 9 a.m.-12 p.m.) on 1290 WLBY. The programs are live streamed at www.1290WLBY.com, and podcast on www.lucyannlance.com. The above interview is a condensed version of a longer conversation that is edited for clarity. The complete audio interview is posted online at www.lucyannlance.com.
Wed, Jan 18, 2012 : 2:48 p.m.
Bravo to Dr. Swidan for telling it like it is. Pharmacy Solutions is a great alternative to your typical chain drugstore. They have a wonderful, caring staff who always take the time to answer questions or to help educate their patients, and they also offer regular free workshops on a variety of health issues. Despite the individual attention, I have never had to wait longer than 5-10 minutes to have a prescription filled. After using Kroger, Meijer, CVS, and Rite-Aid for prescriptions, we switched to Pharmacy Solutions years ago on the recommendation of our Dr., and it was some of the best advice he could have given us. I am really glad that a place like this exists, and wish more people knew about it.
Sun, Jan 15, 2012 : 1:36 p.m.
Here's a link to a press release about some U-M research on this same topic, and its impact on hospitals nationwide: <a href="http://www.uofmhealth.org/news/drug-shortage-0712" rel='nofollow'>http://www.uofmhealth.org/news/drug-shortage-0712</a> Kara Gavin U-M Health System Public Relations
Sat, Jan 14, 2012 : 11:39 p.m.
Are these drugs in short supply in Canada? How about Mexico? I understand they are typically a fraction of the price we pay here.
Sat, Jan 14, 2012 : 5:05 p.m.
Sure would have liked to have heard more about the issue of drug shortage. Isn't that the topic in the headline?
Sat, Jan 14, 2012 : 10:18 p.m.
Yeah this is shoddy reporting.
Sat, Jan 14, 2012 : 3:42 p.m.
Raw material shortages,yep you bet. The shortage is on the bottom line but supply and demand will change this problem.
Sat, Jan 14, 2012 : 3:37 p.m.
Most likely there are existing government regulations plusitems in our newly crafted Obama care that are affecting and will continue to affect the availability of medications. If it's not profitable then the drug companies aren't going to produce the drugs; it's that simple. Whether you supported Obama care or not it will affect your life if you are someone that needs medication. There will be les and less medications available as the government continues to squeeze suppliers and manufacturers over reimbursement rates. There are already declining numbers of doctors and they will continue to ecline as reimbursements continue to be less that costs. The end result of Obama care will be that people who used to be kept alive with expensive treatments and medications will be given counseling and pain management (if it's available) plus hospice care. Good luck especially if our leader gets re-elected and some of these rules aren't repealed.
Sat, Jan 14, 2012 : 9:54 p.m.
Let me see if I understand this correctly. Right now, many people can not afford to receive proper care. They end up in the ER when their situation becomes too bad for them to manage. These people should continue to be denied affordable care, because if they are not, there might not be enough doctors for the people who are currently able to afford care. I also understand that these people should be denied ER care, because they were not responsible enough to see a doctor before they got so sick. Oh, and drug companies intentionally create addicting medicine so that so many people will want the medicine that they can't keep up with production, and will then raise prices because there is a shortage. Have I got that all right?
Sat, Jan 14, 2012 : 8:52 p.m.
Doctors' groups and medical schools had hoped that the new health-care law, passed in March, would increase the number of funded residency slots, but such a provision didn't make it into the final bill. "It will probably take 10 years to even make a dent into the number of doctors that we need out there," said Atul Grover, the AAMC's chief advocacy officer. and The main cause of the shortages is production problems at factories, the GAO found. Industry consolidation has left fewer facilities to make drugs, so when one falls behind, the rest of the system tries to catch up. Per the FDA: In 2010, a majority of the drugs in shortage had quality and manufacturing problems. Some of these quality problems included the presence of particulates, microbial contamination, and newly identified impurities in sterile injectables. Companies sometimes voluntarily stop production or suspend production of critical drugs when manufacturing problems occur so that they can resolve the root cause of product-quality problems. Some of these issues are complex, and companies may need to take substantial amounts of time to correct the underlying cause of the problem.
Sat, Jan 14, 2012 : 8:40 p.m.
"The new federal health-care law has raised the stakes for hospitals and schools already scrambling to train more doctors. Experts warn there won't be enough doctors to treat the millions of people newly insured under the law. At current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges. The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007." online.wsj.com/article/SB10001424052702304506904575180331528424238. html
Sat, Jan 14, 2012 : 5:53 p.m.
Well, at least you hit the problem right: 'If it's not profitable then the drug companies aren't going to produce the drugs; it's that simple.' We really need to get the huge drug companies under control; they 'merged' to the point where they are monopolies and are now trying to force the market to increase their profits. This never should have been allowed to happen. Just take a look at the history of Pfiizer and their long history of criminal actions (fined $2.3 billion and its leadership should have been in jail and the company closed). This has nothing to do with 'Obamacare' but it's not worth my time to show you the facts. You wouldn't listen anyway.
Sat, Jan 14, 2012 : 3:48 p.m.
Is your post conjecture or do you have facts? ( declining number of Doctors) .
Sat, Jan 14, 2012 : 2:48 p.m.
Why does the Dr hate capitalism?
Wed, Jan 18, 2012 : 2:38 p.m.
Maybe because at Pharmacy Solutions they care more about educating patients rather than just making money off them. This is the way a pharmacy should be run, not like the many chain "drive-through" pharmacies we have today.
Sat, Jan 14, 2012 : 2 p.m.
In addition to the shortage of some raw materials, some of the reason is that the FDA has also been more stringent when it comes to drug approvals and production standards. In 2011, the FDA has mandated the halt of production of nearly 200 medications that were found to be substandard in efficacy or safety according to present standards. If a drug shortage is affecting your therapy, ask to have your physician and pharmacist collaborate to determine what alternative medication(s) would likely serve you best. At times, this could even lead to improvement of outcomes.
Sat, Jan 14, 2012 : 12:20 p.m.
I fail to see how drug shortages are connected to abuse and addiction. While taking opioids for pain is necessary in some cases, there is always the risk of collateral damage. The pain management field ignores the potential for addiction, not only be the patient but by friends and family members with easy access to synthetic opioids. But there is good money to be made, and customers with physical dependency are guaranteed to return for more, even if it could be managed with over-the counter pain relief.
Sat, Jan 14, 2012 : 12:30 p.m.
Isn't pain management best left to medical specialists to treat as appropriate vs arm chair "detectives" who post online ?
Sat, Jan 14, 2012 : 11:45 a.m.
Drug companies are learning from the oil industry.