Sedation Drug Shortage

[comfortdentist]

In recent years there have been shortages of more and more drugs and now we have a shortage of sedation and parental analgesics. I recently tried to order midazolam 5mg/cc which I have used for 20+ years. I wasn't able to buy it but fortunately they had some 1mg/cc which I was allowed to buy enough for about 10-15 patients. When I tried to buy some narcotics same thing not available except some meperidine. So I had to settle for something besides what I have used for years. This shortage is in the United States.

[carole]

What does this mean patient wise, I understand what the sedation things are but I don't know what the others are. Does this mean the any numbing drug will be limited as well and maybe rationed. Just because it is in the states doesn't mean it won't effect us in the UK in time.

I don't know a lot about drugs legal or otherwise, so if this is a silly question, sorry for my ignorance.

[TimidLady]

That must be terrible, having to ration it among your patients. Is this due to these medications being replaced by ones you don't think are appropriate/safe/effective? Or is is getting impossible to get anything? I can't help but wonder if this has anything to do with drug companies doing it on purpose for some reason that may have nothing to do with dentistry and everything to do with our healthcare changes.

[comfortdentist]

The shortages are not for local anesthesia only for sedative drugs. There are two reasons it seems.
1. All are generics and due to low prices the manufacturer has a difficult time pricing the drug to make enough money to justify its manufacture.
2. These are controlled drugs which the DEA limits how much may be made each year. This has resulted in shortages recently.

[chickenjen]

So does that mean sedation will slowly stop being an option for patients, then??
I don't know how I would have gotten through 9 extractions without IV sedation...........at the very least my treatment would have been more prolonged. There's NO WAY I could have sat through 9 extractions, completely aware.......I would have had to break up it up into 2 extractions here, 2 there. At the worst, I would have lost my nerve and not went through the treatment AT ALL and I would still be suffering with countless toothaches from countless infections.
How can this be addressed??

[comfortdentist]

the reality today is that you order whatever narcotic you can get. This becomes a patient safety issue as sedating patients is an art different people need different amounts at different times so every doctor gets to know a couple of drugs very well and now many have to change drugs pending availability.