Agency urges restricted use of some scarce drugs

The Georgia Department of Public Health has asked EMS providers to reserve certain medications for the most critically ill patients, amid a shortage of drugs to treat people in emergency situations.

The state agency is also exploring whether extending expiration dates on medications can serve as a remedy for the EMS drug shortages, which are occurring nationwide.

Public Health has formed a committee to identify the most needed medications. The agency is requesting that the Association of State and Territorial Health Officials create a national list of these drugs, and their doses and forms, to encourage pharmaceutical companies to produce more of them.

The state response to shortages of drugs used by ambulance crews comes in a letter sent Friday from the Public Health commissioner, Dr. Brenda Fitzgerald, to the chairman of the Georgia EMS Medical Directors Advisory Council.

Earlier this month, Dr. Robert Cox, chairman of the advisory council, alerted the public health agency to the problems caused by the shortages. Cox’s letter, obtained by Georgia Health News, said the EMS drug shortages posed a ‘‘real danger to our patients today, without relief in sight.’’

The physicians said there had been reports of expired medication being put to use when up-to-date medication was not available. “The risk of using properly stored expired medication is preferable to helplessly witnessing the death of an adult or a child,’’ said the letter written by Cox.

The EMS physicians had also asked about allowing access to lifesaving drugs from the Strategic National Stockpile.

Fitzgerald said in her letter that the CDC has not opened up that stockpile as a solution. But she added, “I have engaged the CDC and other state and federal partners with the clear goal of ending the shortages and increasing production of these critical medications.’’

“Together, we will find a solution,’’ Fitzgerald said in her letter to Cox.

The Georgia situation is part of a nationwide problem with availability of EMS medications.

A recent article in the Journal of Emergency Medical Services said the shortages first surfaced nationally in 2010, starting with epinephrine, which treats cardiac arrest, and dextrose, which replenishes bodily fluids and nutrients and is used to treat insulin shock.

EMS officials have also experienced shortages of benzodiazepines, which treat seizures and anxiety, and narcotic pain relievers.

The EMS drug gap reflects wider shortages of medications that hospitals, physicians and patients have wrestled with over the past several years.

Drug shortages have nearly tripled from 2005 to 2010 and reached record levels last year, as pharmaceutical manufacturers halted operations or had production problems, the Washington Post recently reported.

The Food and Drug Administration has helped firms resume production more quickly and has approved emergency imports of supplies, the Post said.

“There is always a concern that we will have a shortage of medications,” said Dennis Westover of Metro Atlanta Ambulance in a Saturday 11alive article on the EMS drug problem.

Dr. Patrick O’Neal, director of health protection for the Georgia Department of Public Health, told 11alive: “There definitely have been shortages. They are essentially moving shortages, not the same from week to week, and there is no predictability how long each one will last,” he said.

O’Neal will lead the state committee working on the drug shortage problem.

A Public Health spokesman said recently that the agency is not aware of any impact on Georgia patients from the shortages.