On April 1st, the FDA demanded that the production of concentrated liquid morphine, among others, be stopped.
9 days later, they changed their mind and rescinded the decision.
Had they gone through with the ban, shockwaves would have been sent through the palliative care community. As physician Christian Sinclair notes, with only the lower concentration available, “Giving a dying patient with dysphagia 5ml instead of 1ml to get them 20mg of morphine will make a big difference in oropharyngeal secretions. So then we may see an increase in distress from families, patients, and staff about ‘pooling secretions’ leading to more scopolamine patches and atropine which are unfortunately ineffective at doing anything with accumulating secretions from exogenous sources, like medications.”
It’s amazing that the FDA reversed course in what seemed to be record time. The entire palliative care community, including their organizations, physicians, patients and families presented a united front of dissent, which certainly helped persuade the FDA.
Dr. Sinclair also notes the important role social networks, like blogs, Twitter and Facebook, played in rapidly spreading the message as well as the ramifications surrounding the announcement. Here’s a slideshow summarizing the course of events:
Well done.
Related posts:
- Are patients who enter hospice care really abandoned by their primary care doctors?
- Do not resuscitate or Allow natural death, does it make a difference?
- Palliative medicine as the villain?
- My take: Social networks, Obama, mandates, Super Bowl, military malpractice
- Wikipedia and palliative care
- Social networks for physicians
- Do doctors who use social media prescribe more medications?
{ 2 comments }
What’s particularly shocking is that the agents pressing to “create shortages” (their words) had no freaking clue that the difference in volume of dosage made any meaningful difference.
More to your point of social networks making a difference in a misguided approach to regulation pushed in ignorance of the consequences:
The ability to rapidly mobilize an army of David’s revealing the mistake, exposing an agenda unrelated to patient care, is a very good thing.
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