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9 days later, they changed their mind and rescinded the decision.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: