Buprenirphine stock shortage

[smilingjane]

Morning friends

My chemist is finding it difficult to obtain my weekly Buprenorphine script sometimes.

This time I have had to wait 3 weeks.

Luckily I have accrued an emergency supply for situations like this.

I am the only patient on their books that they provide to and my surgery tries to steer clear of prescribing this form of opiod.

Does anyone else have this problem and does anyone know why this happens?

The chemist did tell me that they have four suppliers and that those suppliers have a quota of each product and when that runs out theres nothing.

What does everyone think is going on?

[Madlegs1]

There is a world wide shortage in manufacturing capacity across all medicines.

This has been made worse by COVID and various other upsets of trade routes. Also increased demand for war impacted areas.

Most modern countries have websites that monitor such shortages.

Oxycontin 10mg was unavailable in Ireland for about 2 months earlier this year. Oxycontin 5mg wasn't affected. Go figure!???😝🍀

[smilingjane in reply to Madlegs1]

Hi Madlegs, thanks for responding :)OMG ..... at least 5mg was available.This is scary stuff, esp' with these particular meds. What would I have done without my emergency stash?

And the idea that there are people out there unable to take their script from chemist to chemist.

Thinking ahead ... if it becomes that I cannot obtain my script and my supplies run out, what would the GP give me and others as a substitute?

Back to Oxy or ..... This is very worrying. I am relectant to contact my GP in case they try to give me something less suitable

[Madlegs1 in reply to smilingjane]

Hopefully, as in my case, the pharmacist is allowed to be creative.

There may be different strengths available, or different manufactures. Or even alternative opioids such as methadone etc.

But there may be severe restrictions on changing opioid prescription and I wouldn't have much( read "any") faith in regulatory bodies reacting with lightning speed to rectify such situations.

Only alternative in such situations might be to ask the local teenagers for contacts on the "street ".

Doesn't say much for our enlightened modern civilisation???😥

[SueJohnson in reply to Madlegs1]

At least in the US I sure wouldn't go to getting them illegally on the street as some have been laced with fentanyl which has caused many deaths.

[Madlegs1 in reply to SueJohnson]

Exactly!

[smilingjane in reply to Madlegs1]

My pharmacist can be creative in dose only and there are unfortunately restrictions in changing opiod scripts.Thing is of course, (I think) There arn't any similar opiods to Buprenorphine. Obv' methadone is better than nothing but I have read that can (for some) eventually result in augmentation.

I wonder what eastern medicine may offer ... Kraton ..... its a bit gritty though!!

[SueJohnson in reply to smilingjane]

It's tramadol that can result in augmentation, not methadone.

[smilingjane in reply to SueJohnson]

Oh is it? thanks for correcting me

[Joolsg]

Utterly terrifying. We would all go straight into withdrawal. As Madlegs says, there is a worldwide issue with medicines manufacturing.I have a very good relationship with my local pharmacy ( small, family run) and I know they will be creative if need be.

[smilingjane in reply to Joolsg]

Jools,In which way would they or, are they allowed to be creative??

For my future reference!

[smilingjane in reply to smilingjane]

I am very nervous of mentioning this to my GP in case they take it away from me.Do you know if they can legally do that?

[Madlegs1 in reply to smilingjane]

You can certainly have a conversation with your doctor about the situation and your fears.

You can ask him/her/them what strategies they have in place to ensure your continued good health.

You can emphasise how threatened you feel and what terrible steps you are contemplating if they don't have a satisfactory backup strategy in place with your pharmacy.

They cannot stop your medication.

All the best.

[smilingjane in reply to Madlegs1]

Thanks MadlegsI am copying this down for gp conversation.

[Madlegs1 in reply to smilingjane]

Oooh! I'm going to be famous!!😝

(Or infamous?)🤔

[smilingjane in reply to Madlegs1]

Ha!!!

[Joolsg in reply to smilingjane]

My pharmacist calls around several different supply companies and also other chemists. He always manages to find stock that way. Boots and larger companies just won't do this.

[smilingjane in reply to Joolsg]

Intetesting.

When I call pharmacists they say they can't say for def' whether the product will arrive from the suppliers until their orders arrive the following morning from the script being handed to them

I have a good indi chemist who uses four suppliers. You are right, local indipendant chemists can be so much more helpfull

[ChrisColumbus]

There are a couple of health professional subscription databases which record current shortages: it's possible that your GP Practice Manager may have such a subscription and may (or may not) be able to advise you/your pharmacist

[smilingjane in reply to ChrisColumbus]

Interesting Chris, thank you

[Madlegs1]

This is a screenshot of the Irish information.

Shows what is in deficit and when may be expected to return.

I'm sure there is one for UK.

O

[smilingjane in reply to Madlegs1]

Thank you for that Madlegs

Very intetesting.

Do you pay a subscription to obtain this info?

[Marlayna]

I am in the US and even from state to state there are different problems. I’m currently living in Nevada and have to have an oxy prescription called into Los Angeles and find a way to go pick it up. Smaller cities in California are often out of it with no telling when they will get more. Nevada simply would not fill my prescriptions. It terrifies me to think what would happen if I ran out. By 3 PM every day I am in great discomfort. I literally cannot imagine a night without medication.

[smilingjane in reply to Marlayna]

Oh MarlaynaWhat a horrible situation you are in.

It sounds as if you are not on a high enough dose to cover 24 hours.

Is it harder to obtain Buprenorphine than Oxy in the states?

[Marlayna in reply to smilingjane]

I don’t know. I will ask Dr. B. about this the next time I see him.

[smilingjane in reply to Marlayna]

Are you going to ask for an appropriate dose to cover you 24/7?

[smilingjane in reply to Marlayna]

Or send an urgent email.No one should have to suffer the terrible nature if RLS when there are meds out there to help.

Ii am doing well on low level Bubrenorphine.

[dickJones]

Yes, it’s a real problem. Out of 5 chemists in my town, only 1 - Lloyd’s - carries stock of Buprenorphine tablets. I’m going into town today to try to get a dialogue going with Bell Chemist, my pharmacy of choice. It’s a small outlet and there’s more chance of getting some personal rapport going. I’ll also have a word with the Lloyd’s branch and try to determine why there’s ready (so far!) availability. Branch ‘creativity’ is the only way of negotiating within what is clearly a serious and worrying problem of manufacture, supply and distribution.

Two additional thoughts. 1. There is a general staff shortage in UK pharmacies and so their capacity to cope with customer anxieties is constrained. 2. Cannabis is a viable treatment for both RLS and PLMD, but if one is to isolate those strains that might address our conditions in the UK, private treatment at a properly constituted clinic is the only fairly straightforward route. In the case of cannabis, at least supply isn’t a problem!

[Strike26]

hi - this keeps coming up as an issue (I experienced 5 days “cold turkey” when my meds weren’t available last year). The primary cause is Brexit and imports into the UK and less often supply problems at the manufacturers, most of whom are in SE Asia. My chemist (large chain) had posters up asking customers to write to their MP re: Brexit problems. This just goes on and on!!! Alex

[Hoochybaby]

brexit?

[Renaul]

I have had the same problem recently. I’m lucky that my GP prescribes 200 at a time so I manage to keep a reserve.

I found an independent chemist who has multiple suppliers and he has no trouble getting my supply.

[smilingjane]

Hi RenaulYes. I'm issued 200 ml scripts and my chemist has 4 suppliers, but sounds like different suppliers to yours.

Do you know which suppliers your chemist use? It would be helpful for me to pass that info on to my chemist.

Also, which part of the country are you in? Maybe that makes s difference too? I'm in the north east. (England).

Thanks for responding

[queenmedieval]

This is mental, never heard of the chemist running out of subbies or methadone before, there would literally be a riot in the pharmacy if addicts got turned away. My pharmacy serves a lot of addicts in this town. As for pharmacists getting creative, that's mental too as they are normally so cautious, on the phone to the drug service with any small concern before dispensing. When I was on supervised methadone a new pharmacist accidentally gave me a double dose (think she got confused as I was supposed to take Saturday's supervised and be given Sunday's to take away). They called an ambulance and wouldn't let me leave. I've literally just finished reducing off methadone, finally clear of opiates after 17 years, but my partner still has a few months to go on his reduction. He will freak out when I tell him there could be a shortage. We rely on this stuff to function. The fear of withdrawal is intense, which is why many of us do have an emergency stash - although we had to break the rules to accumulate it, sounds like it's just as well if we can't rely on the legit supply

[smilingjane in reply to queenmedieval]

Hi QueenmedievalYou are right, it is very frightening.Even though I live in an innercity area, I was suprised when my chemist told me I was the only one on Bup in their chemist.

For some reason others are on Oxy or Methadone. Some come in for their meds daily.

I think if more people were on Bup then this would not be happenning.

It's maddenning to have a chemist offer you your prescription back to take to other chemists to 'try". Imagine if I had run out that day and had nothing.

I wonder in these circumstances whether a script coukd be taken into a hospital pharmacy?

Also I wonder whether hospital (A@E) would be obliged to issue medication to bide people over?