Here's what you should know about the injectable opioid supply crisis: 9 insights

Injectable opioid shortages are hitting hospitals in every department, including operating rooms, emergency departments, cancer clinics and outpatient surgery facilities, The Daily Universe reports. 

Here's what you should know:

1. The shortage was triggered when the FDA discovered sterility problems and other issues at a Kansas-based Pfizer factory in 2017. The company — which makes 60 percent of injected opioids in the U.S. — cut production.

2. Most of Pfizer's injectable opioids won't be back in full supply until the first quarter of 2019, according to the company's Manufacturing Quality Head John Kelly. Pfizer has poured more than $300 million so far into replacing the plant's production lines and other technology.

3. Local injections of lidocaine and bupivacaine, as well as a standard painkiller for eye surgery and orthopedic procedures, are also in short supply.

4. In April, the American Society of Health-System Pharmacists found 98 percent of hospital pharmacists surveyed had dealt with moderate or severe shortages of morphine, fentanyl and hydromorphone. Many hospitals were completely out of one or more.

5. The AMA declared drug shortages a public health crisis in June. The organization urged government agencies to treat it as a national security threat and possibly designate medicine factories as critical infrastructure.

6. The shortages might let up slightly in the next few months, according to the FDA's head of drug shortages, Valerie Jensen. The current opioid shortage began nearly one year ago, and it's expected to continue into 2019.

7. Injected opioid providers Fresenius Kabi, West Ward and Akorn have begun making more, but they're much smaller companies than Pfizer.

The FDA began expediting approvals needed to make more opioids and allowed Pfizer to distribute opioid-filled glass syringes that were previously withheld because of possible cracks and particle contamination.

8. Salt Lake City-based Intermountain Healthcare is one example of a system where outpatient surgery facilities, cancer clinics and acute-care departments are affected. The availability of painkillers varies constantly, Chief Pharmacy Officer Sabrina Cole said.

9. The shortage is forcing physicians and pharmacists across the U.S. to reserve opioids for certain patients and give others less desirable alternatives, which experts say can lead to mix-ups and mistakes.

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