Drug shortage
Scarcity of Pethidine tablets a challenge for some people with sickle cell
Woman says Pethidine is the only medication that eases the pain of some people with sickle cell.

LOCAL shortage of Pethidine tablets has sparked some concerns among some members of the sickle cell community who rank it as their top medication to alleviate pain.

President of the Pharmaceutical Society of Jamaica Dr Tyrone Smith explained that while the scarcity of the medication is due to a supply chain issue, alternative pain medications are available.

A 26-year-old living with sickle cell said he has not received the prescription drug, Pethidine, since last year.

"I have been experiencing this mostly at public hospitals since October of last year. I am allergic to morphine so I usually get Pethidine, but all of a sudden there is no Pethidine in the hospital. All I have been getting is Panadol," he said.

SMITH...it not a case where pethidine is the only available treatment option

A 23-year-old woman with sickle cell said even though she does not take Pethidine anymore, she believes morphine is being pushed on patients.

"I am not even surprised that there is a shortage, but I don't know why it is an issue to give it to us. It is very irritating, especially if it is the only thing that is helping your pain and they are insisting that you take something else that you know will not really help you. It is as if you have to convince them to give it to you," she said.

She said while she understands that a few people with the disease abuse the medication, "that does not mean all of us are like that".

A 50-year-old woman, also with the disease, added: "I am not aware of the shortage. Many years ago they had stopped giving us Pethidine. I don't even get it at my private doctor; the only time I get it is when I am in the hospital."

A 37-year-old man explained that while he is allergic to Pethidine and takes morphine instead, the pill is commonly used by other people with sickle cell.

"I wasn't aware of this shortage. Morphine is the only thing that can stop my pain but for most people with sickle cell, Pethidine is what they take, and it would not be the first I am hearing about a shortage like this," he said.

According to Smith, the Pethidine tablet being out of stock from the distributor end should not cause a drastic change as the injectable form is available.

"Since that last supplier was exhausted then, they have not been able to get any supplies in as yet. And sometimes it is a case where they are not even sure how soon they will get another supply because you have to appreciate that Pethidine is not one of your regular prescription drugs. It is actually a narcotic, so it is treated differently," said Smith.

"The supplier actually has the injectable in stock but the injectable is going to be used only on the hospital ward, so you would understand that one would have to be admitted on the ward to get the injection," said Smith.

At the same time, Smith said there is a particular inclination noticed among some people with sickle cell, who stick to taking Pethidine as it naturally brings on a euphoric feeling.

"It has to be something that is controlled and managed properly. We have morphine available as another narcotic drug. You don't experience that euphoric effect from morphine but you still get that adequate pain relief from it," he said.

"It is just a matter of treatment options, so it not a case where Pethidine is the only available treatment option. There are persons that actually have sickle cell who have not used Pethidine because, while you have some people that may crave Pethidine for the euphoric feeling that they get, you have some persons who want to avoid it totally for the same reason," he explained.

When the Observer contacted Facey Commodity, the supplier of Pethidine, it did confirm that there is a shortage of the tablet.

"Pethidine is available both in private and government, but in the injectable presentation. The tablet is not available from our main supplier, Martindale, since the second quarter of 2023," general manager for Facey Commodity pharmaceutical, Keisha Nelson Brown told the Observer in a response by e-mail.

She noted that while there have been queries for the tablets, the shortage is not a major concern for the company.

"The main buyer of Pethidine — both injectable and tablets — is the National Health Fund, and on the recently awarded tender there was no request for the tablet presentation," said Nelson Brown.

In the meantime, she said the company is seeking other options to get the tablets.

"We are looking at other possible authorised sources for the tablets. Pethidine as an opioid has to be sourced from authorised manufacturers or distributors as the management of such drugs are closely monitored by the International Narcotics Control Board," she said.

BY BRITTNY HUTCHINSON Observer staff reporter hutchinsonb@jamaicaobserver.com

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