Painkiller shortage forces Windsor pharmacists to make tough calls

Pharmacies are dealing with a prescription painkiller shortage as they try to accommodate customers with limited supply. CTV Windsor’s Travis Fortnum reports.

A national shortage of a commonly prescribed painkiller is being felt locally — forcing Windsor-Essex pharmacists to ration supply, split doses, and find stopgap solutions for patients in pain.

“We’re basically out now,” said Tim Brady, owner of Brady’s Drug Store.

“We’re limiting people to 30-day supplies instead of three months, just trying to spread it around.”

Brady is talking about Oxycocet, a medication that combines oxycodone and acetaminophen into one pill.

It’s similar in composition to better-known brand names like Percocet (oxycodone and acetaminophen) and Tylenol 3 (codeine and acetaminophen).

Health Canada confirms those are among several products in short supply across the country due to “manufacturing disruptions and increased demand.”

According to the federal regulator, that includes:

• Acetaminophen with codeine: Lenoltec No. 1, No. 3, No. 4, and Emtec-30
• Acetaminophen with oxycodone: Oxycocet, Apo-Oxycodone/Acet, and Rivacocet

“Health Canada recognizes how important these medications are for people managing pain and acknowledges the impact shortages may have on their daily lives,” a spokesperson said in a written statement.

“We understand that this can be distressing for patients and their families. The department is doing everything it can to help resolve these shortages.”

Health Canada said it’s working with manufacturers, distributors, provinces and territories to “monitor the situation and explore options to increase access.”

But for patients walking into pharmacies today, it’s a challenge already at hand.

“It’s scary,” said Brady.

“If you’ve been stabilized… and suddenly it’s not available, you don’t want to go back to that place again.”

That’s why his team is calling around to other pharmacies, dispensing what they can — and, when needed, working with doctors to prescribe an alternative.

Hospitals are feeling the squeeze too.

“We saw this coming,” said Antoinette Duronio, director of pharmacy services at Windsor Regional Hospital.

She said her team reviewed its inventory early and began adjusting distribution to avoid disruptions.

“We review the stock, determine when we might run out and restrict it to the patients who absolutely need it — while finding alternatives for others,” she said.

Mina Tadrous, a pharmacist and drug policy researcher at the University of Toronto, said the shortage reflects the complexity of the pharmaceutical supply chain.

“For one pill to end up in your vial, it probably has ingredients from multiple countries,” he said.

“It’s gone through maybe eight or nine different factories, and it’s ended up in that place. And so, if something along that chain happened, you start to see a domino effect.”

He added:

“It’s what we call is a fast mover — a commonly used medication… You’re faced with a scenario where you have to make tough choices.”

Making those choices could be easier, the Canadian Pharmacists Association (CPhA) argues, if pharmacists had more authority to act independently during shortages.

“Under federal rules (the Controlled Drugs and Substances Act), pharmacists aren’t allowed to prescribe or switch medications like opioids, even in situations like this,” said Tyler Gogo, senior manager of communications for the CPhA.

“We’ve raised this issue before — if pharmacists had more flexibility under the CDSA, they could provide care in a more timely and convenient way.”

Gogo pointed out that while most provinces allow pharmacists to adjust prescriptions for non-controlled drugs, the federal CDSA prevents them from doing the same with opioids like Oxycocet or Tylenol 3.

“That means pharmacists can’t easily help patients switch medications, even when there’s a shortage.”

This restriction exists because opioids are tightly regulated due to their high risk for addiction and abuse, requiring physician oversight for any adjustments.

As for how long might this specific shortage last?

“It’s expected to last into early August,” said Gogo.

Health Canada recommends patients speak with their doctor or pharmacist, “who can help identify alternative treatments or strategies to manage their supply.”

And on the ground, Brady is asking for patience and understanding from those who rely on these medications.

“We’re not trying to make your life difficult,” he said.

“It’s just we can’t get any.”