The Hospice Clinician Blog

Opioid Medication Shortages in Hospice Care

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Best Practices for Dealing with Opioid Shortages in Hospice

Occasionally hospice and palliative care programs have to deal with shortages of medications that are essential to providing quality end-of-life care. We are reminded to remain aware of this issue as it has been a year since the major shortage of opioids affected hospices nationwide. Whether a regional or national shortage, there are some things you can do to help alleviate the problem until resolved.  

• Check with your pharmacies regularly to determine which opioids are available at which pharmacies. Availability may change frequently. This seems to vary not just from one region of the country to another but from one pharmacy to another within the same town. If your hospice has a relationship with a Pharmacy Benefit Manager, utilize their assistance and possible Mail Order options (if shortage is regional.)
• Communicate and share this current supply information among nurses and physicians to reduce problems and delays related to ordering products that are not available.
• Physicians and nurses should be prepared to convert patients from one opioid to another in the event of specific product shortages. Once again, if your hospice has a relationship with a Pharmacy Benefit Manager, utilize their pharmacist consultation services to assist.
• Have equianalgesic conversion references available to help nurses and physicians with opioid conversions.

We have included an abbreviated opioid conversion chart to help. For more information about conversion to methadone, refer to our previous blog article Methadone for Hospice Patients.