Lack of drug led to 'agony' death

fruitfly

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Lack of drug led to 'agony' death
BBC News
July 12, 2006

The former husband of a mother of three says she died in agony from cancer because of a shortage of a painkiller.

Joe Fortescue from Alfreton, Derbyshire wants the government to provide more diamorphine, which has been in short supply since 2004.

He said his 49-year-old ex-wife from Nottingham was screaming in pain in the days before her death because it was not available.

Gedling Primary Care Trust said there was a national shortage of the drug.

Highly effective

Diamorphine is an opiate produced from poppies.

"I want to know why the drug is not available more readily to make patients comfortable in their last hours," Mr Fortescue said.

He said his former wife was diagnosed with cancer three years ago and had been prescribed morphine up until a few days before her death.

She was then prescribed diamorphine, which is a stronger derivative of morphine, but the supply ran out and the district nurse was not able to replace it, he said.


We cannot meet much more than 50% to 60% of the market demand
Pharmaceutical firm Wockhardt

"The district nurse rang around but couldn't locate the drug - if you went on the street you could probably buy heroin illegally in five minutes, but you can't get a prescribed drugs for days," Mr Fortescue said.

Pharmacist Lyndon Close of Burrows and Close Pharmacies said: "There is nothing as effective as diamorphine for battling the immense pain that patients suffer in the later stages of a terminal disease."

He said the supply shortage dated back to December 2004.

"This has been going on for a year and a half - since then we have been scrapping for supplies almost on a weekly basis."

He said there are some dedicated poppy farms in the UK to produce raw material for the medication, but there were stringent controls on them.

Screams of pain

Mr Fortescue said: "I don't want anybody to go through what my three children had to go through - the hell of having to listen to their mother scream in pain."

Gedling PCT said it was aware of the problem with the supply of diamorphine and had been consulting Macmillan Cancer Care and the GPs who support that service on the best way to resolve it.

"A scheme will shortly be launched for certain pharmacies across Greater Nottingham to hold stocks of palliative care drugs such as Diamorphine... to be able to supply them at short notice," it said.

The pharmaceutical firm that supplies diamorphine, Wockhardt, said: "Capacity constraints in our manufacturing facilities mean that despite our best efforts we cannot meet much more than 50% to 60% of the market demand".

The Department of Health was not available for comment.

Link
 
Outrageous.

If that was my loved one I'd be down in the ghetto coppin heroin. Nobody should suffer like that.
 
Read that in the paper today, how shit.

If i had been the husband or son i'd been either breaking into a pharmacy or buying something off the streets.
 
Uh... why couldn't they just find one of at least a half dozen other opiates to prescribe her in place of heroin?

Also... what makes this article great is that it comes from the UK... where the papers go out of their way to demonize heroin. In fact, there was one published just yesterday about a girl who needed to have her arms amputated. Of course, this article mysteriously fails to mention that diamorphine and heroin are one and the same.

Not to mention claiming that this lady died from pain due to the lack of a drug is about as silly as the article last week where a father claimed his son killed himself because he smoked marijuana.

Are there any rational human beings alive today?
 
davesoviet said:
Not to mention claiming that this lady died from pain due to the lack of a drug is about as silly as the article last week where a father claimed his son killed himself because he smoked marijuana.

Where are you gettin that from? She died of cancer, not lack of heroin. I don't think the article is implying that heroin would have saved her life. She would have died anyway, that's what terminal means. She just didn't have to die screaming in pain.

I agree with you on the unusal insistance on heroin. Any number of painkillers could have lessened her suffering.

I don't care what you call it. If I'm dying of a painful, terminal disease I want large amounts of any and all opiates.
 
my stomach turns.

also, if he can find heroin on the street in 5 minutes why the HELL didnt he do it??

that kind of makes me mad, im assuming hes just assuming. ''demonizing heroin''

i cant find any fucking heroin...
 
I'm amazed she wasn't prescibed Fentanyl. Though, Diamorphine would have made her last hours more pleasant.
Very, very typical that the health department weren't around to comment. At-least it shows that they're guilty.
 
Malice said:
Where are you gettin that from? She died of cancer, not lack of heroin. I don't think the article is implying that heroin would have saved her life. She would have died anyway, that's what terminal means. She just didn't have to die screaming in pain.

The headline.

'Agony death'. Which implies the agony of pain did her in a bit faster.
 
davesoviet said:
Uh... why couldn't they just find one of at least a half dozen other opiates to prescribe her in place of heroin?

It is strange... in the UK one can get fentanyl, dilaudid etc on prescription, although they're extremely tight with them and you generally have to be dieing of cancer. Which she was though...

Also... what makes this article great is that it comes from the UK... where the papers go out of their way to demonize heroin. In fact, there was one published just yesterday about a girl who needed to have her arms amputated. Of course, this article mysteriously fails to mention that diamorphine and heroin are one and the same.

Indeed I have noticed this too.. see this news article - UK: Department of Health running out of smack - posted 18 months ago which details the shortage mentioned. In this too they studiously avoid saying that diamorphine is the same as heroin. Typical... the government also never mentions that the National Health Service dishes out 20,000 doses of heroin a day (when there isn't a shortage) - it wouldn't look good for their anti-drugs propaganda 8)

Meanwhile our troops are in Afghanistan, drumming up support for the Taliban by destroying the very crops that we're short of. :\
 
A bit off topic but i got a question, If i had herion prescribed and they had none left so i went and got street herion and then got searched by police and they found it. would it be illegal? herions a bit far fetched because its prescribed at the last stages of death but for another drug.
 
^Most definitely it would be illegal. But, it would be likely the magistrate(?) would hold some sympathy for the situation and grant you some form of leniancy. You might even get away with it too, but it's most definitely not "legal".
 
fruitfly said:
"The district nurse rang around but couldn't locate the drug - if you went on the street you could probably buy heroin illegally in five minutes, but you can't get a prescribed drugs for days," Mr Fortescue said.

Nottingham Queen's Medical Centre is only a few miles from Gedling and one of the biggest hospitals in Europe. I find it difficult to believe that they did not have any Diamorphine available. I would guess that, in this instance, this is just as much about red tape than lack of stock.
 
Could see the headlines

"Husband kills terminally ill wife with heroin"
 
Well, first of all, the woman was clearly an outpatient - as evidenced by the role of the District Nurse. Ms Fortescue had probably been prescribed morphine in tablet form (perhaps), maybe moving to another administration route before being finally placed on diamorphine (which could have been administrated in any number of safe ways).

When the diamorphine ran out, morphine probably wouldn't have been a realistic option. In her final days, sucking on a mophine tab or sticking a suppository up her arse wouldn't have been preferable or sufficient - thus either subcutaneous or IV drip would have provided consistent and measured relief.

Unfortunately, the solubility of morphine isn't that great, meaning that it would have to be diluted into a fairly large solution in order to provide a decent dosage, thus ruling out subcutaneous administration (there's only so much that can be given through this route). With that in mind, the only route available for large-dose morphine administation would be via IV drip. Unfortunately, I'm not convinced that medical staff can set up such a rig outside of a hospital environment, largely due to risk (I know, I know... it's daft considering she's a terminal patient...)

For all we know, she and the family may have declined to enter hospital (as is often the case with terminal patients), thus limiting the choices of alternative treatment. Not that that excuses the shortfall or obscure treatment choices... but it just offers some context to the story.

Fentanyl wouldn't have been such a great choice either. Off the top of my head, I think there's a high degree of 'reaction' to fentanyl.

Regarding the shortfall, the company involved in its production suffered a severe quality control failure a couple of years ago and have had sourcing problems ever since. Christ, they should see my parents back garden... they grow poppys for their beauty!
 
7zark7 said:
Nottingham Queen's Medical Centre is only a few miles from Gedling and one of the biggest hospitals in Europe. I find it difficult to believe that they did not have any Diamorphine available. I would guess that, in this instance, this is just as much about red tape than lack of stock.
Most likely a factor.

I wonder if the Acute Trust was in communication with other Trusts with a stake in her care?

Sorry for the double post... just venting... :X
 
it annoys me that they fail to mention that diamorpine and heroin are the exact same drug. most people reading the article would not make that connection
 
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