Bend paramedics using expired drugs

A manufacturer drug shortage is affecting paramedics and fire departments nationwide, including those in Central Oregon. The Bend Fire Department has turned to expired drugs, if they don’t have a fresh supply.

At one point in January, when the drug shortage hit hardest, Bend Fire had 11 expired medications in their drug kits. The problem has eased a bit since then, but officials fear the issue will continue.

“We got to the point where we had to make a decision,” said Tom Wright, the department’s emergency medical services program manger. “Either we just not carry the drug whatsoever, or we use the drugs that we had, but were expired.”

Two drugs the department is having difficulty keeping in stock are Versed, a medication used to sedate patients, and a rarely used drug called Ipecac, which is given to patients who swallow a poison and must vomit.

“Expired drugs are used in clinics in Third World countries, and they seem to work okay,” Wright said. “We know that the military has used expired drugs, so we had a history that nothing bad was going to happen by using an expired drug. The worst thing that would happen though, is it may not be as effective. It may not be as strong.”

Worried about the legality, Wright reached out to the Oregon Health Authority, contacted the governors office and spoke with the Food and Drug Administration. He said no one had clear information about the risks.

“So we worked with the legal team the city had, we worked with the city insurance carrier and we worked with physician advisers, who all agreed, it’s better to give an expired drug than no drug at all,” Wright said.

If patients are conscious, paramedics will give them the option of whether they want the expired drug. If they are unconscious, they’ll give it to them.

“We have one ambulance that’s hardly ever used, and it’s kind of the old emergency backup with the old drugs on it,” Wright said. “But the goal is, as we get the fresher ones in, we’ll pull the expired drugs off.”

Wright said after a year and a half of questions, the Oregon Health Authority gave medics permission to carry and use drugs for up to a year after their expiration date.

Bend Fire was the first in Oregon to craft a policy. It’s since been adopted by other departments in the state, and may be accepted by others across the nation.