Pharmacists and hospice care providers in Massachusetts say the industry is experiencing a shortage of morphine, a powerful prescription opioid painkiller. And while the causes of the shortage are unknown, it’s already affecting people who use the drug to treat severe pain, including cancer patients and people in hospice care.
“There is a shortage,” said Dina Breger, pharmacy manager at Greater Boston Long Term Care Pharmacy in Walpole. She said it’s been at least a few weeks since the pharmacy was able to get morphine to patients that need it.
“We do have quite a few patients that we service that reside at assisted living facilities that we usually provide morphine in pre-filled syringes, and we are not able to get that medication,” she said.
Breger said morphine has been on back order since July, and a spokesperson for the Massachusetts Department of Public Health said there have been occasional shortages since 2024. Now, with morphine in short supply, hospitals and physicians have to look harder to find it.
Patients in need of the drug have few other options.
“There is no alternative,” Breger said. “It’s the end-of-life medication and clearly they need it for pain.”
Christine McMichael, executive director of Hospice and Palliative Care Federation of Massachusetts, told GBH News the shortage is having an impact, but it is “being managed.”
The U.S. Food and Drug Administration includes some, but not all, types of injectable morphine on its list of current drug shortages. But Pharmacist Saad Dinno, co-owner of Acton Pharmacy, said he’s been having trouble accessing the liquid form of the drug, too.
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Dinno said the concentrated morphine sulfate — a fast-acting liquid form of the pain medication — has been intermittent in the last two to three weeks.
“Right now there’s a lot of ‘out-of-stocks’ is what I’m seeing for the liquid morphine,” he said.
For some patients, switching to the tablet form of the drug is an option — but he says it’s not available to everyone.
“If the patient has a hard time swallowing, we may have to, you know, look at other aspects that are suppository or something like that,” Dinno said.
Alan Lyles, Rosenberg Professor of Public, Private and Nonprofit Partnerships at the University of Baltimore, does quantitative analysis on drug shortages nationally and internationally. He attributes some of the shortage to profit margins.
“In the generic industry, these are notoriously thin margins. And if you look, there are many generic medications that are approved to be manufactured, but that industries are not induced to do that because there’s such a low profit in that,” Lyles said. Morphine is one of those medications, he added.
Another aspect to consider is the uncertainty around the global supply chain and potentially the impact of tariffs that disrupt critical “active pharmacy ingredients.”
Lyles said the current morphine shortage could be the result of either or both — disruption or low margins — and Lyles said the FDA cannot force a company to make a product.
He said there are long-term policy solutions to this problem. For example, in Finland, he said a recent study shows having an obligatory reserve supply of medicines, particularly those at risk of being in shortage, tends to smooth out shortages, when compared to other nations.
For those at home, in hospice care or ambulatory care, where the shortage may acutely impact patients, Lyles suggested taking proactive action to reduce anxiety.
“Reach out to your pharmacist and health care provider,” he said. “Express your concern and ask what their plan is for you or if you are adequately going to be able to meet your needs with morphine.”
