Cherokee Nation experiencing Tramadol shortage

BY D. SEAN ROWLEY
Senior Reporter
01/13/2020 04:30 PM
TAHLEQUAH – During the Jan. 13 meeting of the Tribal Council’s Health Committee, councilors were told of a medication shortage that could have far-reaching effects among patients in the Cherokee Nation’s health system.

Dr. Roger Montgomery, Health Services medical director, said there was a nationwide shortage of the painkiller Tramadol, which is frequently prescribed to treat moderate levels of pain.

“Common medications used every day across the country ebb and flow in their availability,” Montgomery said. “Tramadol is in extremely short supply and the details of why are not clear, but it originates with the manufacturer. The availability will be a critical issue in the next few weeks for our patients who take Tramadol.”

Montgomery said Tramadol is similar in strength to codeine, or what is prescribed in a Tylenol 3 tablet. Because Tramadol is not as strong as hydrocodone or oxycodone, withdrawal symptoms are usually not as severe. However, those who use the drug to manage chronic pain could experience withdrawal if the drug is suddenly discontinued.

“When our patients go to refill their medication, our providers will use their judgment to refill with an alternative medication,” Montgomery said, adding that Health Services doctors had been notified of the shortage. “It should be best to prescribe a substitute medication during the shortage.”

Since its approval for use in the U.S. during the mid-1990s, the opioid Tramadol has become the 39th most prescribed medication in the country. It is inexpensive and is available under generic names. It is usually given in combination with acetaminophen.

Several committee members had questions after Montgomery told of the Tramadol situation. He said transitioning to a different medication would require patients to visit their prescribing doctors, per state drug regulations. 

“Prescriptions will run out at different times,” he said. “We’ve notified the providers and asked them to make themselves available to see those patients as needed.”

CN Chief of Staff Todd Enlow said the CN would take steps to minimize the impact of low Tramadol stocks.

“It’s unfortunate that there is a national shortage of Tramadol that may affect some of our Cherokee Nation Health Services patients,” Enlow said. “Our health administration has been working diligently to identify patients who may be affected and reach out to other suppliers about shipments. Cherokee Nation Health Services remains committed to serving our patients and providing continued access to care.”
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