Published: Nov 09, 2012 5:26 PM EST
Updated: Nov 09, 2012 6:42 PM EST

LEE COUNTY, Fla. - Cause for concern.  EMS workers in southwest Florida say they're worried about a shortage in pain medicine that first responders use.  Things like morphine are in such short supply, EMS crews are having to use alternative medicine or mix medicine at all hours of the day.

EMS crews that work in southwest Florida said they're watching and waiting because medications they depend on, every day, that they take to call to treat injuries, may become a thing of the past.    

Todd Coulter is the Division Chief of EMS for Estero Fire Rescue.  When it comes to the future and medications for patients, critical is Coulter's level of concern.

"27 years I've been doing this and I've never seen the problem.  Its daily," said Coulter.

A daily issue of certain medications like morphine and fentanyl, used to treat pain, are not readily available for the people who are first on scene: paramedics.

"For right now, our pain meds we don't have any right now so that creates a problem for someone who has a broken hip or a fractured arm," said Coulter.

The good news is, Estero Fire has dual response with Lee County EMS and Lee County carries some of the pain medication Estero might not have.  But soon, that could stop.

"How does it make you feel knowing that there might be a call where you guys can't help a patient the way you should be able to?" said Genevieve Judge, WINK News reporter.

"Good concern.  One of the things that we do, people count on us to be there and to have the equipment and the medications to take care of them," said Coulter.

And some medications they have in stock, can't even be used.

Expired medication is used for training and not for actual medical use because just one day past the expiration date in the state of Florida means medics can't use it.

"This just isn't Estero or even Lee county, this is nationwide so its got to be fixed from the top and come down," said Coulter.

At Lee Memorial Hospital, John Armistead is the Director of Pharmacy.  He said doctors are seeing a number of drug shortages that affect patient care but he believes the issue is on the decline.  However, some pain medications EMS crews use have increased in price from 75% to 180%.  Armistead said one of the main issues for the shortages, the economy.  It's too expensive for the drug companies to make.

"Juggling and kind of dealing with moving drug from one hospital to another to meet patient care need is now a daily occurrence where in the past it might have been more a couple types of month we would do this thing," said Armistead.

So if medication isn't available when you or a loved one needs it, what does that mean for you?

"There are drugs of choice and drugs of second choice if you will so sometimes we have to go to the drug of second choice to treat an individual patient.  Its not necessarily bad but it may be a different side effect profile or may require different monitoring," said Armistead.

While not bad, second choice drugs could cost you more out of pocket.  Armistead said an issue is doctors prescribe medications that aren't available.  He said from here, doctors need to get on the same page, work to put a plan in place to discuss what's best for the patient overall.  

As for Coulter at Estero Fire Rescue, patient care is the top priority for the medics first on scene.

"I don't think its a patient care issue at this point.  Could it be?  Absolutely.  At this point right now, there is nobody at risk and nobody at harm.  We're just going to have to be creative and take care of our people and our patients," said Coulter.

There are about 70,000 drugs on the US market and doctors are seeing shortages in around 200 to 300 of them.

Medications like morphine and fentanyl are seeing back orders into early 2013.  Coulter said this critical care drug shortage is predicted to last another three to four years.