It’s been called the new “it” bag. The “vitamin drip”­—a trendy, expensive treatment

of vitamins and nutrients delivered intravenously—is billed as a way to beautify and

reenergize those who are tired, stressed out, dehydrated, or too busy to get a good

night’s sleep.

X Factor judge

Simon Cowell swears by it.

Madonna,

Cindy Crawford, and the Miami Heat’s

Rashard Lewis have been rumored to be fans.

Meanwhile, unbeknownst to them, patients across the country—especially premature babies—have

been malnourished because of a lack of some of the same nutrients used in the vitamin

drip.

In late May,

Washingtonian reported that nationwide

shortages are threatening the lives of patients who need IV nutrition to survive.

Hospitals have resorted to hoarding, rationing, and bartering. At least 15 people—almost

certainly more—have died. The shortages particularly endanger infants in neonatal

intensive-care units (NICUs), whose young bodies have no nutrient reserves.

Last week, the manufacturer of the most-used adult and pediatric IV multivitamin informed

health systems that its product—which contains B and C vitamins, among others—is now

in shortage. Medical professionals say that, as a result, intravenous B and C vitamins

now may be in danger of also going into shortage. In the 1990s, a multivitamin shortage

led to a widespread thiamin (vitamin B-1) deficiency that caused several deaths.

Amid this public-health crisis, private clinics around the country are using high

doses of intravenous B and C vitamins, and other nutrients that are in shortage, for

nonmedical purposes. In some cases, clinics are taking nutrients out of the same limited

pool that supplies hospitals and home health-care agencies. In other cases, facilities

are injecting clients with nutrients from sources that don’t meet hospital safety

standards.

“Children Are Dying” Special report: Because of nationwide shortages, Washington hospitals are rationing, hoarding, and bartering critical nutrients premature babies and other patients need to survive. Doctors are reporting conditions normally seen only in developing countries, and there have been deaths. How could this be allowed to happen?

Doctors have used the vitamin drip for decades to treat legitimate medical conditions,

but clinics are seeing a recent upsurge in people asking for it for other reasons.

At the Miami Institute for Age Management and Intervention, for example, the menu

of vitamin-drip treatments includes the Recovery Cocktail (“a healthy hangover cure”),

the Healthy Hair/Skin/Nails Cocktail, the Executive Stress Cocktail, and the Skin

Lightening Cocktail, which the institute’s staff says helps Asian-Americans and African-Americans

“achieve a lighter, fairer skin tone.”

Celebrities, models, and business executives are using the drip to make them look

better for photo shoots and other events.

It’s also become popular among athletes. In Washington, professional football and

basketball players have sought out the handful of centers that offer the drip. “It

facilitates muscle recovery,” says

Andre Etherly, business administrator and clinical liaison at Proactive Wellness Centers in Vienna.

“An athlete’s body consumes a lot of things it can’t replace readily—like if a basketball

player has to play two nights in a row, he can’t replenish fast enough.”

Physician

Sakiliba Mines, who owns DC’s Institute of Multidimensional Medicine, treats cancer patients but

also administers IV drips to healthy attorneys, George Washington University students,

and others. This month, she treated a new patient who requested an IV because she

was preparing for the bar exam.

Ever since singer

Rihanna tweeted a photo of her IV line in 2012, the practice has also come to be known as

the “party-girl drip,” leading people to flock to IV centers to use it as a hangover

cure. In Las Vegas, a company called Hangover Heaven offers it out of a bus equipped

to run as many as 14 IVs at a time.

Some of Hangover Heaven’s IV bags contain calcium—which is currently in “absolute

shortage,” according to the American Society of Health System Pharmacists (ASHP).

Simon Cowell has said he receives a weekly treatment containing magnesium and other

nutrients. At the time of this writing, ASHP reports that there is no magnesium commercially

available from any FDA-approved US manufacturers.

Sakiliba Mines reports that she typically uses a concoction containing magnesium,

potassium, selenium, zinc, calcium, and chromium—all of which are in shortage. Over

the past 2½ years, hospitals nationwide have run out of many of them.

Asked whether her clinic has been affected, Mines says, “Not at all. I’m very well

stocked.” Just down the road from her facility, George Washington University Hospital

was out of calcium chloride and short on zinc chloride, magnesium sulfate, selenium,

and other items this past spring.

If hospitals can’t get IV nutrients for ailing infants, how can private clinics procure

them for someone who wants prettier nails or lighter skin?

Mines said she gets nutrients directly from the manufacturers but declines to say

which ones.

Patients Medical, a holistic wellness center in New York City, gets some of its IV

nutrients from Henry Schein, a global distributor of medical supplies. Henry Schein

spokesperson

Susan Vassallo explains that the company serves medical offices, not hospitals, and fills orders

on a first come, first served basis unless the Centers for Disease Control and Prevention

recommends otherwise. Only when a nutrient is on “extreme back order” would Henry

Schein restrict the quantities of customer orders. “We have not done that yet with

these products,” Vassallo says.

Proactive Wellness Centers in Vienna has “not come across any extreme shortages,”

Etherly says. His office buys nutrients from compounding pharmacies, which get them

in bulk from a distributor. Etherly says most bottles the company receives “come unopened

directly from the main manufacturers.” When pressed, he agrees that Proactive Wellness

Centers could, in theory, give vials of nutrients to local hospitals in need.

Etherly says that clinics have more options than hospitals because they’re not constrained

by “policies, rules, and regulations.”

That’s why a bus like Hangover Heaven can obtain nutrients. Anesthesiologist

Jason Burke, who runs Hangover Heaven, says he’s “reasonably skilled at calling around to find

out what’s getting ready to go on back order—we always stay ahead of the game. Hangover

Heaven [sees] a lot of demand for our services. You’re on vacation, you have a hangover,

you feel awful—I can’t let shortages get in the way.”

Burke uses a compounding pharmacy to produce his formulations. He buys nutrients that

aren’t in shortage from a distributor called McKesson Medical-Surgical.

Burke says he’s confident in his source. But compounding pharmacies, which create

made-to-order drugs, have been a danger to patients.

Last October, an outbreak of fungal meningitis killed 61 people and infected more

than 700 because of unsanitary conditions at a compounding pharmacy. Following the

outbreak, the FDA conducted inspections of 30 compounding pharmacies that produce

sterile drugs. Each one had “objectionable conditions,” including unidentified black

particles in vials, rust and mold in supposedly clean production rooms, gloveless

technicians handling sterile products, and employees wearing nonsterile lab coats.

Because of these and other safety problems, many hospitals have stopped using compounding

pharmacies, says

Bona Benjamin, ASHP director of medication-use quality improvement.

Experts say IV treatment centers might also be giving placebos, using expired products,

or diluting the vitamins.

What can be done? The FDA has “very limited authority” to conduct inspections of compounding

pharmacies, spokesperson

Curtis Allen says. During the agency’s spring inspections, some pharmacies were so uncooperative

that it had to get administrative warrants from the courts and US marshals had to

escort the inspectors at the sites.

Distributors don’t police their buyers, either. The GW Center for Integrative Medicine,

a DC facility that offers IV nutrient drips, typically buys calcium gluconate from

McKesson Medical-Surgical, which purchases directly from manufacturers. Spokesperson

Randy King says that the company supplies physicians’ offices, pharmacies, other distributors,

and a few health systems: “We don’t know how [the nutrients] are being utilized once

they’re sold.”

Most healthy people don’t know enough about the shortages to ask whether their hangover

treatment is using nutrients that could otherwise go to a NICU.

But the concern at the root of the shortages is that there’s no centralized system

to monitor the medical inventories of hospitals, home health-care companies, clinics,

and other treatment facilities. If there were a system that tracked the deliveries

of the nutrients, an oversight entity might be able to redirect them to hospitals

in need instead of clinics helping healthy people recover from a hangover or look

good in a photo shoot.

“It’s appalling that we are sacrificing the health of our babies for beauty, energy,

and hangover relief,” says clinical pharmacist

Steve Plogsted, who chairs the drug-shortage task force of the American Society for Parenteral and

Enteral Nutrition. “We’ve got babies’ lives hanging in the balance while we’re worried

about getting through a hangover.”

Alexandra Robbins is the author of six books, most recently The Geeks Shall Inherit the Earth.

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