The lone U.S. manufacturer of the anesthetic sodium thiopental announced that it will no longer produce the drug because of its controversial usage in lethal injections, drawing criticism from physicians and pharmacists who say they need the drug for certain patient groups and surgical procedures.

Sodium thiopental is not as widely used in surgery as it once was — propofol and other newer anesthetics having largely surpassed it in popularity — but it's still "considered a first-line anesthetic in many cases," says the American Society of Anesthesiologists in a statement on Hospira's decision to halt its production. For example, the drug may be needed in procedures involving "geriatric, neurologic, cardiovascular and obstetric patients, for whom the side effects of other medications could lead to serious complications." The American Society of Health-System Pharmacists also expressed concern that the drug would not be available for "specific high-risk patients."

Providers had already been dealing with a shortage of sodium thiopental for months, on top of the ongoing shortage of propofol supplies. Hospira's decision to halt production of sodium thiopental was based on pressure the company had received from authorities in Italy, where the drug was being manufactured, to assure that it wouldn't be used in lethal injections. The company couldn't make that promise, so decided to stop production altogether.

"It is an unfortunate irony that many more lives will be lost or put in jeopardy as a result of not having the drug available for its legitimate medical use," says the ASA.

In addition to criticizing Hospira's decision, the ASA notes that the situation points to a larger issue of "the increasing problem of drug shortages that jeopardize patient safety."

Irene Tsikitas