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.
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.