Naloxone, an opioid overdose antidote.
Scott Olson—Getty Images
By Sy Mukherjee
June 5, 2018

In the midst of an opioid addiction and overdose epidemic that appears to only be getting worse, one of the major companies that manufactures a form of naloxone—an antidote for opioid overdoses that U.S. Surgeon General Jerome Adams has recommended more Americans carry with them—has issued a nationwide recall for two lots of the drug. The reason? Those batches of naloxone may be contaminated with “embedded and loose particulate matter” on the syringe plunger that could cause harmful side effects. And it’s the latest in a string of supply chain mishaps for naloxone manufacturer Hospira and its parent company, drug giant Pfizer.

“In the event that impacted product is administered to a patient, the patient has a low likelihood of experiencing adverse events ranging from local irritation, allergic reactions, phlebitis, end-organ granuloma, tissue ischemia, pulmonary emboli, pulmonary dysfunction, pulmonary infarction, and toxicity,” Pfizer stated in its voluntary recall notice with the Food and Drug Administration (FDA). Pfizer noted that its specific version of naloxone is only meant for use with trained medical professionals and first responders.

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Pfizer says that there haven’t been any adverse event reports related to the recalled naloxone lots to date. The drug is now commonly carried by first responders and family members of opioid painkiller and heroin addicts as it can reverse deadly overdose symptoms like the inability to breathe.

But this is far from the first significant public health concern stemming from problems at Hospira, which Pfizer bought out in a $17 billion deal back in 2015. My Fortune colleague Erika Fry detailed the myriad issues at the company, and how they’ve put the squeeze on hospitals and patients seeking basic, critical injectable drugs like saline, sodium bicarbonate, and others, in a recent feature.

“The simple answer to why America currently has so many shortages of generic sterile injectable drugs: America’s leading manufacturer of generic sterile injectable drugs hasn’t been making them,” writes Erika of Hospira, noting that the firm “had 370 products that are depleted or in limited supply, 102 of which the company has indicated will not be available until 2019” as of May 11.

There a number of reasons behind the manufacturing woes, including production slowdowns due to plant upgrades and technical issues, and the bombshell of Hurricane Maria in Puerto Rico, where many common generic injectable and IV drugs are manufactured. It also doesn’t help that Pfizer and Hospira command the vast share of the nation’s injectable market, forcing nationwide recalls with outsize effect when something goes wrong. But with the opioid epidemic raging on, claiming tens of thousands of lives every day, the naloxone recall could hit particularly hard, if only temporarily.

This article has been updated to clarify that Pfizer is not the sole manufacturer of naloxone and that its product is meant for use by trained professionals.

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