Vitamin Cocktails: An Ethical Dilemma Of Supply And Demand

There is a big difference between access and excess. Having access to something doesn't necessarily mean you need it, especially when others need it more. Take, for example, the use of intravenous vitamin therapies (IVT), also known as vitamin drip treatments, which have gained popularity in recent years. Today, IVT has moved beyond the trendy Hollywood health scene and is now more accessible than ever. The problem, however, is that the IV drugs that are now being offered recreationally are in short supply for those chronically and critically ill patients that depend on this therapy as their sole source of life-saving nutrition.

For the recreational user, IVT commonly involves four to six weekly sessions in which a personalized "cocktail" of vitamins and minerals are delivered via intravenous tube directly into the bloodstream. Promising everything from instant relief from fatigue and depression to stimulating your metabolism and immune system, IVT providers are everywhere and can be seen in the unlikeliest of places. There is even a "clinic" in the Las Vegas airport marketing the elixir as the perfect hangover cure.

A national debate currently exists over the scientific merit of IVT. It certainly sounds alluring; the idea of simply popping into your doctor's office for a maximum dose of the vitamins and minerals you just can't seem to get enough of from your daily diet. But the reality is there has not been enough significant research conducted to back up the elaborate claims.

However, beyond the efficacy argument is a more urgent ethical dilemma. Currently, critical nutrients such as zinc, selenium, copper, multiple vitamin infusion, potassium, sodium, and vitamin K, many of which are now being given at these pop-up IVT centers, are in short supply.

The problem seems to be a breakdown in distribution regulations. Under U.S. law, IV hydration solutions, electrolytes, vitamins, and trace minerals are prescription drugs rather than food, dietary supplements, or supplies. Their use and distribution are regulated by law for medical purposes only. To acquire and prescribe IV drugs, you must be a licensed medical provider. While many of these "medical spas" and boutique clinics are registered and owned by a licensed provider, it is unclear whether the providers are involved in the actual delivery of the therapy.

But the obvious question is how these rogue clinics are procuring the IV drugs when more credible medical establishments are doing without. The unnerving answer is we simply don't know. Most of these boutique businesses are unwilling to disclose the sources from which their products are purchased or prepared.

Regardless of whether they are going through black market suppliers or legitimately acquiring the IV drugs, the fact remains these recreational IVT sites are supply competitors with the clinical care facilities serving patients who have no other nutritional options.

Intravenous nutrition methods were never intended to be used recreationally. They are, however, vital to the medical community, keeping patients who are too sick to eat, or who suffer from the adverse effects of nutritional deficiencies, alive. Members of my organization, the American Society for Parenteral and Enteral Nutrition (ASPEN), utilize this procedure every day in order to expedite healing for seriously ill patients.

Ultimately, mainstream IVT is unproven, potentially unsafe, and — given the IV drug shortage — seemingly unethical. Once you've observed how patients truly depend on intravenous nutrition to survive and thrive, it seems to trivialize the method to use it for trendy, recreational purposes. Such an invasive IV approach should be viewed as life-saving clinical care, not an easy fix for a few too many martinis.

Gordon Sacks, PharmD, BCNSP, FCCP, is the Immediate Past President of the Board of Directors for the American Society for Parenteral and Enteral Nutrition (ASPEN) and currently leads the Department of Pharmacy at Auburn University.