IV therapy to your door operating in unregulated grey area




Photo by Robert Geiger | Flickr/CC BY 2.0

Intravenous therapy companies are springing up across the Phoenix and Tucson metro areas, offering treatments for common ailments, all while operating in a regulatory grey area.

Meanwhile, a new company is hoping to bring the service right to people’s doorsteps.

Amid all this, medical professionals are trying to educate consumers about the potential risks of receiving vitamin cocktails through an IV.

Arizona IV Medics is unlike the IV lounges that have been cropping up in places like Tucson and Phoenix that have been getting headlines and raising eyebrows from the medical community.

People who seek out IV therapy receive fluids, vitamins and sometimes medicine directly into their bloodstream, usually to treat ailments like hangovers, dehydration and migraines. Even celebrities have been known to partake.

What makes Arizona IV Medics different is its particular business model. 

They come to you. 

Instead of going to a lounge, the company delivers IV therapy at people’s homes and businesses. 

The company touts IV treatments to treat migraines, the flu, colds, chronic illness, food poisoning and low energy. 

“It’s a way to help a lot of people, its a real feel good business,” Matt Heistan, Arizona IV Medics CEO said to the Arizona Mirror. Heistan, a Peoria firefighter, has been working in the field of IV therapy for the past five years, including the last three at Arizona IV Medics. 

The Arizona Department of Health Services doesn’t license IV therapy lounges or mobile providers like Arizona IV Medics. 

Currently, the agency’s main guidance to consumers is to make sure that anyone who is giving you an IV is registered with their respective medical board, AZDHS told the Mirror. A spokesman said the agency isn’t asking state lawmakers to give it licensing authority over the IV therapy industry. 

In the state of Arizona, you have to be a nurse, doctor or an emergency medical technician to administer an IV. 

“When giving someone IV fluid, you’re changing the composition of their blood,” Aliria Rascón clinical assistant professor from the Edson College of Nursing and Health Innovation at Arizona State University told the Mirror, adding that anyone with underlying health conditions should share that information with any IV therapy company they may plan to work with.

Marlene Steinheiser, PhD, RN, CRNI, and Director of Clinical Education for the Infusion Nurses Society said that anyone looking into IV therapy may want to do their research and weigh the risks and rewards before going in. 

“Anything over the counter, vitamins included, can cause issues,” Steinheiser said. 

What is IV therapy?

Although IVs are a routine procedure in many medical settings, they aren’t risk-free, Rascón said. 

“Not every IV insertion goes smoothly,” Rascón said, adding that failed IV insertions can cause vascular and nerve damage. 

In fact, the Emergency Care Research Institute placed infections related from IV lines as No. 9 on the list of the top 10 patient safety concerns for 2019

But what exactly is an IV and how does IV therapy work? 

An IV is not just a needle. 

The needle is just the part of the IV that is used to puncture the skin and vein. Then a plastic catheter, which can vary in style and size, is guided into the vein and the needle is pulled out. 

The plastic catheter is the main part of the IV that stays in a person’s body and which administers the fluids and medicine into the bloodstream. 

All registered nurses, or RNs, in the state of Arizona are allowed to place and give IVs and administer basic IV fluids like the ones used by Arizona IV medics and most IV lounges. 

All the people currently working with Arizona IV Medics are registered nurses, Heistan said. 

“Our highest priority is patient safety,” Heistan said, adding that his company’s patients get evaluated before an IV is inserted and anyone who is determined to be too sick will be referred to their primary care doctor or 911, if needed. “We’re not really focused on profits at any cost.”

Heistan said his company has plans in place to deal with severe reactions and his employees have emergency medicine with them when they visit patients. 

But what exactly are the IV therapies that Heistan offers? 

Packages can range from a base bag of pure saline solution, a saltwater solution commonly given in hospitals, to a $175 “Myers’ Cocktail” that consists of Vitamin B complex, Magnesium, Zinc, Vitamin C and Glutathione.

Heistan said that the Myers’ Cocktail is like “chocolate chip cookies” and that “everyone has their own recipe.” 

Myers’ Cocktail is named after Baltimore physician John Myers and generally contains magnesium, calcium, various B vitamins and vitamin C. 

Most research on the cocktail’s effects has been anecdotal, but a paper by Yale researchers that sought out to see how it could treat fibromyalgia found that it was as useful as a placebo

Risk v. Reward

Heistan said that his biggest patient group by far has been people who are experiencing migraine attacks. 

Migraines affect more than 1 billion people worldwide, including more than 39 million people in the United States. Every 10 seconds, someone in the United States goes to an ER for a migraine, according to the Migraine Research Foundation. That’s 1.2 million ER visits a year. 

“The last place you want to be when you have a migraine is in the ER,” Heistan said. Many people who have had migraines know that lights and sound are significantly worse during an attack, and many of Heistan’s migraine patients see having an IV come to them as a win-win. 

In fact, a large number of the online reviews for Arizona IV Medics appear to be people who have used the service for migraines. 

“There’s a need for these types of things,” Steinheiser said of models of medicine like telemedicine and mobile medicine that are becoming more and more popular. 

However, Steinheiser stressed that there are still risks that consumers need to be aware of and factor into their decisions. 

There are a number of questions consumers need to think about before utilizing IV therapy. 

“If they’re mixing things, what precautions are they taking?” Steinheiser said. 

Many of the IV lounges will allow customers to pick a basic IV bag and then choose their own additives, meaning that they’ll be adding them at the lounge or, in the case of mobile companies, at a customer’s home. 

Another thing to consider is personal health. 

Heistan said that his company screens all its patients, and certain underlying health issues – say, congestive heart failure or renal failure – will not be cleared. 

Earlier this year a Kansas man died a few days after his receiving his twelfth IV infusion. His autopsy revealed his death was most likely related to underlying health issues, but authorities there have now begun to look into if he should have been receiving the infusions, given his underlying health problems, according to The Kansas City Star

Heistan said anyone looking to do IV therapy should talk to their primary care doctor before doing so, and both Rascón and Steinheiser said it is important for consumers to know their own personal health background prior to going if they do plan to. 

Lack of regulations

Currently there are no regulations that oversee how IV lounges, both brick-and-mortar and mobile, operate in the state. 

“When you walk into a hospital, you know that they are accredited,” Steinheiser said. The only oversight over IV lounges is on who administers the IVs themselves. 

Only RNs, licensed nurse practitioners, paramedics and EMTs can give IVs. EMTs, RNs and LPNs all are overseen by the nursing board, while paramedics report to AZDHS. 

Most IV lounges in Arizona are naturopathic, and report to the Arizona Naturopathic Physicians Board

It also gets confusing when certain types of infusion therapy are already regulated by the state and federal government, but IV therapy is not.

“In terms of regulation, I welcome it,” Heistan said, adding that anything to make the industry safer is something he would appreciate. In fact, he said he hopes to be at the forefront of pushing for regulations when the legislature returns to work in January. 

Not much has happened in regards to regulation elsewhere. 

Last year, the Federal Trade Commission took its first case against an IV therapy marketer in Texas for claims it was making about its Myers’ Cocktail. That company claimed its IV could treat ailments such as cancer, multiple sclerosis and congestive heart failure.

Heistan knows they can’t cure everything and doesn’t make any big claims. 

“If you have flu-like symptoms, we can treat your symptoms, we can’t cure it,” Heistan said, adding that his service isn’t meant to replace seeing a doctor for major medical issues. 

As for the regulations? 

The Nursing board does not generally regulate facilities but it does have jurisdiction over the nurses who work at them. 

However, even if the nursing board did step in to see if it could give some guidance and oversight, there could still be other areas where things could fall through. 

“A drip lounge staffed entirely by paramedics wouldn’t fall under the purview of the nursing board,” Steinheiser said. 

Requests for comment to both the Arizona Nursing Board and the Arizona Medical Board were not returned.