Re: UK: Several Addicts die as anthrax infects heroin users
Re: UK: Several Addicts die as anthrax infects heroin users
http://www.promedmail.org/pls/otn/f..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,80778
Archive Number 20100106.0054
Published Date 06-JAN-2010
Subject PRO/AH/EDR> Anthrax - UK (02): (Scotland)
ANTHRAX - UK (02): (SCOTLAND)
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A ProMED-mail post
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International Society for Infectious Diseases
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[1]
Date: Wed 6 Jan 2010
Source: BBC News [edited]
<http://news.bbc.co.uk/2/hi/uk_news/scotland/glasgow_and_west/8443809.stm>
'Anthrax heroin' cases spreading
--------------------------------
Health officials believe contaminated heroin -- thought to be
responsible for cases of anthrax in Glasgow -- may be circulating
elsewhere in Scotland. It comes after the death of 2 more drug users
with the infection in Glasgow and Tayside.
A total of 11 cases have now been confirmed in Tayside, Glasgow, and
Lanarkshire with 5 fatalities. The 11 confirmed cases of anthrax
occurred in a male patient in NHS Tayside, 3 male patients in NHS
Lanarkshire, and 4 men and 3 women in NHS Greater Glasgow and Clyde.
Test results are being awaited from a female patient in Fife who is
currently under investigation for anthrax.
Health officials believe that contaminated heroin or a contaminated
cutting agent mixed with the heroin may be responsible for the
infections. Dr Colin Ramsay, consultant epidemiologist at Health
Protection Scotland, said: "Evidence now suggests that potentially
contaminated heroin may be in circulation in other parts of Scotland,
not just the Glasgow area. All heroin users need to be aware of the
risks contaminated heroin is potentially dangerous taken by any route,
not just injection. I would advise heroin users to stop using heroin
and seek advice from local harm reduction and drug services for
support."
--
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[The official NHS report has yet to be up on its website for this. - Mod.MHJ]
******
[2]
Date: Mon 4 Jan 2010
Source: News & Star [edited]
<http://www.newsandstar.co.uk/news/focus/cumbria_health_chiefs_urge_vigilance_after_anthrax_heroin_scare_1_656464>
Cumbria health chiefs urge vigilance after anthrax heroin scare
---------------------------------------------------------------
Drugs don't come with any guarantee. There's no breakdown on the back
of the packet listing the ingredients. Desperate to push up their
profits and get more sales from their illegal stock, dealers dilute
them with all sorts. No-one tells them what they can't put in. Users,
often crying out for their fix, still buy from them -- perhaps
thinking they know what they are getting. But they can never be sure.
Sadly, that uncertainty can be a potentially lethal gamble, tragically
illustrated in the past few weeks. 3 drug users have died in Glasgow
after being infected with anthrax. Doctors believe they may have
injected contaminated heroin. Experts suspect the drug -- or a
contaminated agent used to cut it -- could be to blame, although
health bosses at NHS Greater Glasgow and Clyde are still trying to
identify the source.
The lethal bacteria alert has, however, triggered warnings in Cumbria.
One heroin user was tested for potential anthrax poisoning after being
taken to Carlisle's Cumberland Infirmary on Christmas Day [25 Dec
2009]. Results in that case proved negative, but those who inject
drugs are being warned that they cannot afford to let their guard down.
NHS Cumbria's director of public health has stressed anthrax's lethal
consequences. Dr John Ashton has urged any users who experience
unusual symptoms such as swelling or pain at the injection site to
seek immediate medical help. He said: "What this episode illustrates
is the risk and danger of street drugs and the effect and use of
narcotic drugs. Street drugs are not guaranteed to be of any purity in
the way that prescription drugs are. There are no safeguards. The
nature of the trade is such that all the way along the supply route --
from the fields of Afghanistan to the streets -- they are likely to be
cut and diluted with various substances every time they change hands.
This can potentially be very hazardous."
Senior police officers in the county, who are constantly working to
break down supply networks, have also warned of the anthrax threat.
They stress that taking drugs at any time is dangerous. They have seen
connections between Cumbria's drugs trade and that in Glasgow, as well
as major north west cities such as Manchester and Liverpool. Some
cases have seen significant amounts of class A drugs recovered after
cars have been stopped on the motorway.
Detective chief inspector Lee Johnson: "There are links that we have
seen and that is why we are concerned." The detective has seen drugs
which have been cut with various agents. He added: "We know suppliers
put all sorts into drugs to increase their profits, which increases
the risk to individuals. Drugs are dangerous. If they are not cut,
their purity is higher and there is the risk of overdose. If they are
cut, you don't know what they have been cut with. Then there are
people sharing needles. There are significant public health risks.
There are always going to be health risks with all types of drugs,
especially when they are drugs which are injected."
Anthrax is a deadly bacterial infection, which occurs mostly in
animals in Asia and Africa. Humans are seldom infected and it is
extremely rare for anthrax to be spread from person to person. Heroin
often comes from countries where anthrax is more prevalent in animals.
Bone meal, an animal product, is sometimes used as a cutting agent. It
has been reported that the contaminated heroin in this case could have
come from Afghanistan, where the disease is endemic. 2 strong
possibilities for the cause of the bacteria are said to be gelatin and
bone meal from contaminated animals. No cases of anthrax have been
found in British livestock in recent times.
Dr Ashton was involved with a case a number of years ago when there
was contaminated heroin in the north west -- identifying the
contaminant and helping deal with it. He said: "When this cropped up
in Glasgow, my immediate thoughts were that we may be looking at a
repeat of that. I knew we needed to advise users to be wary of what
they are buying and, if they feel unwell or different to how they
would normally feel after they have been using, to seek medical advice."
Dr Ashton does not condone drug use, but is a supporter of calls for
the controlled availability of drugs. "One of the main reasons for
that is so people who are buying drugs can be confident about what
they are using and not putting themselves at risk," he explained. He
admits addicts can often have trouble in their lives -- and that
substances being used to cut the drugs creates "an extra layer of
hazard". "This is one more reason for people to think seriously about
getting into treatment and coming off drugs," Dr Ashton said.
If, however, people are going to continue taking risks and use drugs,
he says reducing the risk of harm is essential. "That is why you have
to be vigilant," he added. "Because so many drugs users lead chaotic
lives it can be difficult for them to control what they are doing and
where they are buying their drugs. That's why I would prefer them to
contact the health services and start getting prescribed alternatives."
Police also say they will help users to give up drugs and help them to
get onto support programmes. A critical part of their anti-drugs work
is bringing down those responsible for putting drugs on Cumbria's
streets. And they are resolute in their determination to continue that.
DCI Johnson said: "The suppliers are the ones who cause the real
problem. We work closely with our partners in tackling drugs and to
raise awareness of drugs issues. We are committed to building safer
and stronger communities across Cumbria. One way we can do that is by
cracking down on those people involved with illegal drugs." By
targeting these people, DCI Johnson believes there can be success in
driving down crime generally. "Links between the 2 are well-known," he
added. "We have had significant successes in the last year in
dismantling organised crime groups, specifically those involved in
drugs supplying. We don't tolerate drug dealing. More importantly, the
courts are ready to hand-down substantial prison sentences to people
who supply drugs. Cumbria Constabulary is dedicated to tackling drugs
crime and the harm it causes to our communities. We have expert teams
of detectives who are dedicated to demolishing organised crime groups
and hitting criminals where it really hurts. The supply, production
and use of drugs can ruin lives, families, and is a huge drag to
communities."
Police hope that by working with the public and other agencies, they
will continue to bring drug dealers to justice.
And DCI Johnson stressed the important role that Cumbrians have in
helping them secure future successes. He said: "It is up to the
community to keep telling us about people who are involved with
drugs." Previously, the last 2 known anthrax-related deaths in the UK
were both of men who made drums.
Anyone with information about those involved with drug dealing in
Cumbria should call police on 0845 3300247 or Crimestoppers
anonymously -- 0800 555111.
--
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[I don't apologise for this very long posting as most members will be
ignorant of the drug trade, however cool we may like to think
ourselves. Secondly there are presently suspect cases in Scotland
being carefully studied. If these turn out to be also spore
contaminated heroin cases, it will indicate that the contamination
happened further up the chain than just in Glasgow. This implies that
significant numbers of users in Scotland and northern England are at
risk. Which is why all unexpected reactions need to be followed up and
called in. - Mod.MHJ]
******
[3]
Date: n/a
Source: DrugText [edited]
<http://www.drugtext.org/library/articles/97842.htm>
An analysis of 228 'street' heroin samples across the UK (1995-96) and
discussion of monitoring policy
----------------------------------------------------------------------
[Author: Ross Coomber, University of Greenwich, London]
Recent research has suggested both that illicit heroin in the UK may
not be adulterated/diluted ('cut') with dangerous substances and also
that it is actually adulterated/diluted far less than is often
believed (Coomber, 1997a, 1997b, 1997c). Forensic evidence does not
report on the proportion of samples where no cutting agents are found
but merely presents evidence of when they are and what they are,
making judgements about how often the cutting of drugs takes place
reliant upon other less definite data. Moreover, from the presentation
of existing forensic data on cutting agents the impression can be
formed that the adulteration/dilution of heroin is the norm. A
specialty arranged analysis of 228 'street' seizures to test this
assumption, however, suggests that nearly half [44 percent] of the
heroin which was sold for use in the UK in 1995-96 may not have been
adulterated at all.
Comparison of this new data with previously published data on 'cutting
agents' suggests that much less adulteration has probably also been
common in previous years. When compared with other new data from
Customs seizures, the argument put forward by Coomber (1997a) that
most adulteration/dilution is professionally managed (as opposed to
the work of a strung-out 'junkie') prior to importation and that only
a relatively small proportion of heroin sold is adulterated/diluted by
those believed to do so -- the 'street' dealer -- is strengthened.
Current monitoring procedures are unsystematic and insufficient. At
the very least, effective monitoring of the makeup of illicit drugs
would improve understanding of trafficking and production trends as
well as provide evidence of what happens to drugs after they reach the
street. On this basis, policy recommendations are made for improved
strategic recording of future forensic data for, in the 1st instance,
the UK, and then for the possibility of a Europe-wide approach to such
monitoring.
--
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[Remember, these are '90s data but the article is still well worth
reading. At that time the commonest cutting agent was a mix of
paracetamol and caffeine. - Mod.MHJ]
[see also:
Anthrax - UK: (Scotland) 20100101.0011
2009
----
Anthrax, human - UK (04): (Scotland) 20091224.4333
Anthrax, human - United Kingdom (03): (Scotland) 20091222.4317
Anthrax, human - UK (02): (Scotland) 20091219.4288
Anthrax, human - UK: (Scotland) heroin users 20091217.4270]
...................................mhj/mj/dk
