Problems with contaminated drug supplies reemerged on two fronts this week, with health authorities in Scotland announcing another case of anthrax among heroin users and health authorities in Quebec warning that cocaine continues to be contaminated with levamisole, a veterinary de-worming agent.
"There is no way to tell if your heroin is contaminated and there is no way to take heroin which we can advise is safer or less likely to result in illness or death if it has anthrax contamination," warned Dr. Colin Ramsey, consultant epidemiologist for Health Protection Scotland. "Drug users are advised that the only way to avoid the risk of anthrax in this outbreak is not to take heroin. While we appreciate that this may be extremely difficult advice to follow, it remains the only public health protection advice possible due to the nature of anthrax infection."
Such advice dismays harm reductionists, who have called for more informational campaigns and the prescribing of pharmaceutical heroin to addicts.
Users should seek urgent medical attention in the event of symptoms such as redness or swelling at or near an injection site, or other symptoms of general illness such a fever, chills or a severe headache, as early antibiotic treatment can be lifesaving, Health Protection Scotland said. Marked swelling of a limb which has been used as an injection site is a particularly important sign of possible anthrax infection.
Meanwhile, in Montreal, the National Public Health Institute of Quebec has issued a report on levamisole contamination in cocaine (sorry, French only) in the province. According to that report, eight out of 10 blood samples taken from known cocaine users in Quebec contained the cutting agent.
When ingested by humans, levamisole can cause nausea, dizziness, and diarrhea. Chronic use can lead to neutropenia, a potentially lethal blood disorder, or a related condition, agranulocytosis.
The US DEA first reported the presence of levamisole in cocaine in 2002 and its use is on the rise. In November 2009, Center for Substance Abuse and Mental Health Services published a survey indicating that 70% of cocaine seized in the US contained levamisole.