Source: Scottish Drugs Forum

16 April 2010

The number of anthrax deaths among heroin users in Scotland has risen to 12, with the first death in Lanarkshire being confirmed today (16 April 2010).

The announcement coincides with news that the the total number of confirmed cases in Scotland has risen from 33 to 35 since the outbreak was first identified in Glasgow in December 2009.

Greater Glasgow and Clyde, and Lanarkshire, are the areas where the two new cases have been confirmed.

The 12th fatality, in Lanarkshire, is the first death to take place in four weeks.

The latest increase in confirmed cases comes three days after Health Protection Scotland announced the first confirmed case in Lothian, the eighth health board area in Scotland where heroin users have been affected.

The new figures bring the number of cases in Greater Glasgow and Clyde up to 16, of whom seven people have died. Greater Glasgow and Clyde has seen three new cases and an anthrax-related death in the past month.

The newly confirmed case in Lanarkshire marks the first increase in cases there since mid-February.

Anthrax can be cured with early treatment – See Anthrax and Heroin Users: What Workers Need to Know

Symptoms are:

* Swelling or redness at or near the place where someone injects, such as in arms or legs

* High fever and/or temperature

* Feeling chilled or flu-like

* Severe headache

If you spot ONE OR ANY of these symptoms in a service user, please advise him or her to GO STRAIGHT TO THE NEAREST HOSPITAL ACCIDENT AND EMERGENCY DEPARTMENT or seek urgent GP/medical advice.

Anthrax Training

SCOTTISH Drugs Forum is offering face-to-face group briefing sessions for workers engaged directly with heroin users at risk of infection.

Target staff groups including staff in treatment services and also in non-specialist settings such as homelessness support organisations, mental health, criminal justice and other social work/care areas.

WHO IS INFECTING SCOTTISH HEROIN USERS WITH ANTHRAX?

Source: Herald Scotland

17 Jan 2010

By Jasper Hamill and Arron Merat

The shadowy nature of the heroin trade, and the desperation of addicts, makes tracking and tracing the anthrax doubly hard

It is a health scare which has seen seven people die in Scotland so far with another 14 hospitalised, yet there is no panic in the streets, few headlines and little fearful talk in homes or in offices.

The reason for the silence? The victims are all drug addicts, a faceless heroin-injecting underclass, who few care about. In the last month, anthrax-infected heroin has killed four people in the Greater Glasgow and Clyde area, two in Tayside and one in the Forth Valley.

Although it’s likely that the heroin was infected with anthrax somewhere en route from the poppy fields of Afghanistan, there is no way that police and medics can rule out that the drug was deliberately infected once it arrived in the UK.

The big problem facing police and doctors struggling to deal with the anthrax scare is that they just don’t know how, where, when, why or at whose hands the heroin became contaminated.

Was it as a result of the heroin accidentally coming into contact with infected farm material while being stored or in transit from the Middle East to Britain? Was it because a middle man unwittingly used a contaminated bulking agent? Was it done maliciously? And if so, by whom? A callous dealer? Someone targeting Glasgow’s junkies? Even the most far-fetched theories can’t be ruled out.

The country’s leading microbiologist, Professor Hugh Pennington, points to the distinct possibility of the anthrax coming into contact with the heroin in the country of origin, yet he also believes that it is possible that the anthrax could have been maliciously added to the heroin inside Britain.

“In the UK there used to be problem with anthrax-infected imports, particularly wool from areas east of Turkey,” he said. “It is no great surprise that it would be prevalent around the areas in Afghanistan where heroin is processed. You can’t completely rule out maliciousness as theoretically – people would be able to get hold of anthrax in the UK, although you’d need a specialist microbiological knowledge to do so.”

Police are investigating the labyrinthine heroin supply chain, hoping that if they identify the source of the infection, they will be able to stop further deaths. Find the supplier, the theory goes, and you find and therefore save the customers. But the shadowy drug routes from Afghanistan to Scotland are difficult to trace and health officials are braced for more anthrax cases.

Some of the main theories about how anthrax spores came to contaminate the heroin, include the possibility that bonemeal, which is sometimes used to cut – ie, bulk up – heroin batches came from diseased animals.

Another theory suggests that the equipment used to manufacture the drug was contaminated. Some peasant producers mix raw opium with water and chemicals in an oil barrel before heating the mixture over a large fire. These barrels may have previously been used to carry diseased meat, cattle feed or even manure.

Professor Graeme Pearson is a former director general of the Scottish Crime and Drug Enforcement Agency (SCDEA), the country’s leading crime-fighting unit, and is now with Glasgow University’s Unit for the Study of Serious Organised Crime. He has investigated the heroin production process and says he is surprised infections are so rare.

He said: “I’ve seen videos of heroin production and it’s a horrible and unhygienic process. It’s surprising that this doesn’t happen more often.”

Anthrax exists as small, hardy spores that can lay dormant for up to 100 years. If these spores are breathed in, eaten or come into contact with skin, they cause an infection.

Dr Colin Ramsay, consultant eEpidemiologist at Health Protection Scotland, has been following the anthrax infections ever since the first victim was identified.

He said: “The current hypothesis remains that the anthrax cases are linked to contamination of either heroin or a cutting agent.”

While the police and medics remain temporarily at a loss, it may be thought that Scotland’s addicts themselves might be doing something to save themselves from infection. Sadly, that is far from the case.

Heroin addicts, experts warn, are too in thrall to their next fix to heed the risks of shooting up with anthrax-infected heroin.

Patricia Tracey, from Glasgow Drug Crisis Centre, claimed that it was “unrealistic” to expect addicts to listen to public health warnings. “Users are concerned, but not concerned enough to stop using,” she warned.

The recent deaths have exposed the flaws in the Scottish Government’s drugs policy, Jolene Crawford, the head of pressure group Transform Drug Policy Foundation Scotland, claimed.

She said: “If it was contaminated beer that was killing these people there would be uproar. But there is no outrage.

“It is accepted that some heroin will be lethal because by prohibiting it we gift control to criminals. Were opium and heroin to be legally available via regulated pharmacies and doctors’ surgeries, we would not have to see our children, mothers, fathers, brothers and sisters die unnecessarily in this way.”

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