Anthrax & Heroin Users

Anthrax 1 There have been 15 cases of Anthrax with 7 deaths reported in Heroin users across Scotland. This was reported in a press release by Health Protection Scotland on 22nd January 2010.

Dr Colin Ramsay, Consultant Epidemiologist at Health Protection Scotland, said:

“Heroin users all across Scotland need to be aware of the risk that their supply may be contaminated. They should seek medical advice urgently if they experience signs of infection such as redness and swelling of an infection site or high fever. I would urge all drug users to stop using heroin immediately and contact local drug services for support.

In addition, any users who continue to inject heroin are strongly recommended not to re-use filters, but to use a fresh filter each time they are used. Users who do not currently use filters are reminded of the current harm reduction policy to do so, however they must ensure these are discarded after each use. Use of filters will not make heroin safe or remove all traces of anthrax contamination so the best advice remains not to use heroin by any method.”

What is anthrax?

Anthrax is a very rare but serious bacterial infection caused by the organism Bacillus anthracis. The disease occurs most often in wild and domestic animals in Asia, Africa and parts of Europe; humans are rarely infected. The organism can exist as spores that allow survival in the environment, e.g. in soil, for many years.

How has anthrax been affecting drug users in Scotland?

There is an ongoing outbreak of anthrax in heroin users in Scotland. Since December 2009, a significant number of heroin users have been found to have anthrax infection. Sadly, a number of these people have died. It is thought that they contracted anthrax from taking heroin contaminated by anthrax spores.

What are the symptoms?

Early identification of anthrax can be difficult as the initial symptoms are similar to other illnesses.

Symptoms vary according to the route of infection:

Anthrax in drug users

Drug users may become infected with anthrax when heroin or the cutting agent mixed with heroin has become contaminated with anthrax spores. This could be a source of infection if injected, smoked or snorted. The clinical presentation is likely to vary according to the way in which the heroin is taken and might include:

  • Swelling and redness at an injection site, which may or may not be painful
  • Abscess or ulcer at an injection site often with marked swelling (oedema)
  • Septicaemia (blood poisoning)
  • Meningitis
  • Symptoms of inhalational anthrax; symptoms begin with a flu-like illness (fever, headache, muscle aches and non-productive cough) followed by severe respiratory difficulties and shock 2-6 days later. Untreated disease is usually fatal, and treatment must be given as soon as possible to reduce mortality.

Cutaneous Anthrax Can anthrax be treated?

Cutaneous anthrax can be readily treated and cured with antibiotics. Mortality is often high with inhalation and gastrointestinal anthrax, since successful treatment depends on early recognition of the disease.

Prompt treatment with antibiotics and, where appropriate, surgery is important in the management of anthrax related to drug use.

How is anthrax spread?

A person can get anthrax if they inject, inhale, ingest or come into direct physical contact (touching) with the spores from the bacteria. These spores can be found in the soil or in contaminated drugs. It is extremely rare for anthrax to spread from person-to-person. Airborne transmission from one person to another does not occur; there have been one or two reports of spread from skin anthrax but this is very, very rare.

How do drug users become infected with anthrax?

Heroin or the cutting agent mixed with heroin may become contaminated with anthrax spores from the environment. This could be a source of infection if injected, smoked, or snorted.

More information is available at; www.hps.scot.nhs.uk/anthrax

Dangers of Opioid Pain Medications

pills 3 Opioid pain medications include a broad range of drugs, such as morphine, codeine and oxycodone. They are marketed under many different brand names, including Percocet®, OxyContin®, and Tylenol No.1®.

When used as directed, opioid pain medications are effective and the side effects (e.g., drowsiness, nausea, constipation, etc.) are generally manageable. However, abuse of these medications can have serious health effects and may lead to addiction.

Opioid pain medications are generally used to manage moderate to severe pain, which may be acute (e.g., short-term pain following surgery) or chronic (e.g., long-term pain associated with a medical condition, such as different types of cancers). They may also be used to control moderate to severe cough, control diarrhea, and treat addictions to other opioids, including street drugs like heroin.

Potential for Abuse and Addiction

In addition to treating pain, opioid medications can also cause euphoria (a "high"), and this makes them prone to abuse. Patients taking opioid medication for pain may or may not experience a high. However, all opioids have the potential to be addictive. Addiction refers to the compulsive use of a substance, despite its negative consequences. People with a personal or family history of substance abuse, including alcohol, may be at higher risk of addiction to opioid pain medications.

Over the past decade, abuse of and addiction to opioid pain medication has emerged as a public health issue. Abuse of these medicines can cause serious health effects for the user, including a risk of death from an overdose. Drug abuse and addiction to any substance may also cause problems at work or school, and can result in the breakdown of family relationships. In addition, drug abuse can result in financial costs to society for things like healthcare, crime, and lost productivity.

Other subjects in this article include;

  • Side Effects of Opioid Pain Medications
  • Other Safety Concerns
  • Overdose
  • Drug Interaction
  • Physical Dependence / Withdrawal
  • Minimizing Your Risk
  • Health Canada’s Role

Need More Info?

And, visit the Centre for Addiction and Mental Health and search for these resources: "Do You Know…Opioids," "Oxycontin: Straight Talk" and "Is it Safe for My Baby – Pain Medications."

Full article at; Health Canada

See also; Narcotics Anonymous

Alcoholic Beverages Containing Caffeine

fea_caffeine_drink FDA to Evaluate Safety and Legality of Alcoholic Beverages Containing Caffeine

“The increasing popularity of consumption of caffeinated alcoholic beverages by college students and reports of potential health and safety issues necessitates that we look seriously at the scientific evidence as soon as possible.” — Dr. Joshua Sharfstein, Principal Deputy Commissioner of Food and Drugs, FD

What are caffeinated alcoholic beverages?

Caffeinated alcoholic beverages are alcoholic beverages to which the manufacturer has intentionally added caffeine and/or other stimulants that are metabolized as caffeine (e.g., guarana). An increasing number of companies are producing these beverages, with young people as the apparent marketing target. The reported prevalence of combined caffeine and alcohol use among U.S. college students is high as 28%.

What are the potential health concerns with caffeinated alcoholic beverages?

  • Studies have shown that people who drink caffeinated alcoholic beverages drink larger quantities of alcohol.
  • Caffeine can mask the negative effects of alcohol intoxication, increasing the chance that users will engage in potentially risky behaviors, such as drinking and driving, because they don’t feel that they are intoxicated.
  • Users of caffeinated alcoholic beverages are also more likely to experience alcohol-related consequences, such as being taken advantage of or taking advantage of someone else sexually.
  • Consuming these beverages may also be associated with adverse effects on heart rhythm, most likely in individuals with pre-existing cardiovascular conditions.

Is caffeine approved by the FDA for use in alcoholic beverages?

A food additive is presumed by the FDA to be unsafe unless its particular use has been approved by federal regulation or is Generally Recognized As Safe (GRAS) under the conditions of its intended use. The FDA has approved caffeine as GRAS for use only in non-alcoholic cola- type beverages at concentrations of no greater 0.02 percent. The FDA has not approved caffeine for use at any level in alcoholic beverages.

What is the FDA doing about this?

On November 13, 2009, the FDA issued a mandate to nearly 30 manufacturers* of caffeinated alcoholic beverages to produce within 30 days their rationale and supporting data concluding that their use of caffeine in an alcoholic beverage is either GRAS or prior sanctioned.** To be GRAS, the burden is on the manufacturers to show that 1) the use of caffeine is safe for use in alcoholic beverages based on publicly available scientific evidence and 2) there is a consensus among qualified experts regarding the safety of caffeine for this use. In their letter to manufacturers of caffeinated alcoholic beverages, the FDA states that, “If FDA determines that the use of caffeine in your alcoholic beverage is not GRAS or subject to a prior sanction, FDA will take appropriate action to ensure that this product is removed from the marketplace.”

*In the past year, Anheuser-Busch and Miller agreed to discontinue their caffeinated alcoholic beverages and agreed to not produce any caffeinated alcoholic beverages in the future.

**A substance is considered prior-sanctioned if its specific use in food was authorized by the FDA or the Department of Agriculture prior to September 6, 1958.

SOURCES: Adapted by CESAR from the following documents available on the FDA website at http://www.fda.gov/Food/FoodIngredientsPackaging/ucm190366.htm: “FDA to Look Into Safety of Caffeinated Alcoholic Beverages; Agency Sends Letters to Nearly 30 Manufacturers,” FDA Press Release, 11/13/09; FDA, Questions & Answers on Caffeine in Alcoholic Beverages, 2009; CAB Letter to FDA from Attorneys General, 9/25/09; CAB Letter to FDA from Scientists, 9/21/09.

Organisation for Fetal Alcohol Syndrome

The Australian National Organisation for Fetal Alcohol Syndrome and Related Disorders Inc.

(NOFASARD) was established and incorporated in Adelaide in 1998. It is Australia’s peak body representing parents, carers and others interested in or affected by Fetal Alcohol Spectrum Disorder (FASD). NOFASARD currently receives no operational funding and is staffed totally by volunteers.

The Aims and Objectives of NOFASARD are:

  • To promote and resource good practice in the management of Fetal Alcohol Syndrome and related disorders resulting from prenatal alcohol exposure.
  • Provide information, advocacy, education and support that will assist carers and those working with and affected by Foetal Alcohol Syndrome and related disorders.
  • Work towards the prevention of Foetal alcohol syndrome and related disorders.

NOFASARD members lobby State and Federal Agencies, politicians and professional associations about:

  • The lack of appropriate education about the effects of alcohol use during pregnancy
  • The lack of acknowledgment of this disability by health authorities in Australia
  • The lack of appropriate management strategies and support for people with FASD.

Through education and advocacy, NOFASARD members aim to improve the lives of children/adults with FASD. Representatives from the organization present at seminars and workshops for both government and nongovernment agencies throughout Australia

More information at; http://www.nofasard.org.au/

Hepatitis C

Hepatitis C in alcoholism, addiction The highest rates of hepatitis C are in addicts and alcoholics.

Hepatitis C is a chronic liver disease caused by the hepatitis C virus (HCV). Because many people do not have symptoms when they are infected, it is important for those at risk to take action to avoid infecting others.

Background

Although HCV has existed for a long time, it was only identified in 1989. HCV causes inflammation of the liver, which can progress to cirrhosis (extensive scarring that can affect the normal function of the liver).

Some people recover from their infection, but 75-85% progress to the chronic (carrier) state. People with chronic hepatitis C may not have symptoms for decades. Approximately 35% of those who have chronic hepatitis C, do not know that they are infected.

Other topics in this article are;

  • Health Risks of Hepatitis C
  • The Health Effects of Hepatitis C
  • Minimizing Your Risk

Full story at; Health Canada

See also;

Hepatitis B

Doctor assessing Hepatitis B in alcoholism Some of the highest rates of hepatitis B are in alcoholics and addicts.

Hepatitis B is a liver disease caused by the hepatitis B virus. The virus is carried in blood and body fluids. It can lead to serious liver damage, life-long infection, liver cancer, liver failure and even death. Fortunately, there is a vaccine that can protect you against hepatitis B.

Background

Hepatitis B virus (HBV) is one of a group of viruses that attacks the liver. Six hepatitis viruses have been identified but three – known as A, B, and C – cause about 90% of the acute hepatitis cases in Canada.

HBV is the most common form of hepatitis virus in the world. It is easily transmitted and is significantly more infective than HIV. HBV is primarily transmitted from one person to another through blood or other body fluids, such as vaginal secretions and semen. It is usually spread through sexual contact or by sharing contaminated needles or other drug equipment. It can also be transmitted from mother to child during pregnancy and birth.

The majority of people infected with HBV do not have noticeable symptoms and may unknowingly be experiencing liver damage and infecting others. That is why it is important for those most at risk to be vaccinated against the virus and avoid risky behaviour.

Topics in the linked article include;

  • Symptoms of HBV
  • Risks of Hepatitis B Exposure
  • The Health Effects of Hepatitis B
  • Minimizing Your Risk

Full story at; Health Canada

See also;

5 Stages of Alcoholism

Grapes and Wine may cause alcoholism The Disease of Alcoholism

There are, and have been, many theories about alcoholism. The most prevailing theory, and now most commonly accepted, is called the Disease Model.

Its basic tenets are that alcoholism is a disease with recognizable symptoms, causes, and methods of treatment. In addition, there are several stages of the disease which are often described as early, middle, late, treatment and relapse.

While it is not essential to fully define these stages, it is useful to understand them in terms of how the disease presents itself.

This series of articles describes the signs and symptoms of each stage as well as exploring treatment options.

  1. Early or Adaptive Stage
  2. Middle Stage
  3. Late Stage
  4. Treating Alcoholism
  5. Relapse to drinking

1 – The Early or Adaptive Stage of Alcoholism

The early or adaptive stage of alcoholism is marked by increasing tolerance to alcohol and physical adaptations in the body which are largely unseen.

This increased tolerance is marked by the alcoholic’s ability to consume greater quantities of alcohol while appearing to suffer few effects and continuing to function. This tolerance is not created simply because the alcoholic drinks too much but rather because the alcoholic is able to drink great quantities because of physical changes going on inside his or her body.

The early stage is difficult to detect. By appearances, an individual may be able to drink a great deal without becoming intoxicated, having hangovers, or suffering other apparent ill-effects from alcohol. An early stage alcoholic is often indistinguishable from a non-alcoholic who happens to be a fairly heavy drinker.

In the workplace, there is likely to be little or no obvious impact on the alcoholic’s performance or conduct at work. At this stage, the alcoholic is not likely to see any problem with his or her drinking and would scoff at any attempts to indicate that he or she might have a problem. The alcoholic is simply not aware of what is going on in his or her body.

See also;

  1. Early or Adaptive Stage
  2. Middle Stage
  3. Late Stage
  4. Treating Alcoholism
  5. Relapse to drinking