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

Under 21 Alcohol Restrictions Sought

Angry teenager London, UK, Officials Ask Retailers Not to Sell Alcohol to Customers Under Age 21

Facing an epidemic of youth binge drinking, the mayor of London and other officials are backing a call for supermarkets and other “off-license” alcohol retailers to refrain from selling beer, wine and liquor to customers under age 21.

The Daily Mail reported July 17 that the voluntary program was developed by officials in London’s Borough of Croydon and endorsed by London Mayor Boris Johnson.

A pilot program in the town of Armadale in Scotland, where alcohol sales to teens were banned on weekends, cut the rate of assaults and vandalism. In Croydon, bars and clubs have also voluntarily stopped selling to customers under age 21. The legal drinking age in Great Britain is generally 18, although youths younger than that can legally drink in some settings.

“I do think that we have got a huge problem with binge drinking, underage drinking and general abuse of alcohol in this city, and I certainly think that this idea is a very interesting one,” said Johnson. “Where we have got particular problems in particular areas, off-licences and supermarkets should stop the sale of alcohol to the under-21s.”

However, Frank Sodeen of the group Alcohol Concern warned that, “There is a risk that this would alienate people, and it is also difficult to see how it would work unless every shop agreed to take part. Otherwise 20-year-olds will find it pretty easy to find the places where they can still buy alcohol.”

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Recovery Focused Approach to Tackling Drug Use in Scotland

Scots flag Recovery Focused Approach to Tackling Drug Use in Scotland

Scotland’s first national drugs strategy The Road to Recovery: A New Approach to Tackling Scotland’s Drug Problem was launched on May 29, 2008. The Government believes that preventing drug use is more effective than treating established drug problems and that treatment services in Scotland should be based on the principle of recovery.

The key priorities are:

  • better prevention of drug problems, with improved life chances for children and young people
  • more people recovering from problem drug use
  • communities that are safer and stronger places to live and work
  • ensuring that children affected by parental substance use are safer
  • improving the effectiveness of delivery at a national and local level

The Government’s vision for how drug treatment services in Scotland should be delivered is based on the principle that recovery should be the explicit aim of all services providing treatment and rehabilitation for people with problem drug use.

‘Recovery’ is the principle that people suffering from problem drug use should receive support which does more than just reduce the immediate risks and harms of addiction. Individuals become active participants in their own care, moving forward in the hope and belief that they will get better.

What do we mean by recovery?

We mean a process through which an individual is enabled to move on from their problem drug use, towards a drug-free life as an active and contributing member of society. Recovery is most effective when service users’ needs and aspirations are placed at the centre of their care and treatment. There is no right or wrong way to recover.

The Road to Recovery sets out the Government’s vision of recovery as an achievable goal for people with problem drug use and the actions it intends to carry out to promote a shared understanding of how to promote and support recovery. These include establishing and supporting a ‘recovery network’, building the capacity of services which can help services users choose the treatment that is right for them, and ensuring that the principles of recovery are reflected in the reform of delivery arrangements and in training and workforce development programmes.

Scots to Screen all Drinkers

Scots flag Scottish patients face quiz over drink habits at Last

A MULTIMILLION pound scheme has been launched to halt serious alcohol problems before they take hold in drinkers who are unaware they are exceeding safe limits.

Doctors, nurses and dentists across Scotland will be trained to quiz thousands of patients about their drinking habits and offer counselling to those breaching safe levels.

Women who regularly drink more than three units a day and men who drink more than five will be subjected to a ‘brief intervention’, where NHS staff will warn them about the dangers of alcohol, ask them to cut back on their drinking and tell them to return for a follow-up appointment.

Despite repeated attempts to highlight safe levels of alcohol, in Scotland there is still confusion about how much it is safe to drink. High on the list of people health officials want to reach are those who drink at home in the evening, after work and at weekends. They are unwittingly putting themselves at risk of a range of health problems, including high blood pressure and liver disease.

The move, part of an £85m three-year Scottish Government alcohol strategy, will see around one in six Scots ‘screened’ for their drinking habits during routine appointments with GP’s, dentists and nurses.

Full story at Scotland on Sunday

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Focus on recovery

Scots flag Focus on recovery for Scottish drug addicts

SCOTLAND’S new drug strategy will focus on helping addicts into recovery rather than treatment programmes.

Community safety minister Fergus Ewing is expected to unveil the Scottish Government’s drug abuse plan to Holyrood later this week.

And the key theme will be for treatment services to go beyond harm reduction and to help addicts to become drug-free.

Ewing said that drug users had “the right to the same care and treatment as the rest of us and shouldn’t be treated as second class citizens”.

Full story at Scotland on Sunday

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Recovery will be key in new drugs strategy

Scotland piper Blogger’s note; Along with England there is a shift in policy focus for healthcare workers to be aware of their responsibilities and duties to all people including those who have alcohol or drug illnesses.

All agencies in Scotland, UK dealing with drug addiction and its underlying causes need to refocus their talents and energies on helping addicts into recovery, Minister for Community Safety Fergus Ewing said today.

Responding to the publication of the Scottish Advisory Committee on Drug Misuse (SACDM) Sub-Group’s ‘Essential Care’ Report, Mr Ewing confirmed that the path to recovery would be at the centre of Scotland’s new national drugs strategy which will be published before the summer.

The new report is published today as former Health Minister Susan Deacon chairs a conference in Glasgow looking at how the concept of ‘recovery’ might be applied to the field of drug addiction.

Mr Ewing said that the emerging focus on recovery represents ‘a real opportunity to put a strategy in place that commands widespread professional, political and public support’.

Some of the main findings of the SACDM Sub-Group’s Essential Care Report are:

  • There is a need for a major change in the philosophy of care for people with problem substance use in Scotland
  • Substance users are people with aspirations
  • Policy makers, commissioners and services need to consider how they can help them recover
  • Substance users have the right to the same quality of care as the rest of us

Mr Ewing said:

“The Essential Care report contains a number of welcome recommendations which are already being looked at as we develop our new drugs strategy.

“I believe we need to get better at encouraging each addict’s personal vision of recovery by reducing practical barriers to services, while giving people hope by acknowledging that recovery is achievable.

“I have met former addicts who tell me that the key to believing in your own recovery is ‘believing it can happen for you’ – being optimistic that you can recover. The concept of recovery represents a significant shift in thinking and has happened in the field of mental health – why shouldn’t people with drug problems believe they can recover too?

“That’s the question that all the agencies working to tackle drug misuse need to ask themselves. If the answer isn’t yet a straightforward ‘yes’ – then they need to challenge the approaches they are taking. We have a real opportunity to put a strategy in place that commands widespread professional, political and public support. I want us all to seize that opportunity.

“We will publish a new drugs strategy for Scotland before summer and its main focus will be recovery. It is essential that people experiencing drug problems have access to a range of wider services including employment, housing, and health that help them to move-on and rebuild their lives.”

The Scottish Government is organising this conference to provide an opportunity for discussion and debate about what recovery means for people with problem drug use in Scotland, to develop a shared understanding about how to promote and support recovery and discuss the implications of building up a Recovery Movement.

This approach has been used successfully in the mental health field for people with similarly complex needs and the conference will hear from Simon Bradstreet of the Scottish Recovery Network about what has been achieved. Turning Point Scotland, one of the biggest voluntary sector providers of drug services have been ‘learning as an organisation’ to put recovery at the forefront of their care, and will share their experience with delegates.

Above all, there will be input from people with personal experience of drug problems who are driving along their own recovery and who are showing it can be done.

The majority of the Essential Care report is concerned with the Essential Care that is needed to address problems in other areas of drug service users’ lives; their general health, their mental health and their social skills and relationships. It lists all the areas which may need attention, together with evidence of their benefits.

But the main conclusion is something more visionary. The report states that there needs to be a major change in the philosophy of care for problem substance use in Scotland – focused on the recovery of each individual and putting service users’ aspirations at the centre of care.

See Scotland Government

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