In the wake of seven confirmed deaths and a further 14 infections in Scotland, health authorities in Germany suspect that a 24 year old male has also died due to anthrax poisoning. The man was admitted to hospital on December 6th after injecting himself with heroin and later died of multi-organ failure on December 13th. Although the death was not originally thought to be anthrax related a wound swab taken on December 18th revealed anthrax spores.
The deaths have sparked a scare amongst health officials who fear that the death toll may rise to fifty and that infected heroin maybe circulating all over Scotland. Now it seems that the contaminated heroin may not be only in Scotland. In 2000 a similar outbreak of anthrax infected heroin claimed 43 lives. However some of the advice issued by health officials has sparked controversy. Dr Colin Ramsay consultant epidemiologist at Health Protection Scotland advised heroin addicts “to stop using heroin and seek advice from local harm reduction and drug services for support.” This statement has been attacked by a group of doctors and drug experts who have described the advice from the government run agency as “reckless in light of the fact that waiting times in Scotland for Opiate Substitute Treatment (OST) are the longest in the UK”.
Heroin users already face a greater threat of infection by diseases such as AIDS/HIV and Hepatitis C, the idea that the Anthrax scare will be a sufficient cure to long term heroin addiction is far-fetched. One teenage drug user stated in the Paisley Daily Express that “It’s scary but the problem is that folk like myself just can’t break their addiction to heroin. I’m still taking the drug, even though I’m worried that the batch I’m using might be contaminated. I just can’t help myself. I would rather put my life at risk than do without my heroin.”
Scotland has some of the highest levels of heroin abuse in Britain although waiting times to prescribed medication for heroin addiction treatment can range from between 8 and 52 weeks. The letter sent by the group of doctors and drug experts to Scottish Deputy First Minister, Nicola Sturgeon urges the Scottish government to “respond to the health crisis in a responsible manner” and states that they need to “provide for rapid access and low threshold prescribing of appropriate alternatives to street heroin – including GPs prescribing dihydrocodeine”. Gary Sutton, head of drug services at Release, said the group’s UK-wide helpline fielded a “disproportionate” amount of calls from Scotland.
Harm reduction policies have lately received some negative press in Scotland and recently Professor McKeganey criticised the Scottish government’s decision to spend £4.5m on needle exchanges and other efforts to curb rising Hepatitis C transmission rates. McKeganey, of Glasgow University’s Centre for Drug Misuse believes that harm reduction is a failed policy and the government should be investing more funds into abstinence based drug rehabilitation programs. However since the conservative government introduced harm reduction policies to curb the HIV epidemic in the eighties drug deaths reduced and HIV transmission rates to new users dropped. Also research from Scotland last year shows that methadone cuts the number of heroin use incidents and so cuts the risk of infection. The usual advice to avoid heroin use related infections is to stop injecting the drug. However this will not work with the anthrax problem as the spores can still be in inhaled if the heroin is smoked or ingested in other ways.