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Europe: Anthrax Heroin Toll Rises as England Marks First Death

English authorities announced Wednesday that a Blackpool heroin user died of anthrax, making him the first fatality in England from what is apparently a batch of heroin contaminated with anthrax. The bad dope has been blamed for nine deaths in Scotland and one in Germany since the outbreak began in December.

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anthrax spores
The anthrax fatality announcement from the National Health Service (NHS) in Blackpool came just five days after the Health Protection Agency issued a statement warning that a female heroin user in London had been hospitalized with anthrax.

The spate of anthrax cases among heroin users is baffling police and health experts, who have yet to actually come up with any heroin samples containing anthrax spores. There is speculation that the heroin could have been contaminated at its likely source in Afghanistan, perhaps from contaminated soils or animal skins, or that it was present in a cutting agent added there or at some other point on its transcontinental trek to northern Europe.

The cases in Germany and England have no known link to those in Scotland, leading to fears that tainted dope could be widespread. On the other hand, the numbers so far reported as being infected remain relatively small.

Although harm reductionists and drug user advocates have called for measures including public information campaigns among users, swift access to drug treatment, and making prescription heroin more widely available, British health officials continue to do little more than tell users to quit. Dr. Arif Rajpura, director of public health at NHS Blackpool, was singing from the same official hymnal this week.

He repeated warnings for users to stop using and advised them to be on the lookout for symptoms of anthrax, including rashes, swelling, severe headaches, and high fevers. "Heroin users are strongly advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. This is a very serious infection for drug users and prompt treatment is crucial," he said.

Europe: Anthrax Heroin Toll Rises as England Marks First Death

English authorities announced Wednesday that a Blackpool heroin user died of anthrax, making him the first fatality in England from what is apparently a batch of heroin contaminated with anthrax. The bad dope has been blamed for nine deaths in Scotland and one in Germany since the outbreak began in December. The anthrax fatality announcement from the National Health Service (NHS) in Blackpool came just five days after the Health Protection Agency issued a statement warning that a female heroin user in London had been hospitalized with anthrax. The spate of anthrax cases among heroin users is baffling police and health experts, who have yet to actually come up with any heroin samples containing anthrax spores. There is speculation that the heroin could have been contaminated at its likely source in Afghanistan, perhaps from contaminated soils or animal skins, or that it was present in a cutting agent added there or at some other point on its transcontinental trek to northern Europe. The cases in Germany and England have no known link to those in Scotland, leading to fears that tainted dope could be widespread. On the other hand, the numbers infected remain relatively small. Although harm reductionists and drug user advocates have called for measures including public information campaigns among users, swift access to drug treatment, and making prescription heroin more widely available, British health officials continue to do little more than tell users to quit. Dr. Arif Rajpura, director of public health at NHS Blackpool, was singing from the same official hymnal this week. He repeated warnings for users to stop using and advised them to be on the lookout for symptoms of anthrax, including rashes, swelling, severe headaches, and high fevers. "Heroin users are strongly advised to cease taking heroin by any route, if at all possible, and to seek help from their local drug treatment services. This is a very serious infection for drug users and prompt treatment is crucial," he said.
Location: 
Blackpool
United Kingdom

Europe: Anthrax-Tainted Heroin Death Toll Up to Ten

The death toll from anthrax-tainted heroin in Europe has risen to 10 as Health Protection Scotland confirmed that a heroin user who died in the Glasgow area on December 12 was infected with anthrax. Nine of the 10 deaths occurred in Scotland; the other occurred in Germany.

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anthrax spores
The latest announced death is actually the earliest. Prior to the announcement of this death, the earliest known death took place December 16.

At least 19 drug users -- 18 of them Scottish -- have been diagnosed with anthrax since the outbreak began. A pair of heroin deaths in Sweden turned out to be unrelated, and a cluster of deaths in Portugal has not been confirmed as being linked to anthrax.

While Scottish authorities have yet to find any anthrax-tainted heroin, they believe either the heroin itself or cutting agents have been contaminated with anthrax spores. They said there is no evidence of person-to-person infection.

"While public health investigations are continuing to attempt to identify the source of the contamination, no drug samples tested to date have shown anthrax contamination, although a number of other types of potentially harmful bacteria have been found," said Colin Ramsay, an agency epidemiologist. "It must therefore be assumed that all heroin in Scotland carries the risk of anthrax contamination and users are advised to cease taking heroin by any route. While we appreciate that this may be extremely difficult advice for users to follow, it remains the only public health protection advice possible based on current evidence."

As noted in our earlier story linked to above, harm reductionists have called for other measures, ranging from informational campaigns to liberalized prescribing of pharmaceutical heroin.

Infected patients typically developed inflammation or abscesses around the injection site within one or two days and were hospitalized about four days after that. In some severe cases, the lesions developed necrotizing fasciitis, a flesh-eating disease.

Feature: Anthrax-Tainted Heroin Takes Toll in Europe, Prompts Calls for Emergency Public Health Response

European heroin users are on high alert as the death toll rises from heroin tainted with anthrax. At least eight people have died -- seven in Scotland and one in Germany -- since early December, and another 14 Scottish heroin users have been hospitalized after being diagnosed with anthrax. Meanwhile, drug reform and drug user activists are reporting a cluster of nine suspicious heroin-related deaths in Coimbra, Portugal, although it is unclear at this point whether they are linked to anthrax-tainted heroin.

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anthrax spores
The Scottish government has responded by urging heroin users to stop using and to seek drug treatment. That advice has not gone over well with drug users and public health and harm reduction advocates, who are demanding an emergency public health response.

The first four Scottish deaths were in Glasgow, but after one person died in Tayside and one in the Forth Valley earlier this month, Health Protection Scotland epidemiologist Dr. Colin Ramsay said: "The death of this patient in NHS Forth Valley indicates further geographical spread of the cases, meaning that heroin users all across Scotland need to be aware of the risks of a potentially contaminated supply. I would urge all users to stop using heroin immediately and contact local drug support services for help in stopping. If any heroin users do notice signs of infection, for example marked redness and swelling around an injection site or other signs of serious infection such as a high fever, they should seek urgent medical advice."

The French government has also reacted, with the General Directorate for Health issuing a statement Tuesday warning that contaminated heroin may be circulating in France and other European countries. Noting the rising death toll, the statement said "the likeliest source is heroin contaminated by anthrax spores."

Heroin users should be alert, the French statement said, because heroin contaminated with anthrax is indistinguishable from other heroin. "There is no outward sign or color enabling the user to tell whether the heroin has been contaminated by anthrax, and contaminated heroin dissolves or is used in the same way as uncontaminated heroin," it said.

Anthrax is a potentially lethal bacterium that exists naturally in the soil and can also occur among cattle. It is also a potential bio-terror weapon.

The vast majority of heroin consumed in Europe comes from Afghanistan, and while so far evidence is lacking, speculation is that anthrax spores may have been present in bone meal, an animal product sometimes used as a cutting agent. Another possibility is that containers used in the heroin production process were contaminated with anthrax spores. And, given fears that Al Qaeda and its Taliban allies could resort to biological warfare against the West and given the Taliban's role in the Afghan opium and heroin trade, a bio-attack cannot be completely ruled out.

"The anthrax-infected heroin hasn't decreased use, whether people are injecting it or chasing [smoking] it," said Tam Miller, chair of Chemical Reaction, an Edinburgh drug user group, and a member of INPUD (the International Network of People who Use Drugs). "People are scared -- you can be sure of that -- but I think they're more afraid of withdrawing. The Scottish government's advice was for people to stop using heroin, but that won't happen."

Instead, Miller said, heroin users are doing what they can to protect themselves. "Users feel there's not much they can do personally and, as usual, they feel isolated," he said. "A lot are looking up the effects on anthrax on the net and passing on information to people with no internet access. We think the powers that be should put out information on how to spot signs if someone has been in contact with access. Basically, mate, the Scottish government wants little to do with it."

The Scottish government's response so far has drawn a harsh rebuke from the United Kingdom's harm reduction and public health community. In a Tuesday letter to the Scottish government, the International Harm Reduction Association, the drug think tank Release, the Transform Drug Policy Foundation, the UK Harm Reduction Alliance, and individual public health experts called on the government to put in place an emergency public health plan to deal with the crisis.

The letter said the government's advice to heroin users to stop using and enter treatment was "reckless in light of the fact that waiting times in Scotland for opiate substitute treatment (OST) are the longest in the UK. Many of those accessing services are informed that it is a condition of their treatment to engage with the service for a minimum period of time, before they will be entitled to a prescription offering an alternative substitute medication, usually methadone. In some areas of Scotland we have been informed that waiting times for OST can be up to 12 months."

[There is another potential issue with methadone, as well. The antibiotic drug Cipro, used to treat anthrax, interacts with methadone, leading to the possibility of methadone overdoses.]

Given the reality of treatment shortages and delays, it is "unacceptable" for the Scottish government to just tell users to stop or to go to treatment that isn't there, the letter said. "It is clear that this kind of approach can only lead to the death of more vulnerable people."

Instead, the Scottish government must immediately implement a public health plan that includes rapid access and low-threshold prescribing of alternatives to street heroin, the letter-writers advised. They recommended prescribing dihydrocodeine, a synthetic opiate approximately twice as strong as codeine. It is sold in the US under brand names including Panlor, Paracodin, and Synalgos.

"Such an approach will go some way to prevent any more loss of life and will provide greater protection to the public as a whole," the letter said. "Failure to adopt such a policy would mean that the Scottish state would be failing in its duty to its citizens."

Joep Oomen of the European Coalition for Just and Effective Drug Policies (ENCOD) had another suggestion. "The only decent reaction to this kind of episode is to immediately open facilities where people can test their heroin and where they can use in safe conditions, supervised by people who can help if anything goes wrong," he said.

"Hopefully, in the longer term, because of these incidents, authorities will start to see the need for introducing heroin maintenance programs, not as a trial for a limited group of people, but as a permanent service for all those who cannot abstain from heroin for a longer period of time," he added.

Ultimately, said Oomen, prohibition is the problem. "Adulteration is a practice that belongs to the illegal market," he said. "It happens because the people who control the heroin market have no interest at all in the health of their customers."

Dr. Sharon Stancliff of the US Harm Reduction Coalition agreed with her colleagues' assessment of the Scottish government's response. "Telling people to stop is not useful information," she said. "Maybe some occasional users will have a glass of wine instead, but if people are sick and treatment is limited, telling people that heroin is bad for them isn't going to have much impact," she explained.

"At this point, the European harm reduction people should be getting the word out, and the medical people over there need to be on the alert," she added.

Stancliff said she had seen no sign of heroin contaminated with anthrax on this side of the Atlantic, but she was worried. "I hope the DEA is out there buying heroin to see what's in it," she said. "If there is any hint of it here, physicians should be alerted by the Centers for Disease Control as they were with levamisole-tainted cocaine."

If the anthrax-contaminated heroin is coming from Afghanistan, as most heroin consumed in Europe does, US heroin users may catch a break. Most heroin consumed here is of Mexican or Colombian provenance.

But on the other side of the Atlantic, adulterated heroin is killing drug users.

Harm Reduction: Drug-Related Deaths Rose Dramatically in Recent Years, CDC Says

In a report released Wednesday, the Centers for Disease Control (CDC) has found that drug-related deaths -- the vast majority of them overdoses -- increased dramatically between 1999 and 2006, and that drug-related deaths now outpace deaths from motor vehicle accidents in 16 states. That's up from 12 states the previous year and double the eight states in 2003.

More people died from drug-related causes than traffic accidents in the following states: Massachusetts, New Hampshire, Rhode Island, Connecticut, New York, New Jersey, Maryland, Pennsylvania, Ohio, Michigan, Illinois, Colorado, Utah, Nevada, Oregon and Washington.

The news comes even as harm reductionists and public health advocates seek to gain support on Capitol Hill for passage of H.R. 2855, the Drug Overdose Reduction Act, sponsored by Rep. Donna Edwards (D-MD). The bill would create a federal grant program to support both existing and new overdose prevention programs across the country.

"Patients and their families could receive written instructions on how to recognize and respond to an overdose. In addition, college campuses could utilize overdose prevention money to educate students on how to recognize and respond to an alcohol overdose," advocates for H.R. 2855 wrote in a letter to Reps. Henry Waxman (D-CA) and Frank Pallone (D-NJ), chairmen of the House Energy and Commerce Committee and the committee's Health subcommittee, respectively.

Something like H.R. 2855 is desperately needed. According to CDC researchers, who examined death certificate data from around the country, some 45,000 died in traffic accidents in 2006, while 39,000 people suffered drug-related deaths. About 90% of the drug deaths were classified as overdoses, but researchers also included in that figure people who died of organ damage from long-term drug use.

Researchers reported a sharp increase in deaths tied to cocaine and to the opioid analgesics, a class of powerful drugs, used medically for pain treatment (as well as for non-prescription drug-taking via the black market), that includes fentanyl, methadone, morphine, and popular pain relievers like Vicodin and Oxycontin. Cocaine-related deaths jumped from about 4,000 in 1999 to more than 7,000 in 2006, but methadone-related deaths increased seven-fold to about 5,000, and other opioid deaths more than doubled from less than 3,000 to more than 6,000. Interestingly, heroin-related deaths actually declined slightly, hovering just below 2,000 a year throughout the period in question.

And despite all the alarms about young people dying of drug overdoses, the 15-24 age group had the lowest drug-related death rate of any group except those over 65. Only about three per 100,000 young people died of drug-related causes in 2006, compared to six per 100,000 among the 25-34 age group, eight per 100,000 in the 35-44 age group, and 10 per 100,000 in the 45-54 age group.

CDC researchers did not discuss causes for the increase in overall drug-related deaths or the rate of drug-related deaths.

Public Health: Feds Finally Issue Warning on Tainted Cocaine

Three weeks ago, Drug War Chronicle reported on cocaine cut with the veterinary agent levamisole and asked what the federal government was doing about it. Ten days later, the feds responded to the situation, with the Substance Abuse and Mental Health Services Administration (SAMSHA) issuing a public health alert on September 21.

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The alert, sent out to medical professionals, substance abuse treatment centers, and other public health authorities, warned of the "life-threatening risk" that much of the US cocaine supply may be adulterated with the veterinary anti-parasitic drug. It has been linked to a serious, sometimes fatal, blood disorder called agranulocytosis, with SAMHSA saying there are at least 20 confirmed or suspected cases and two deaths in the US associated with the tainted cocaine.

Despite being first noticed by forensic scientists at least three years ago and by the DEA late last year, there has been little public awareness of the public health threat. SAMHSA expects the number of cases to rise as public and professional awareness spreads.

"SAMHSA and other public health authorities are working together to inform everyone of this serious potential public health risk and what measures are being taken to address it," said SAMHSA Acting Administrator Eric Broderick, DDS, MPH.

The addition of levamisole to cocaine is believed to be done by Colombian drug traffickers. Ingesting the tainted drug can seriously reduce a person's white blood cells, suppressing immune function and the body's ability to fight off even minor infections. People who snort, smoke, or inject crack or powder cocaine contaminated by levamisole can experience overwhelming, rapidly-developing, life threatening infections, SAMHSA warned. Other serious side effects can also occur.

The DEA is reporting that levamisole is showed up in over 70% of cocaine analyzed in July, and authorities in Seattle are reporting that 80% of persons testing positive for cocaine are also testing positive for levamisole.

In its alert, SAMHSA warned that:

THIS IS A VERY SERIOUS ILLNESS THAT NEEDS TO BE TREATED AT A HOSPITAL. If you use cocaine, watch out for:

  • high fever, chills, or weakness
  • swollen glands
  • painful sores (mouth, anal)
  • any infection that won't go away or gets worse very fast, including sore throat or mouth sores; skin infections, abscesses; thrush (white coating of the mouth, tongue, or throat); pneumonia (fever, cough, shortness of breath).

The Centers for Disease Control and Prevention (CDC) is also getting in on the act. CDC will shortly publish a case report analysis in its Morbidity and Mortality Weekly Report and will be working with state public health authorities to collect information on the phenomenon. That information will be "used to guide treatment and prevention initiatives to address this public health concern."

One thing the feds are not doing is coming up with a test kit that would allow users to detect the presence of levamisole in cocaine. That's too bad, said Dr. Michael Clark, assistant professor in the Department of Psychiatry and Behavioral Science at the University of Washington Harborview Medical Center. "I thought to myself, why isn't there a test kit? It is easy to test for," he said. "It would be like testing your hot tub for its chemistry. Take a sample, mix some chemicals together, add a reagant, and see what turns what color."

Clark is working on developing just such a test kit. "It could be used at street level, and it could be used by a lot of public health and harm reduction groups. You want to identify levasimole before people ingest, very much like the Ecstasy testing. You could do the same thing with cocaine and levasimole," he said.

Overdose and Other Drug-Related Deaths Now Closing In on Car Wrecks as Leading Accidental Killer in US

In a report released Wednesday, the Centers for Disease Control (CDC) has found that drug-related deaths—the vast majority of them overdoses—increased dramatically between 1999 and 2006, and that drug-related deaths now outpace deaths from motor vehicle accidents in 16 states. That's up from 12 states the previous year and double the eight states in 2003. More people died from drug-related causes than traffic accidents in the following states: Massachusetts, New Hampshire, Rhode Island, Connecticut, New York, New Jersey, Maryland, Pennsylvania, Ohio, Michigan, Illinois, Colorado, Utah, Nevada, Oregon and Washington. According to CDC researchers, who examined death certificate data from around the country, some 45,000 died in traffic accidents in 2006, while 39,000 people suffered drug-related deaths. About 90% of the drug deaths were from overdoses, but researchers also included in that figure people who died of organ damage from long-term drug use. Researchers reported a sharp increase in deaths tied to cocaine and to the opioid analgesics, a class of powerful drug that includes fentanyl, methadone, morphine, and popular pain relievers like Vicodin and Oxycontin. Cocaine-related deaths jumped from about 4,000 in 1999 to more than 7,000 in 2006, but methadone-related deaths increased seven-fold to about 5,000, and other opioid deaths more than doubled from less than 3,000 to more than 6,000. Oddly enough, heroin-related deaths actually declined slightly, hovering just below 2,000 a year throughout the period in question. And despite all the alarums about young people dying of drug overdoses, the 15-24 age group had the lowest drug-related death rate of any group except those over 65. Only about three per 100,000 young people died of drug-related causes in 2006, compared to six per 100,000 among the 25-34 age group, eight per 100,000 in the 35-44 age group, and 10 per 100,000 in the 45-54 age group. CDC researchers did not discuss causes for the increase in overall drug-related deaths or the rate of drug-related deaths, but several plausible (and complementary) explanations come to mind: the introduction and widespread use of Oxycontin, the fentanyl-tainted heroin epidemic that appeared in 2006, the increasing non-medical use of prescription pain relievers, and the increasing use of methadone as a pain reliever.
Location: 
Atlanta, GA
United States

Feature: Tainted Cocaine Sickening, Killing People, But Feds Slow to Act

On the last day of August, media outlets around the country ran an Associated Press story reporting that nearly one-third of the cocaine in the country is tainted with a veterinary medicine, a de-worming agent called levamisole. According to the AP, the tainted cocaine is responsible for at least three deaths in the US and Canada, as well as sickening more than a hundred other people.

According to health authorities, the cocaine tainted with levamisole is linked to an unusual incidence of agranulocytosis, a condition of a suppressed immune system, whose symptoms include persistent sore throat, persistent or recurrent fever, swollen glands, painful sores, skin infections with painful swelling, thrush, and other unusual infections.

The DEA suspects that levamisole is being added as a cutting agent by Colombian drug traffickers. Researchers speculate that it may boost the cocaine high by acting as a dopamine reuptake inhibitor, but there is of yet little research to support that.

While the cumulative death toll and illness count was news, the fact that cocaine is being laced with levamisole shouldn't have been. Delaware public health officials issued a health advisory on levamisole-tainted cocaine in 2005, and British researchers reported in 2006 on 14 deaths in a one-year period from the tainted cocaine.

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Last fall, the DEA quietly reported in its obscure Microgram Journal that levamisole-contaminated cocaine had been encountered beginning in April 2005 and that the percentage of contaminated cocaine had generally increased since then to reach 30% of all samples by October 2008 (page 83). But it didn't publicize those findings.

Soon after, local public health alerts about levasimole-tainted cocaine deaths or illnesses began trickling in, including Alberta, Canada, in November 2008, Los Angeles County in December 2008, New Mexico in January, Erie County, Pennsylvania, in March, and King County, Washington, in June.

Also early this year, researchers reported on cases of agranulocytosis after consumption of levamisole-laced cocaine in January in the Annals of Internal Medicine, and Criminal Justice Policy Foundation head Eric Sterling blogged about it in March.

Given the large number of cocaine users in the US, tainted product poses a significant public health risk. According to the most recent National Survey on Drug Use and Health released yesterday, there are 1.9 million "current cocaine users."

"If it really 30% of the cocaine, that would be a huge public health problem," said Dr. Sharon Stancliff, medical director for the Harm Reduction Network. "Medical people need to be aware of this."

They aren't, said Dr. Eric Lavonas, assistant director of the Rocky Mountain Poison and Drug Center in Denver, where nearly half of the cocaine is thought to be cut with levasimole. "I would think it would be fair to say the vast majority of doctors in the United States have no idea this is going on," he said. "You can't diagnose a disease you've never heard of."

But despite the mounting pile of reports and alerts and the potential public health risks, federal officials have remained silent. That may be about to change.

"The Center for Substance Abuse Treatment (CSAT) is going to put out a 'dear colleague' alert," said Stancliff. "It should happen relatively soon."

The Centers for Disease Control is also expected to issue an alert, sources told the Chronicle, though a media specialist at CDC denied that. "We don't do drugs," she said -- unaware of the CDC's involvement in a national alert about fentanyl-tainted heroin in 2006 and 2007 and pointing the Chronicle toward CSAT. CSAT had not responded to Chronicle inquiries by press time.

The 2006-2007 wave of fentanyl-tainted heroin overdoses -- hundreds of people died from them -- provides a model for how CSAT and the CDC might respond to the ongoing levasimole-tainted cocaine problem. As the Chronicle reported at the time, people began overdosing on the tainted heroin in the fall of 2006.

While the initial response by federal agencies was slow, by the summer of 2007, CSAT had issued a nationwide alert to outreach workers, treatment providers, and hospitals warning of the deadly problem. The CDC also got involved, although to a lesser degree. That summer, a team of CDC epidemiologists went to Detroit in response to a request from the Michigan Department of Community Health. The team assisted state and local officials with autopsy reports and analysis to help understand the overdose wave and formulate prevention guidelines for clinicians and educators.

The current wave of deaths and illnesses related to levasimole-tainted cocaine is not as severe as the fentanyl overdoses -- so far at least -- but as indicated above CSAT is set to act soon. Whether the CDC will actually get involved this time around remains to be seen.

While waiting for the feds to act, harm reductionists and public health workers are struggling with how to best act on the tainted cocaine. "Medical people need to be aware of this," said Stancliff, "but can we make warnings about smoking versus shooting versus snorting? I have no idea. There may be differences in terms of biomedical availability, but we don't know that yet," she said.

Nor was Stancliff certain about whether it was time to alert needle exchange clients about the problem. "When New York state sent out an advisory, we made sure the Injection Drug Users Health Alliance was aware of it, but I'm never sure when we should be alerting the people going to the needle exchanges. We want to save our alerts for times when people are thinking about changing their behavior."

For Doctor of Public Health David Duncan, a Kentucky-based expert on substance abuse and epidemiology, contaminated drugs are an expected consequence of prohibitionist regimes. "This is one of the things you inevitably have with black market drugs," he said. "You don’t know what you’re dealing with and the makers don’t necessarily know what they’re making. It seems to be an iron law of prohibition--outlaw something and whatever it is, it gets stronger and more dangerous."

"The appropriate public health response is to tell people there is a contaminant, and we’re not sure how dangerous it is," said Duncan. "But all black market cocaine contains contaminants. As long as it is illegal, there is risk of contamination. The only way to make it safe is to make it legal."

Stancliff added that testing for levasimole in cocaine is relatively simple. That leads to the obvious question of whether a drug testing program like those that evolved around Ecstasy and the rave scene may be appropriate. At least one specialist thinks so.

"I thought to myself, why isn't there a test kit? It is easy to test for," said Dr. Michael Clark, assistant professor in the Department of Psychiatry and Behavioral Science at the University of Washington's Harborview Medical Center. "It would be like testing your hot tub for its chemistry. Take a sample, mix some chemicals together, add a reagant, and see what turns what color."

Clark is working on developing just such a test kit. "It could be used at street level, and it could be used by a lot of public health and harm reduction groups. You want to identify levasimole before people ingest, very much like the Ecstasy testing. You could do the same thing with cocaine and levasimole," he said.

But that's addressing the problem on the back end. The solution is an untainted cocaine supply. "Someone needs to talk to those folks in Colombia," Stancliff said. And, as Duncan suggested, someone needs to talk to those folks in Washington--the ones who continue to assist on a prohibitionist regime despite all its negative collateral consequences, of which a tainted drug supply is only one.

India: Moonshine Deaths Stir Alcohol Prohibition Debate in Gujarat

Last week, 136 people died in the Indian state of Gujarat after drinking tainted alcohol, and the incident has stirred debate over the state's alcohol prohibition policy, in existence since 1960. One of India's "liquor barons" has invited the state government to do away with prohibition, and the state government has invited him to shut up about it.

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moonshine still (courtesy Hagley Library)
The deaths occurred in Ahmedabad, about 35 miles from the state capital, Gandhinagar. Most of the dead were common laborers who had allegedly purchased illicit liquor produced or distributed by one Vinod Dagri, currently a fugitive, and described in local media as "the key mastermind in the hooch tragedy case."

It's not the first time contaminated black market alcohol has killed people in Gujarat. And as Gujarat officials were quick to point out, moonshine deaths also occur in Indian states without alcohol prohibition. In a Monday statement, Gujarat government spokesperson Jaynarayan Vyas noted that tainted alcohol had killed 31 people in Kerala in October 2000, 10 were killed and four blinded by bad hooch in Bhubaneswar in February of this year, 13 people died in of bad booze in Kolkata in May 2008, and 142 people in Karnataka had died from illicit liquor over the course of last year.

[Ed: Deaths from tainted alcohol in states that don't have prohibition are comparable to those in Gujarat, only because people in those states have access to alcoholic beverages that were legally produced, then smuggled into their states. If alcohol prohibition were to become more widespread, or nationwide, legally produced alcohol would become a scarcer commodity, and tainted alcohol would likely cause proportionally many more deaths in places like Kerala or Kolkata or Karnataka than it does today.]

Still, Vijay Mallya, chairman of the UB Group, India's largest liquor conglomerate, couldn't resist taking the opportunity to jab at the state's political leadership for its adherence to prohibitionist policies. Mallya offered to help the state craft a "responsible alcoholic beverages policy" in a statement cited in the Hindustan Times. "The deaths are not only tragic but should serve as a wake-up call to our political hypocrites. [Gujarat Chief Minister] Narendra Modi knows full well that every brand of alcohol is available in Gujarat," Mallya said. "The farce of prohibition, which cannot be enforced, leads to illegal, unhygienic and unsupervised production of deadly cocktails which claim innocent lives. It is time that political masters face reality in the interests of people's health," he added.

Minister Modi was not amused. "Many elements are giving the tragic incident political color and are trying to ruin the peaceful atmosphere in Gujarat," he said. "My government is sincere about eliminating the vice of illicit liquor."

State Health Minister Jay Narayan Vyas also suggested that Mallya butt out. "This is an internal matter of the Gujarat government and Mr. Mallya should avoid making suggestions on what should be done in Gujarat," Vyas told reporters in Gandhinagar.

Early this week, the Gujarat government was standing firm. "There is no question of any rethink on easing or lifting the prohibition laws," Vyas said on Monday. "The government is committed to implementing the prohibition laws for the peace, prosperity and security of the people of Gujarat."

Tainted Cocaine is a Consequence of Drug Prohibition

I don’t particularly mind the drug czar pointing out that cocaine can kill you. While far from the deadliest thing on earth, the stuff ain’t good for you, especially given the way some folks get carried away with it. I agree that a sensible drug policy includes telling people that cocaine pretty much sucks.

But here we have the drug czar highlighting reports of tainted cocaine in Canada and proposing drug treatment as the solution to that. Isn’t it ironic that, after tirelessly advocating policies which drive drug distribution underground, the drug czar then cites a poisoned drug supply as an argument for abstinence?

Drug War Issues

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