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Survey shows cocaine use by Spanish adolescents on the rise
POLICY AND PEOPLE
Clostridium novyi revealed as heroin contaminant he likely cause of the recent outbreak of a mystery illness that has killed at least 35 heroin users in the UK and Ireland (Lancet 2000; 355: 2053) has been identified as a toxin-producing strain of Clostridium novyi type A. In Glasgow, where the first cases were recognised, the strain was identified in isolates from 3 of 9 heroin injectors and is expected to be confirmed in the other 6. Brian Duerden, medical director of the UK Public Health Laboratory Service (PHLS), says that C novyi, which is commonly found in soil, is well known as a cause of severe infection in animals and may be found in animal faeces. “Infection in humans is rare, and, as far as we know, this is the first time this bacterium has ever caused an outbreak of infection in drug injectors”. Laurence Gruer, of the Greater Glasgow Health Board, adds that
T
site, has affected only users C novyi is very likely to be the main who inject the drug into muscle cause of the illness, although it has or subcutaneously. not been isolated Citric acid used to from all the patients dilute the heroin in Glasgow, and Rights were not damages the tissue other bacteria may be granted to around the injection involved in some include this site, providing an cases. Jai Lingappa, ideal environment for of the Centers for image in the growth of the Disease Control and electronic media. anaerobic bacterium. Prevention (Atlanta, So far, 48 cases of GA, USA), which, Please refer to the illness have been along with the PHLS, the printed reported in has been involved in Scotland—mostly in identifying isolates, journal. Glasgow—and 20 says: “A lot more deaths. There have work still needs to be been 16 suspected done to clarify how Source of Clostridium novyi cases in England and exactly the C novyi is Wales and 15 in Dublin, Ireland. The contributing to the illness and why contaminated heroin is thought to these people became sick and others have originated in South East Asia. didn’t.” So far the illness, which starts with painful swelling around the injection Dorothy Bonn
Survey shows cocaine use by Spanish adolescents on the rise report released on June 19 by Spain’s National Plan on Drugs, a Home Office-based body, reveals that the extent of cocaine use by the country’s adolescent population warrants the same government attention as that of misuse of drugs such as alcohol, cannabis, and MDMA (Ecstasy). Whereas the use of cocaine has levelled off among the general population, its consumption has substantially increased in people aged 14–18 years. The study showed that 5% of 18-year-olds had taken cocaine at least once in 1994, compared with 8·8% in 1998. But, more worryingly, it revealed that the increase was most pronounced in the younger individuals. Thus, among 16-year-olds, 1·7% had taken cocaine at least once in 1994, but 4·7% had had tried the
A
drug in 1998. And among those aged 14 years, 0·4% had taken the drug in 1994, compared with 1·6% in 1998. The survey was done in five Spanish cities and was based on an overall sample of 33 500 individuals aged 14–29 years. 21 000 of them were students aged between 14 and 18 years. The study examined factors such as consumption of cocaine, cannabis, Ecstasy, LSD, and alcohol (separately and in combination); frequency of consumption; and risk perception. A comparison with data from other European countries showed that 10% of Spaniards aged 14–29 combine their use of alcohol, cannabis, Ecstasy, and cocaine, whereas only 2·8% of other young Europeans do so. It was also revealed that 3·3% of Europeans within this age group take
cocaine several times per month, compared with 5·9% in Spain. Gonzalo Robles, a government representative of the National Plan, emphasised that the increase in the consumption of cocaine among people younger than 18 years is mainly due to an “excessive tolerance by society”. He charged all those involved in the fight against drug addiction with the responsibility of delivering “clear, forceful, and coherent messages”. “We are going to devote special efforts to inform adolescents and to increase the perception of risk among them”, he said. Indeed, the study showed that the risk of cocaine consumption perceived among those younger than 18 has declined over the years. Xavier Bosch
New company seeks to take over management of US organ network
A
new company says it will bid for the contract to run the US organ transplant system, which since 1986 has been run by the United Network for Organ Sharing (UNOS), but has been engaged in a bitter dispute with the government over proposed rule changes. The government maintained that old system of organ donation, which gave preference to patients in the region where the organ was
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donated, meant the organs were not reaching patients in greater need who were living in other regions. UNOS said the new rules unfairly favoured large centres, which tend to have longer waiting lists. A spokesman for the new company, called the Center for the Support of the Transplant Community, said his organisation supported the new regulations. UNOS, he charged, because it also
represents transplant centres, has a “conflict of interest” that raise questions about its suitability as a contractor. But a UNOS spokesman said that while UNOS opposed the changes when first proposed, now that the rules have been adopted, UNOS is working “in lock step” with the government. Michael McCarthy
THE LANCET • Vol 355 • June 24, 2000
For personal use only. Not to be reproduced without permission of The Lancet.
Clostridium novyi revealed as heroin contaminant he likely cause of the recent outbreak of a mystery illness that has killed at least 35 heroin users in the UK and Ireland (Lancet 2000; 355: 2053) has been identified as a toxin-producing strain of Clostridium novyi type A. In Glasgow, where the first cases were recognised, the strain was identified in isolates from 3 of 9 heroin injectors and is expected to be confirmed in the other 6. Brian Duerden, medical director of the UK Public Health Laboratory Service (PHLS), says that C novyi, which is commonly found in soil, is well known as a cause of severe infection in animals and may be found in animal faeces. “Infection in humans is rare, and, as far as we know, this is the first time this bacterium has ever caused an outbreak of infection in drug injectors”. Laurence Gruer, of the Greater Glasgow Health Board, adds that
T
site, has affected only users C novyi is very likely to be the main who inject the drug into muscle cause of the illness, although it has or subcutaneously. not been isolated Citric acid used to from all the patients dilute the heroin in Glasgow, and Rights were not damages the tissue other bacteria may be granted to around the injection involved in some include this site, providing an cases. Jai Lingappa, ideal environment for of the Centers for image in the growth of the Disease Control and electronic media. anaerobic bacterium. Prevention (Atlanta, So far, 48 cases of GA, USA), which, Please refer to the illness have been along with the PHLS, the printed reported in has been involved in Scotland—mostly in identifying isolates, journal. Glasgow—and 20 says: “A lot more deaths. There have work still needs to be been 16 suspected done to clarify how Source of Clostridium novyi cases in England and exactly the C novyi is Wales and 15 in Dublin, Ireland. The contributing to the illness and why contaminated heroin is thought to these people became sick and others have originated in South East Asia. didn’t.” So far the illness, which starts with painful swelling around the injection Dorothy Bonn
Survey shows cocaine use by Spanish adolescents on the rise report released on June 19 by Spain’s National Plan on Drugs, a Home Office-based body, reveals that the extent of cocaine use by the country’s adolescent population warrants the same government attention as that of misuse of drugs such as alcohol, cannabis, and MDMA (Ecstasy). Whereas the use of cocaine has levelled off among the general population, its consumption has substantially increased in people aged 14–18 years. The study showed that 5% of 18-year-olds had taken cocaine at least once in 1994, compared with 8·8% in 1998. But, more worryingly, it revealed that the increase was most pronounced in the younger individuals. Thus, among 16-year-olds, 1·7% had taken cocaine at least once in 1994, but 4·7% had had tried the
A
drug in 1998. And among those aged 14 years, 0·4% had taken the drug in 1994, compared with 1·6% in 1998. The survey was done in five Spanish cities and was based on an overall sample of 33 500 individuals aged 14–29 years. 21 000 of them were students aged between 14 and 18 years. The study examined factors such as consumption of cocaine, cannabis, Ecstasy, LSD, and alcohol (separately and in combination); frequency of consumption; and risk perception. A comparison with data from other European countries showed that 10% of Spaniards aged 14–29 combine their use of alcohol, cannabis, Ecstasy, and cocaine, whereas only 2·8% of other young Europeans do so. It was also revealed that 3·3% of Europeans within this age group take
cocaine several times per month, compared with 5·9% in Spain. Gonzalo Robles, a government representative of the National Plan, emphasised that the increase in the consumption of cocaine among people younger than 18 years is mainly due to an “excessive tolerance by society”. He charged all those involved in the fight against drug addiction with the responsibility of delivering “clear, forceful, and coherent messages”. “We are going to devote special efforts to inform adolescents and to increase the perception of risk among them”, he said. Indeed, the study showed that the risk of cocaine consumption perceived among those younger than 18 has declined over the years. Xavier Bosch
New company seeks to take over management of US organ network
A
new company says it will bid for the contract to run the US organ transplant system, which since 1986 has been run by the United Network for Organ Sharing (UNOS), but has been engaged in a bitter dispute with the government over proposed rule changes. The government maintained that old system of organ donation, which gave preference to patients in the region where the organ was
2230
donated, meant the organs were not reaching patients in greater need who were living in other regions. UNOS said the new rules unfairly favoured large centres, which tend to have longer waiting lists. A spokesman for the new company, called the Center for the Support of the Transplant Community, said his organisation supported the new regulations. UNOS, he charged, because it also
represents transplant centres, has a “conflict of interest” that raise questions about its suitability as a contractor. But a UNOS spokesman said that while UNOS opposed the changes when first proposed, now that the rules have been adopted, UNOS is working “in lock step” with the government. Michael McCarthy
THE LANCET • Vol 355 • June 24, 2000
For personal use only. Not to be reproduced without permission of The Lancet.