Prescription drugs end up in the wrong hands

Prescription drugs are ending up in the wrong hands. Addictions, severe reactions, and death are the result. One in twenty persons over age 12 used a prescription drug for non-medical reasons in a twelve-month period, according to one government-sponsored study.

The misuse of prescription medications ranges from using pills long after they have expired or sharing pills with someone else to setting up a sales operation, as one California physician did, selling pain pills and other medications in exchange for $100 for a “medical exam” that consisted of the transfer of funds from the “patient” to the physician.

Check out the following information sources:

General story: “Prescriptions supplanting illegal substances as drugs of choice,” by Tim Reiterman, Los Angeles Times.

Report of research showing that one in five teenagers misuse prescription drugs, Partnership for a Drug-Free America.

Offer of grants for research on ways to reduce the steep rise in inappropriate use of prescription medication, National Institutes of Health and National Institute on Drug Abuse.

Teens and prescription drug abuse, by Marc Siegel. Los Angeles Times.

For a copy of the research report, Prescription Drugs: Abuse and Addiction, call the National Clearinghouse for Alcohol and Drug Information 800 729-6686.

To report the illegal sale or abuse of prescription drugs call the Drug Enforcement Administration (DEA)’s hot line at 877 792-2873

Where heparin comes from

No comment, but this picture by Gordon Fairclough of the Wall Street Journal shows how pig “guts” give up pulp that is then heated in concrete vats.

Heparin: China says, “Not us,” “Not here”

What would you expect from China? A three-page admission of wrong-doing in the supply of a death-dealing ingredient that goes into the blood-thinning drug, heparin?

Hardly.

China responded by saying the US can’t prove that the “heparin-like” substance that contaminated the supply of heparin came from China and that Baxter won’t cooperate with their investigation.

They’re blaming Baxter and the FDA for not considering more options for the severe allergic reaction that has resulted in 81 deaths so far. Their logic is based on the fact that not everyone who took the drug got sick and that people got sick who did not take a version of the drug containing the alleged contaminant. They also feel that any conclusion is premature until they know the age, illness, past history and other details of those who has suffered from the problem.

Baxter’s statement in response was that they were cooperating to the fullest extent possible.

Read the International Herald Tribune’s account of the latest development in the heparin mystery.

Medications keep giving and giving…

The Associated Press launched a five-month investigation of drinking water in cities across the US. Their researchers found an alarming number of prescription drugs ranging from antibiotics to sex hormones in drinking water supplied to at least 41 million Americans.

The quantities were very small, probably too small to affect the body, but so widespread that concerns are growing about the need for testing the presence of prescription drugs in our drinking water.

Back in 2002 scientists met in the US to discuss the pollution of water by drugs as “a newly emerging issue.” Not really new. Sludge examined twenty years before the meeting found that incoming sewage used in recycling water systems was laced with aspirin, caffeine, and nicotine, according to symposium director Christian G. Daughton.

The Environmental Protection Agency (EPA) is proposing better ways of disposing of unused drugs. Instead of flushing them down the toilet, they should be mixed with “undesirable” waste in the trash and disposed of that way, according to comments by the EPA.

It is hard to sort through the emotion-heavy reports and appeals on the Web about the “crisis” in our water supply. One “reliable” source turns out to be funded by a second “reliable” source that turns out to be owned by a third “reliable” source, each quoting the other as “reliable” but with no other credentials.

The EPA does come through with guidelines and suggestions for finding out if your tap water is safe to drink and what to do about it if you have questions.

(Presented by HealthWorks, a publication for health and safety in the workplace by Griffith Publishing)

How the contaminated heparin drug kills

Finally we have a medical explanation of how the contaminated version of heparin was able to kill individuals who used the blood-thinning drug. A scientific report by a research team on the workings of the substance is being published today in the online version of Nature Biotechnology.

MIT Professor Ram Sasisekharan described the chemical structure of the contaminant, known as oversulfated chondroitin sulfate (OSCS), and states that steps can be taken to screen batches of heparin that have been adulterated by the rogue substance.

Sasisekharan also led another team that showed exactly how OSCS triggers a severe allergy-type reaction that lowers blood pressure and can be life-threatening. This report appears today in New England Journal of Medicine’s online edition.

The NEJM’s article includes a fascinating history of how the contaminant was identified and the effects on the heparin-using public and a case story of a 63-year-old woman who recovered from exposure to the contaminating substance after heparin was given to her from a source not associated with the contamination.

Presented in the public interest by Griffith Publishing

How did contaminated heparin slip through to patients?

The offending component of heparin that is blamed for scores of deaths in the US has been traced to Changzhou SPL, a company registered in China as a manufacturer of chemicals, not drugs.

The Wall Street Journal reported on March 10, 2008, that another company in China, Shenzhen Hepalink, provides the active ingredient for heparin used in kidney dialysis and other “large dose” applications. The report states that Shenzhen Hepalink follows strict guidelines for protecting the ingredient from contamination. The implication is that that patients have no fears if they are taking heparin in large quantities because the medicine came from a reliable source.

The offending active ingredient is “oversulfated chondroitin sulfate,” which originates in the cartilage of animals. Medpage gives an easy-read explanation of how the compound triggers inflammation in two separate pathways, causing death and how it was possible for screening methods not to identify the substance.

In summary, the compound is a “long sugar” molecule with a chemical structure that resembles the heparin so closely that standard tests did not detect it.

Screening practices are quickly being modified so that future adulterants will be more readily detected and kept from distribution.

The interesting point being made by scientists is that it is highly unlikely that the contaminant developed naturally. Instead, it seems to have been deliberately manufactured and shipped for insertion into the heparin compound.

More information about this development:

UPI: Germany recalls heparin made with an active ingredient from China

News about the heparin probe from Associated Press WorldStream; recalls in 6 countries

Q&A by FDA on heparin sodium injections from Baxter

(This blog comes to you from Griffith Publishing, a book writing, editing, design and production service)