A TRAGIC FOOTNOTE

It looks as if the mystery of the hitherto unexplained deaths of some heroin
addicts in Dublin, Glasgow and the north of England in recent weeks is just
about unravelled. Investigators in Scotland appear to have established that
a species of bacterium known as Clostridium - possibly Clostridium novyi, a
less familiar member of the species whose number include the lethal
causative agents of botulism, gas gangrene and tetanus - must have
contaminated the batch of heroin which some heroin addicts injected into
their muscles.

It seems reasonable to infer that this highly toxic bacterium was also the
cause of the deaths among addicts in Dublin and England.

Clostridial bacteria are ubiquitous in the environment and, because they can
survive for long periods in the form of spores, they can be found in almost
all soils, especially those which may contain traces of animal and human
excrement.

A few spores, should they find themselves in an environment with little or
no oxygen, (as when injected into a muscle) can quickly become active
bacteria releasing some of the most potent toxins known to man. It is
unlikely that the source of the contamination of the batches of heroin used
in these tragically fatal cases can ever be established. But the doctors
treating affected addicts will be relieved to know what they may be dealing
with in these potentially lethal cases.

Early and high-dose treatment with certain antibiotics can save lives. There
will, therefore, be some relief among the addicts themselves, their families
and the health services which must care for the affected individuals. But,
tragic as these recent deaths have been, it is important to realise that, in
the annual statistics of deaths due to heroin (clean or contaminated), they
will make virtually no difference. People will go on dying as a result of
taking heroin: there have been eight deaths in Dublin from the use of
contaminated heroin, but there were 86 inquests in Dublin last year where
the cause of death was found to be drug-related. The Clostridial
contamination cases can make only a tragic footnote to so appalling a
national toll.

The current contamination episode, regrettable as it is, must not be allowed
to distract anyone from the overall picture of heroin addiction and the
devastating effects it is having not only on those areas of social
deprivation where it is most rampant, but on the nation as a whole, in terms
of crime, ill-health and, until quite recently, political inertia and
incompetence, not to mention denial.

The current review of the National Drugs Strategy must result in the
provision of vastly greater resources to deal with not only the heroin
epidemic but with the prevention of further deterioration of the situation.

Those areas of urban Ireland which have been socially, recreationally and
educationally deprived for three or more decades past must now be positively
discriminated for with an input of resources to remedy their social,
infrastructural and political neglect.

And everyone must recognise that this will take years to achieve.

Treatment and rehabilitative services for individual addicts and for whole
communities must be provided and improved with speed and generosity. There
is a long and expensive road to travel before the nation can reclaim its
reputation as a caring society.