Testing It Up

Over 3% of sudden death in the region of south-west Spain have been linked to cocaine use by forensic pathologists. These findings can be extended to most of the rest of Europe as well, demonstrating that cocaine use is a growing public health problem in Europe and that no amount of the drug can be considered safe. The study carefully investigated all the conditions surrounding a successive string of sudden deaths between 2003 and 2006. The pathologists tested blood and urine for traces of toxic substances post mortem, and studied the organs, focusing on the cardiovascular system and toxicological analysis. Information was also gathered on substance abuse prior to death, the circumstances of the death and death scene investigations.

There were 668 sudden deaths during the study period, 21 of which were related to cocaine use; of these, all occurred in men between 21 and 45, and most of the cocaine-related deaths were due to problems with the heart and its related systems.

“Our findings show that cocaine use causes adverse changes to the heart and arteries that then lead to sudden death.”  Said Dr Joaquín Lucena, MD PhD. “Any amount of the drug can be considered to have the potential for toxicity due to the fact that some patients have poor outcomes with relatively low blood concentrations, whereas others tolerate large quantities without consequences.”

81% of the men who died after cocaine use also smoked, and 76% had drunk alcohol. Ethanol, the inebriating ingredient in alcohol, increases the “high” cocaine gives while reducing the subsequent “low”. Both of these habits are associated with heart disease and Dr Lucena said: “The combination of cocaine with either or both of these habits can be considered as a lethal cocktail that promotes the development of premature heart disease.”

Drugs like multi-vitamin pills and herbal tonics are causing the untimely deaths of over one thousand people every year with renal and heart failures in the Punjab region alone. Diagnosed with organ problems caused by consumption of high potency drugs illegally made with salts and chemicals of allopathic medicines these patients face serious health problems and often death. All this despite the effort of at least 9 drug courts to prevent the damage from getting worse. Unfortunately the courts are handicapped due to ineffective legislation and inefficient drug testing laboratories of which there only 3 in the region.

Maximum punishment under the Drug Act of 1976 is 7 years imprisonment, but there have been no cases that were given this level of punishment. Most fines which are imposed on those who are found guilty of being involved in the business of spurious drugs are minor. Only 4 % of these pharmaceutical companies in Pakistan make medicine or raw materials while the other 96 % import raw materials/medicine salts or are re-packing industries.

The term spurious drug is complex as some genuine drugs made by unregistered companies are also called spurious, while the bogus drugs which don’t contain ingredients listed on the label, also fall under this heading. The raw material of allopathic medicines (which include salts and chemicals) were instead being given to the mafia which remixes several chemicals to make new allopathic medicines, herbal medicines and high potency health tonics that are dangerous if ingested. Some of these bogus medicines and antibiotics are even available in stores.

On the advice of Chief Minister Punjab Shahbaz Sharif, notices were issued to 400 pharmaceutical companies while 80 companies were asked to submit affidavits that they would use allopathic raw material under legal limits. FIRs were also registered against 14 companies for violation. Drug courts have proven ineffective, and the mafia was taking advantage of the fragile laws with time and better laws this may be changed.