There have been a number of cases where people have contracted botulism after using contaminated heroin in the UK. Wound botulism is a rare but very serious illness that can be fatal and is caused by a bacterial toxin. It is acquired when spores of the bacterium Clostridium Botulinium get into the body via a wound. The spores are found naturally in the environment (for example in soil), so they can contaminate supplies of street drugs such as heroin. People who use these may get a wound infection through injecting the contaminated drug into skin or muscle. The toxin produced by the bacteria is then absorbed into the bloodstream and leads to paralysis. Wound botulism is not spread from person to person but by using contaminated drugs. Remember this advice from Public Health England (PHE):
- There is no way of knowing if the drugs are contaminated
- Overall smoking heroin is likely to be safer than injecting, though there are still risks.
- If possible stop using heroin. See your GP or someone from a drugs service about starting a substitute prescribed medication
- If you must inject make sure you hit a vein – your blood is better at killing this bacteria than skin or muscle
- Don’t share needles, syringes, cookers/spoons or other ‘works’ with other people using drugs
- Use as little citric acid as possible to dissolve the heroin. A lot can damage the muscle or body under the skin and this damage gives the bacteria a better chance to grow.
- Use a different place on your body with clean’ works’ if you inject more than one drug. This is important as some drugs e.g. cocaine can reduce the blood supply to the injection site and could give the bacteria better conditions to grow.
- If you get swelling, redness or pain at the injection site, or pus collects under the skin you should get it checked out by a doctor immediately, especially if the infection feels different to others you may have had in the past.