Pubdate: Thu, 22 Feb 2007
Source: Minneapolis Star-Tribune (MN)
Copyright: 2007 Star Tribune
Author: Chao Xiong
Bookmark: (Heroin)


The Minnesota Department of Health issued an alert Tuesday that 
heroin possibly mixed with a drug used to treat horses may have 
reached Minnesota.

Local health experts suspect a man treated Sunday at a Twin Cities 
hospital used heroin cut with clenbuterol, a veterinary drug used to 
treat respiratory problems in horses. The drug causes long-lasting 
heart palpitations in humans.

The incident in Minnesota echoes other such incidents reported across 
the country.

The man admitted to snorting heroin and then experiencing a "rapid, 
pounding heart beat" that wouldn't subside, said Dr. David Roberts, 
medical director of the Hennepin Regional Poison Center.

The man went to a hospital shortly after using the heroin and was 
anxious, shaking and had a heart rate of 140 beats per minute, 
Roberts said. The average resting heart rate is 60 to 100 beats per 
minute. The patient recovered.

The man was not tested for clenbuterol because it would have required 
sending a sample to an out-of-state lab, a cost the patient couldn't 
afford, Roberts said, adding that there is a possibility that 
something else caused the man's symptoms.

Clenbuterol made its first appearance in humans in 2005 when heroin 
users on the East Coast complained of symptoms. After an apparent 
lull last year, clenbuterol-like symptoms reappeared in a number of 
East Coast patients this year; no cases have been confirmed with 
laboratory tests. Minnesota health officials said at least one 
possible case was recently reported in Illinois.

Clenbuterol is similar to the commonly used asthma medicine, 
albuterol, but is much stronger and longer-lasting. While users of 
albuterol may have to inhale it every four hours to maintain the 
medication's affect, a one-time use of clenbuterol by humans could 
last up to two days, leading to heart palpitations, seizures, low 
potassium levels and increased blood sugar, among other side effects, 
health officials said.

The drug is approved for limited veterinary use in the United States 
and has been used illicitly in humans and livestock to increase 
muscle mass, according to a Centers for Disease Control publication.

Twin Cities-area authorities said they haven't seen heroin cut with 
clenbuterol on the streets, but a Drug Enforcement Administration 
official said some trends are caught after the fact.

Kent Bailey of the Minnesota DEA office said that after an alert was 
issued last summer about heroin being combined with the opiate 
fentanyl, authorities traced the cocktail to about 10 overdose 
deaths. He said he hasn't heard a peep about clenbuterol, which is a 
stimulant and has the opposite effect of heroin, a depressant that 
dulls pain and creates a sense of euphoria.

New Jersey and Philadelphia health officials also released alerts 
this month about possible clenbuterol-tainted heroin, reporting six 
and two unconfirmed cases, respectively. Health officials caution 
that just because admitted drug users show symptoms doesn't mean 
clenbuterol is to blame.

In 2005, about a half-dozen heroin users appeared at different New 
Jersey hospitals with classic clenbuterol symptoms. Authorities were 
able to obtain drug samples from a few patients, which tested 
positive as pure clenbuterol, said Dr. Steven Marcus, executive 
director of the New Jersey Poison Center. The patients had purchased 
the drug thinking it was heroin, he added.

Marcus co-authored an article for the CDC publication about 
clenbuterol, showing that in 2005 about 26 people in five states, 
including New York and the Carolinas, showed the symptoms. All but 
two were hospitalized and eight tested positive for clenbuterol.

Marcus said none of the New Jersey patients died. It is unclear if 
patients elsewhere died, but Roberts said that if a user didn't 
succumb to a heroin overdose and didn't have a preexisting heart 
condition, the addition of clenbuterol probably wouldn't be fatal.
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MAP posted-by: Beth Wehrman