Hospital admissions and a fatality caused by, or associated to MDMA (Ecstasy) powder and tablets in Sheffield – 8th June 2017
There have been two hospital admissions associated with MDMA/Ecstasy use in Sheffield in the early hours of 8th June. One individual has subsequently died.
The young person who died took a brown powder sold as MDMA; they felt ill some hours later before going rigid and collapsing. The second incident involved an individual out with a different group when they became ill following taking a blue diamond shaped Ecstasy tablet.
Advice for those taking tablets or stimulant powders:
- Taking any tablet or powders when you don’t know what’s in it is a big risk
- If you must take something, take a small amount and wait for it to take
effect (at least an hour)
- Don’t top-up thinking there is no effect – it may just take a while to come
- Stay with friends for at least an hour after taking something
- Take regular breaks from the dance floor to cool down
- Sip no more than a pint of water or non-alcoholic drink every hour
- If symptoms of possible toxicity begin to develop (such as severe
overheating, nausea, hallucinations), seek medical help immediately
- Anyone with a heart condition, blood pressure problems, epilepsy or asthma can have a dangerous reaction to stimulant drugs, so is best
advised to avoid them.
If you are a recreational drug user and want advice contact: CGL The Corner (under 18s) 0114 275 2051 START Drug Service (18+) 0114 272 1481
Joanna trained as a Registered General Nurse at Manchester Royal Infirmary in 1990 and then went on to work in the Accident & Emergency (A&E) Department, Gynaecology, Oncology and General Surgery. In 2004 Joanna became intrigued by custody nursing after seeing an advertisement for A&E nurses with West Midlands. In 2005 Joanne applied and was successful in getting a post, and she loved it! Joanne found it particularly exciting being part of an emerging speciality and having the opportunity to develop the role. Joanne went on to became a team leader within Custody and became more involved with training, clinical governance activity and identifying best practice.
More recently Joanne became aware that there was a real shortage of female Sexual Offence Examiners to see victims and felt nurses had lots of relevant skills and knowledge they could contribute to ensuring that victims receive a high standard of care. It seemed a natural development for the Forensic Nurse role. In 2009 Joanne decided to do the St Mary’s FMERSA Course. Joanne experienced some hurdles in trying to become a Sexual Offence Examiner and old fashioned views about a nurse’s ability to do this work, but she persevered and became the West Midlands SARC Manager and a Sexual Offence Examiner in 2013.
In 2015 Joanne started her current role as the National SARC Lead for G4S Health, providing leadership and support to the management of six SARC services. As well as being part of the senior clinical team providing healthcare across Secure, Custody and SARC Services.
There has been recent reports that two men have died in what are thought to be drugs-related incidents as West Yorkshire Police issued a warning to drugs users.
A 36-year-old man in Leeds and a 27-year-old man in Normanton both died on Saturday 15th April. This is in addition to three men and a woman being found dead at separate addresses in South Yorkshire on Good Friday. Bringing the total to five deaths in two days.
In the latest incident, officers found a man’s body at a property in Compton View, Leeds, at about 08:20 BST on Saturday.
None of the deaths are being treated as suspicious, said detectives.
Det Ch Insp Jim Dunkerley, said: “We do believe these deaths are Class A drugs-related.”
Class A drugs include heroin, cocaine (including crack), methadone, ecstasy (MDMA), LSD, and magic mushrooms.
The force said it was aware of warnings issued by other police forces about unusually strong heroin or derivates possibly in circulation.
“It seems prudent to issue a warning now to local drugs users”, said Det Ch Insp Dunkerley.
UKAFN has developed a poster for nurses and paramedics to share with drug users they have contact with. Aiming to reduce the potential for harm. Click here for a PDF copy, or click the image for a JPEG.
A review by HM Inspectorate of Constabulary in Scotland (HMICS) into how adult and child victims of sexual crime access forensic medical services has identified significant variations in availability and quality around Scotland, with services offered to some victims being described as ‘unacceptable’.
The report welcomes the announcement of nationwide standards by the Cabinet Secretary for Justice in February 2017 alongside greater clarity around the statutory responsibilities for delivering these services. These will be critical to improving how victims of sexual crime obtain the medical attention they need while ensuring forensic evidence is also gathered for criminal justice processes.
Evidence for the review was gathered over a six month period and identified a number of issues affecting the quality of service delivered to victims of sexual crime in Scotland.
Gill Imery, Assistant Inspector of Constabulary at HMICS, who led the review, said:
“Sexual crimes have a devastating effect on victims and so it is imperative that the support they receive, both from health and criminal justice professionals is high quality and consistent irrespective of where they live.
“The priority of forensic medical examinations should always be to address the immediate health needs and future recovery of the victim, with the gathering of evidence towards potential criminal justice proceedings being an important but not the sole consideration.
“There are many dedicated and committed professionals working across Scotland who are providing quality service to victims, but there is much more to be done if we are to deliver a consistent service which minimises the distress and discomfort to victims who have experienced a sexual crime.”
The report highlighted that the current Memorandum of Understanding (MOU) between Police Scotland and NHS Scotland for the provision of healthcare and forensic medical services should be reviewed urgently.
There is also a need to provide greater clarity around the statutory responsibility for delivering these services.
The review identified ten key recommendations including the need to address the lack of availability of specialist services offered to victims of sexual crime in Glasgow. Although offering a good service to victims, HMICS found that the Archway service in Glasgow was not available for significant periods of time particularly overnight and at weekends, resulting in a ’two-tier’ service being delivered to victims of sexual crime with the alternative service delivered in a police station being described as ‘inadequate’.
The review found that Scotland was well behind the rest of the UK in respect of the availability of dedicated healthcare facilities which meet both the health care needs of victims and the necessary forensic requirements.
The is an urgent need for Police Scotland to work with NHS Boards to identify appropriate healthcare facilities for the forensic medical examination of victims of sexual crime, phasing out of police premises as soon as is practical.
The report also recognises the need to improve forensic cleaning standards in those police custody settings where suspected perpetrators of sexual abuse are examined.
The report also noted that suspects who were under 16 were being forensically examined and within police custody facilities and recommends that Police Scotland works with NHS Scotland to move these examinations into a more appropriate health care setting.
Assistant Inspector of Constabulary Imery said:
“In order to address the current disparity in forensic healthcare services across Scotland, it is clear that further investment will be required to fund appropriate healthcare professionals, including forensic nurses and the premises and equipment used for forensic medical examinations.
“In cases where victims of sexual crime seek support but are unsure whether they wish to report a crime to the police, they must have the option of a forensic medical examination to capture forensic evidence should they subsequently decide to make a report. It is imperative there is clarity around the process of securing and retaining forensic evidence to allow for investigation at a later stage if the victim subsequently chooses to disclose details of the crime.”
“There are a number of examples of how forensic medical services are provided in other countries, with a victim-centred approach, which would be useful for Scottish Government, Police Scotland, the Scottish Police Authority, NHS Boards and other key stakeholders including those that represent victims to consider.
“At present challenges in staffing of services and access to resources, particularly in remote and rural areas where victims may be required to travel some distance to access services, varies greatly and this is to the detriment of victims of sexual crime.
“Our recommendations have been designed to offer suggestions on how to improve the provision of services currently provided to victims of sexual crime so that they can be assured they will receive the best support from the range of agencies and professionals that they may need to engage with, irrespective of where they live in Scotland.”
This professional resource outlines how providers and commissioners can prevent deaths from drug abuse.
Scale of the problem
There were 2,300 drug misuse deaths registered in England in 2015. This represents an increase of 8.5% on the year before and the highest figure on record.
A drug misuse death is defined as a death where:
- the underlying cause is drug abuse or drug dependence
- the underlying cause is drug poisoning and where any of the substances controlled under the Misuse of Drugs Act 1971 are involved
The Office for National Statistics (ONS) publishes data on deaths from drug poisonings in England and Wales and is broken down by cause of death, sex, age and substances involved in the death.
Deaths involving opioids (such as heroin) account for the majority of drug poisoning deaths. Heroin related deaths in England and Wales have more than doubled since 2012 to the highest number since records began 20 years ago.
There are also a small but rising number of deaths involving:
- new psychoactive substances
- prescription and over-the-counter medicines, including pregabalin and tramadol
Further analysis by PHE found that alcohol is mentioned in around a third of drug misuse deaths annually in England, and that heroin-related deaths increasingly also involve other substances.
The majority of drug misuse deaths, 75% in 2012 in England and Wales, are accidental poisonings. The number of suicides among drug misuse deaths is small but steadily rising. PHE’s analysis suggested that suicide was more common in particular groups. Specifically, 38% of drug misuse deaths occurring in 2012 among those aged 45 or over were classed as suicides, as were 34% of deaths among women.
MHRA: ⚠️Hyoscine butylbromide (Buscopan) injection: risk of serious adverse effects in patients with underlying cardiac disease
Hyoscine butylbromide (Buscopan), given intravenously or intramuscularly, is indicated in acute muscular spasm, as in renal or biliary colic; in radiology for differential diagnosis of obstruction and to reduce spasm and pain in pyelography; and in other diagnostic procedures where spasm may be a problem (eg, gastroduodenal endoscopy).
Risk of adverse reactions
We have received 9 reports of patients who died after receiving hyoscine butylbromide injection (including a report from a coroner). In most of these cases, the fatal adverse reaction was reported as acute myocardial infarction or cardiac arrest.
Hyoscine butylbromide injection can cause adverse effects including tachycardia, hypotension, and anaphylaxis. These effects can be more serious in patients with underlying cardiac disease (eg, heart failure, coronary heart disease, cardiac arrhythmia, or hypertension). Several reports have noted that anaphylaxis is more likely to be fatal in patients with underlying coronary heart disease compared with those without.1 2
Reporting of suspected adverse reactions
Suspected adverse reactions should be reported to us on a Yellow Card.
Article citation: Drug Safety Update volume 10 issue 7, February 2017: 1.
Interview Respondents Needed for Research Project:
‘Police Custody Nursing: Ethical, Social, Policy and Professional Challenges’
Nurses are needed for an exciting and ambitious research project investigating the work of healthcare professionals in the police custody environment. Funded by the Wellcome Trust, and working with the United Kingdom Association of Forensic Nurses (UKAFN), Dr Gethin Rees (Newcastle University) is conducting a pilot study exploring all aspects of the everyday work of nurses in the custody environment: from the mundane to the exciting to the downright dreadful, in order to get a sense of what you do and the challenges you face in everyday practice. With this information, Dr Rees will develop a more detailed and specific research project, with the aim of highlighting and addressing some of the key challenges in custody nursing.
If you agree to take part in the pilot study, Dr Rees will interview you at a place of your choosing. The interview will last between an hour and a half and two hours and will include questions relating to your professional background, training and everyday work, amongst others. In accordance with the British Sociological Association’s ethical practice guidance (available at https://www.britsoc.co.uk/equality-diversity/statement-of-ethical-practice/), all interviews will be anonymous and pseudonyms will be used in follow-up publications. While there are no direct benefits at the pilot stage, having the opportunity to reflect upon your work with someone not directly involved can have its own benefits, and you will have the satisfaction of shaping a project that aims to help nurses and other healthcare professionals working in the custody environment in future.
How do I get involved?
If you would like to be part of the pilot project or would like to know more, please e-mail Dr Gethin Rees at email@example.com. More information about Dr Rees and his past research can be found at: