To: Directors of Public Health of PCTs to forward to:
All GENERAL PRACTITIONERS – please ensure this message is seen by all practice nurses and non-principals working in your practice
– Deputising services
– Project manager/Nurse lead in Walk in Centres
– Lead nurses in PCTs
– PCT Pharmaceutical Advisers to forward to community pharmacists
Alert – contamination of herbal or ’skunk-type’ cannabis with glass beads
1. The Department of Health has recently received information suggesting that batches of herbal and ‘skunk-type’ cannabis have been contaminated with microscopic glass-like beads (or possibly ground glass). Laboratory testing has since confirmed a number of cases from a number of different parts of the country, in which cannabis appears to contain microscopic particles of glass. We have no information on other types of cannabis such as resin.
2. Reports, unconfirmed, suggest that smoking this contaminated cannabis, has been linked with complaints by users of sore mouth, mouth ulcers, chesty persistent coughs, and a tight chest lasting a few days after use.
3. Government advice already makes clear that cannabis is a substance harmful to health. The risk of glass contamination adds an additional layer of risk of harm. Whilst the exact potential health harm from this contamination is not yet fully determined, inhaling hot glass into the mouth, throat, or into the lungs should clearly be avoided.
4. In the current circumstances, the Department of Health advises that smokers of herbal and ‘skunk-type’ cannabis, in particular, should exercise caution.
5. For any patients presenting with concerns about their health after having smoked cannabis which may have been contaminated, or who may benefit from opportunistic health advice due to an identified high risk of cannabis use, the following advice may be useful:
a) Whilst there are no reported serious health effects to date from this contamination, we are not yet able to determine fully what are the possible or likely risks to the health of cannabis smokers.
b) There are anecdotal reports of some cases of the development of sore mouth, mouth ulcers, chesty persistent coughs and a tight chest lasting a few days, after smoking cannabis.
c) To avoid the risk of contaminated cannabis completely, patients should be advised to stop smoking cannabis.
d) If patients feel unable to stop, they should limit use as much as possible.
e) If patients continue to use, they should be warned, if any particular supply of cannabis that they have access to appears to have caused irritation to their mouth or airways, or if they suspect it is contaminated (e.g. due to grittiness when rubbed between moistened fingers), they should stop using that supply, or trading it, immediately; and they should not use any more cannabis from the same source.
f) Patients can be advised that self-help assistance with quitting cannabis can be located at the following website: http://www.talktofrank.com
6. The Department of Health will be making similar information directly available to the public, and to drug user networks, through a range of communication channels shortly after this alert has been sent to the NHS.
7. In addition, as part of the advice made directly available to the public, cannabis smokers will be advised that if they have particular symptoms and concerns about their health after smoking potentially contaminated cannabis, they may wish to discuss symptoms with their general practitioner. If exceptionally they believe they have an urgent problem and cannot access their general practitioner, they may consider they require assessment at an accident & emergency department.
8. As any further relevant information becomes available, the Department of Health will update this advice to practitioners.
This document has been authorised by the Department of Health: Gateway reference no: ****
