Arsenic adulteration in opium ( ARSENICOSIS - A real danger to health in developing countries)

Sections

Summary
Material and methods
Observations
Discussion

Details

Author: D.V. DATTA,, M.K. KAUL,, Division of Hepatic Diseases, Postgraduate Institute of Medical Education and Research, Chandigarh-160 011
Pages: 41 to 44
Creation Date: 1977/01/01

Arsenic adulteration in opium ( ARSENICOSIS - A real danger to health in developing countries)

D.V. DATTA, Associate Professor of Medicine and
M.K. KAUL, Research Fellow
Division of Hepatic Diseases, Postgraduate Institute of Medical Education and Research, Chandigarh-160 011

Summary

The present study reports the high level of arsenic in illegally sold opium in India. This adulteration is supposed to enhance the aphrodiasic properties of opium. The finding highlights the public importance and prevalence of arsenicosis in the Indian subcontinent.

Opium addiction in India is a problem of considerable magnitude, which bas been highlighted during the recent years, though the practice of opium eating has been prevalent since time immemorial [ 1] . Our interest in the problem arose because we observed some patients, who were opium addicts, having a clinical picture of arsenical neuropathy * and hepatomegaly. Further, five opium addicts, who obtained their illegal supply from a village near Chandigarh, died with symptoms of acute arsenic poisoning; one of them at the Institute and the others at a hospital in Chandigarh. Further enquiries into the matter revealed that even the dealer, who himself was an opium addict, died of symptoms of acute arsenic poisoning. There were 40 more cases of acute gastroenteritis in subjects who had obtained their supply from the said source. The opium obtained from the source revealed to have an exceptionally high arsenic content (25,000 µg/100 gm) [ 4] .

Multiple systemic involvement, following arsenic consumption has been labelled as arsenicosis [ 3] . Whether these two diverse entitis i.e., opium addiction and arsenicosis can be correlated in any way is the main object of the present enquiry. The result of the preliminary investigation carried out in this Institution revealed some interesting facts which highlight the problem facing the developing countries in particular, and may have important bearings on the line of management of patients who are opium addicted and present features of peripheral neuropathy and hepatomegaly.

Material and methods

In the present study, 20 samples of opium were analysed for the presence of arsenic. These samples were obtained from both indoor and outdoor patients in this hospital, general practitioners, from physicians in other hospitals and police authorities who had seized them from opium smugglers. Standard opium samples were obtained from the Narcotic Commissioner Gwalior, from Dr. Livtar Singh (Ludhiana) and from registered opium eaters.

* Dr. Datta's findings regarding arsenic-induced neuropathy resulting from consumption of 10-20 g of opium per day with an arsenic content of less than 75 microgram per 100 g, were published in The Lancet (26 Feb. 1977, p. 484) and further discussed in the issue of 3 April 1977 (pp. 903-904) of the same Journal.

A standard spectrophotometeric method by Kingslay and Schaffert [ 6] was used for arsenic estimation in the samples. Total arsenic content (organic and free inorganic) could be measured by digestion of opium in boiling hydrochloric acid. Free inorganic arsenic was measured without digestion. The results were also cross-checked in the Laboratory of Dr. R. Nath, Associate Professor of Biochemistry, Postgraduate Institute of Medical Education and Research and Hyderabad Radioisotope Laboratory with the help of an atomic spectrophotometer which corroborated our findings.

Observations

Twenty samples (16 from illegal sellers and 4 from registered sources) were analysed for their arsenic content. Opium obtained from government sources had 0 to 18.2 µg of arsenic per 100 gms of opium. Opium obtained from an illegal source had arsenic in it ranging from 25 to 29,500 µg/100 gms (table 1). Most of the arsenic in opium was in free inorganic form as it was extractable from opium without boiling in hydrochloric acid (table 2). This marked varia-tion in the arsenic levels in different opium' samples is of interest. Opium samples analysed were basically of two types. One was a semisolid type and the other was a hard solid mass. As a general rule it was found that the semisolid variety had a higher arsenic level than the hard variety.

TABLE 1

Arsenic content of opium obtained from illegal and government registered sources

Sample

 

Arsenic content

 

No.

Sources

µg/100 gms

PPM

1.
Illegal
100.0 1.0
2.
Illegal
50.0 0.5
3.
Illegal
28 600.0 286.0
4.
Illegal
175.0 1.7
5.
Illegal
27 000.0 270.0
6.
Illegal
25.0 0.25
7.
Illegal
29 500 295.0
11.
Illegal
4 300.00 43.0
13.
Illegal
1 980.0 19.80
16.
Illegal
400.0 4.0
17.
Illegal
500.0 5.0
18.
Illegal
650.0 6.5
19.
Illegal
13 600.0 136.0
20.
Illegal
500.0 5.0
21.
Illegal
150.0 1.5
22.
Illegal
500.0 5.0
1.
Registered
0.0 0.0
2.
Registered
18.2 0.18
3.
Registered
16.6 0.16
4.
Registered
16.2 0.16

TABLE 2

Total versus free inorganic arsenic in opium from illegal sources

 

Total

Inorganic free

Sample No.

µg/l00 gms

µg/l00 gms

2 50 50
3 28 600 26 200
5 27 000 26 600
17 500 450
18 650 550
19 13 600 11 680
21 150 150
22 500 400
-
350 300
-
36.4 36.4
-
72.8 54.6
-
09.2 109.2
-
40.0 40.0

Discussion

Opium is a contraband item in India. Registered opium eaters can get their supply from the government sources. However, illegal trade of this narcotic is widely prevalent. So far there is no report available in the literature about the arsenic adulteration of opium used by the addicts. Our preliminary investigations have demonstrated a high arsenic content in the samples obtained from different sources. A small quantity of arsenic present in opium may prove to be apparently harmless if taken as a single dose but it is bound to have a deleterious effect on the health of a person if taken regularly over the years.

The use of arsenic as a medicine in the form of Fowler's solution can effect the liver adversely and has been well documented as an aetiological agent for the development of cirrhosis [ 5] , [ 6] and idiopathic portal hypertension [ 2] , [ 7] , [ 9] .

Available information reveals that the so called opium manufacturers adulterate it with arsenic in varying quantity for two reasons; firstly it is believed to be a general tonic and secondly it is said to be an aphrodisiac, which, when combined with opium - enhances the aphrodisiac quality of opium.

We have been able to conclude that opium is adulterated with arsenic. This makes us aware of the fact that arsenicosis may be quite prevalent in India and hence opium addicts admitted in the hospital should be screened for acute and chronic arsenic toxicity and treated suitably.

However the present investigation is a preliminary report and highlights the public importance. It warns authorities to look for such adulteration. Other adulterants in opium, if any, have not been analysed.

References

001

Chhuttani, P.N., et al. Neuropathy, Neurology , 17:269 (1967).

002

Datta, D. V. Arsenic and non-cirrhotic portal hypertension. The Lancet . I:433 (1976).

003

Datta, D.V. et al . Arsenic content in drinking water in villages in Northern India, J. Assoc. Phys . India, 24:599 (1976).

004

Datta, D.V. et al . Field survey of opium takers in Northern India (1977).

005

Franklin, M. et al . Fowler's solution as an etiologic agent in cirrhosis. Am. J. Med. Sci . 219:589 (1950).

006

Kingsley, G.R. et al . Microdetermination of arsenic and its application to biological materials. Annals. Chem . 23:914 (1959).

007

Morris, J.S. et al . Arsenic and non-cirrhotic portal hypertension. Gastroenterology. 66:86 (1974).

008

Regelson, W., et al . Haemangioendothelial sarcoma of liver from chronic arsenic intoxication by Fowler's solution. Cancer 21:514 (1968).

009

Villenenve, J.P. et al . Idiopathic portal hypertension. Amer J. Med . 61:459 (1976).