Opioids and cancer aren’t a good mix at all! Well if they are misused…
Half a dozen cancer patients in New York developed a rare blood infection after they received injectable opioids that a nurse had diluted with tap water.
The patients became infected with a bacterium called Sphingomonas paucimobilis and were treated with antibiotics. No deaths resulted from the infections.
However, some patients later died from unrelated causes, including complications of cancer, according to the report.
The issue came to light in the summer of 2018, when six patients at Roswell Park Comprehensive Cancer Center in Buffalo, New York, developed bloodstream infections with S. paucimobilis.
This bacterium lives naturally in soil and water, but it rarely causes bloodstream infections, even among people with weakened immune systems.
Because these infections are so rare, doctors suspected a contaminated medication was behind the outbreak. Indeed, an investigation revealed that syringes of hydromorphone, an opioid medication, tested positive for S. paucimobilis.
What’s more, hydromorphone syringes that were stored in a locked drawer that was part of the hospital’s automated medication-dispensing system also tested positive for S. paucimobilis and other waterborne bacteria.
Records showed that a nurse had “repetitively and inappropriately” accessed this storage drawer. Although the syringes showed no overt signs of tampering, tests revealed that the medications in the syringes had been diluted with water. It appears that the nurse tampered with the syringes to remove some of the narcotics for her own use, replacing the drugs with water.
In other words, the outbreak was tied to “drug diversion,” which happens when a person illegally uses medications meant for someone else — in this case, medication meant for cancer patients.
Here an example of drug diversion and its related disease from the government of Colorado:
But it doesn’t only happen in New York. The Centers for Disease Control and Prevention reported that a nurse in Washington state likely infected at least a dozen patients with hepatitis C after she used injectable opioid drugs that were meant for patients.
In this age of profound prevalence of opioid addiction, drug diversion is an important consideration when a cluster of rare bloodstream infection is identified.