Traces of Lead Found in Opiods: Doda and Afeem

Reported by Lisa Steacy

The use of traditional opioids in South Asian communities could potentially carry an additional risk, according to Fraser Health, which recently alerted health professionals to lead contaminated drugs.

Debra Kent of British Columbia Drug and Poison Information Centre said that heavy metal poisoning is a rare but documented risk associated with Afeem and Doda, substances made from the opium poppy and commonly used in South Asian communities in the Lower Mainland.

The primary communities at risk are South Asian males, a demographic which makes up a large proportion of Surrey’s population and is also well represented in South Vancouver. Of Langara College’s 6,000 international students, many are also South Asian.

Hidden risk

“Many are unaware of the dangers of lead in some of these products,” Kent said in an email to The Voice. “There also may be others who feel unwell and don’t go see their physician or heavy metal poisoning isn’t suspected.”

In December, Fraser Health treated a case of lead poisoning in a patient who was using doda to manage chronic pain. The symptoms included “decreased levels of consciousness, seizure-like activity and a whole variety of abnormal blood work.”

Rare but serious

Kent said there are fewer than three cases of reported heavy metal poisoning each year in the province but such cases often require prolonged treatment.

Heavy metals can be introduced accidentally to opium derivatives, through contaminated soil or deliberately by sellers of the drug in order increase its weight and its sale price, according to Dr. Arun Garg, the Medical Director of Fraser Health’s South Asian Health Institute.

Garg said doctors must be diligent about asking patients about traditional drugs as part of patient histories.

“One needs to be putting more emphasis on the public health part of it because as our society becomes more and more plural and multicultural the usage and the interest in some of these traditional preparations and medicines is going to grow,” he said.

Doda is still popular

Garry Sandhu, an addictions counsellor at Path to Freedom, a Surrey facility that primarily serves South Asian men, said Doda and Afeem are often used by truck drivers.

“They are the most popular drugs in our community,” he said.

Both opioid derivatives were openly sold throughout the Lower Mainland before being made illegal in Canada in 2010. Since then Doda use has decreased or gone underground Sandhu said.