A New Source of Opioid and Lead Toxicity on the Block-Kamini: An Emerging Health Hazard-A Case Series.

Introduction: Illicit drug abuse with opioids can inadvertently lead to refractory anemia and lead poisoning. The absence of adequate regulations for Ayurvedic herbal products has led to the adulteration of opioid-containing drugs with lead. As a result, lead toxicity has become a concern within this seldom-addressed population of opioid users. In this report, we present a collection of cases where individuals developed lead toxicity while being dependent on opioids due to their use of a little-known herbal product called Kamini, which contains . This retrospective case series aims to raise awareness about and foster broader recognition of opioid dependence linked to herbal products like Kamini, along with the associated risks associated with its usage.

Methods: We retrospectively analyzed the records of three patients who were opioid abusers and presented with symptoms and signs of lead poisoning.

Results: All three patients were male and presented with complaints of abdominal pain and generalized weakness. Laboratory examinations showed high lead levels and low hemoglobin as well as basophilic stippling. Urine porphyrins were falsely positive in two patients. All three patients showed symptomatic improvement with a decrease in lead levels after chelation therapy.

Discussion And Conclusion: This case series highlights the need for awareness regarding opioid dependence syndrome and potential lead toxicity stemming from the use of Ayurvedic preparations over the counter, such as Kamini. A low threshold should be kept for testing for lead poisoning in patients who present with anemia and/or abdominal pain with a history of opioid dependence.