Deaths following treatment at Portland integrative medicine clinic

Three patients recently died shortly after receiving intravenous injections of colchicine provided by an integrative medicine clinic in Portland Oregon. It was discovered that the batch of colchicine, obtained from ApothéCure Inc., was 10 times as potent as labeled. Two of the deaths have been officially determined to be due to the faulty preparation while the third is under investigation. Colchicine was being used for the off label indication of chronic neck and back pain.

ApothéCure, while purportedly a compounding pharmacy, may in fact have been functioning as a drug company by selling batches of drugs for use in multiple patients. But if it’s a drug company it’s not mainstream. The Autism Diva offers this expose of compounding pharmacies and in this post characterizes them as “un-Big-Pharma”:

It's amazing how people are willing to believe the worst about Big Pharma (which is guilty of some amazing abuses, to be sure) but they are also willing to give un-Big-Pharma a free pass on what they are doing and selling and how much profit they are making.

ApothéCure, it seems, has been investigated before. Dr. Geoffrey Wiss, a Portland emergency physician, was a partner in the integrative medicine clinic and noted that although colchicine was available from manufacturers the clinic ordered it from ApothéCure because it was less expensive. It is unclear who prescribed the colchicine. Although the patients were under the care of naturopaths, Wiss and other M.D.s collaborate in the clinic. Naturopathic physicians have prescriptive privileges in Oregon. Dr. Wiss, profiled here, joined the clinic in 2005 to learn about alternative medicine by working with naturopathic physicians. He was credited with recognizing the pattern of deaths and alerting authorities.

These deaths raise many questions. Were naturopaths, generally loathe to use prescription drugs and whose mantra is first do no harm, involved in the administration of the highly toxic drug colchicine? Well, I guess it is “natural”. After all, it’s an alkaloid.