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The composition of street drugs like heroin and cocaine changes. According to a new analysis, almost all contain at least one toxic adulterant and many contain a large amount of fillers. Most adulterants have pharmacological activities and toxicities. Its presence has an added impact in the context of the COVID-19 pandemic, as some may cause a drastic drop in white blood cells that could leave drug users more vulnerable to infection.
“It is remarkable that we only forgot to note, in the horrible transition from the prescription opioid epidemic to the illicit epidemics of opioids and psychostimulants, that we should pay special attention to which drugs contain the drugs to which the person was exposed – and for how long, ”he said Mark S. Gold, MD, co-author of the review.
The analysis showed that adulterants include new psychoactive substances, industrial compounds, fungicides, veterinary drugs and various impurities. In addition, other drugs are being found in street medications, such as antipsychotics, antidepressants, anxiolytics, antihistamines, anthelmintics, anesthetics, anti-inflammatory agents, antipyretics, analgesics, antispasmodics, antiarrhythmics, antimalarials, natural bronchodilators, decongestants, expectorants. / synthetic hallucinogens, and sedatives.
Illicit drugs are manufactured by nature without the supervision of the Food and Drug Administration and it is increasingly common for substances such as the remains of drugs and other active drugs to be added to batches of illicit drugs to gain weight. , said Gold, a professor at the University of Washington, St. Louis, Missouri. He to study appeared in Current psychopharmacology.
Effects of “terrifying” adulterers
According to the document, the findings of the adulterers and their consequences are worrying Jean Lud Cadet, MD, who was asked to comment on the findings. “Blood dysplasia, the lung problems that some of these adulterants can cause, is really terrifying, to put it bluntly,” said Cadet, a senior researcher and head of the National Institute of Molecular Neuropsychiatry’s research branch. of Drug abuse.
Prior to 2000, street drugs were generally diluted with comparatively benign substances such as caffeine, sugars or lidocaine. Drugs such as phenacetin, levamisole, acetaminophen, i diltiazem began appearing in heroin and cocaine in the late 1990s, and by 2010, more powerful adulterants such as fentanyl, ketamine, i quetiapine it became commonplace. Adulterants can cause various clinical effects, including kidney and liver problems, blood disorders, infections, respiratory tract depression, and cardiac arrest.
In 2015, the U.S. State Department partnered with the Colombo Plan, an international organization based in Sri Lanka, to use field spectroscopy to detect toxins directly from cocaine and heroin samples found in Argentina, Brazil , Ecuador, Peru, Sri Lanka, Thailand, Honduras, Guatemala, Mexico, Colombia and South Africa. They found several adulterants such as aminopyrine, diltiazem, metamizole, levamisole, and phenacetin.
A similar project with 431 heroin and cocaine samples from Vermont and Kentucky found that 69% of the samples had five or more controlled drugs, toxic adulterants, or impurities. About 15% had nine or more and 95% of the samples had at least one toxic adulterant.
In the midst of the COVID-19 pandemic, these adulterants acquire even greater importance. People with substance use disorders often have other health conditions that can make them more vulnerable to viral infections, which can be exacerbated by the effects of adulterants on white blood cells or other systems. The pandemic has also had an indirect effect in causing a shortage of drugs on the street. During production shortages, traffickers could increase power by adding more cutting and adulterating agents. As a result, COVID-19 i opioid addiction they tend to reinforce each other.
“The clinical message would be that ours [substance use] patients contract infectious diseases and must be prioritized [COVID-19] vaccination, “Gold said.
The findings came as a surprise to Cadet, and this illustrates the need to raise awareness of the presence of adulterants on street drugs.
“If you weren’t aware of it, the general public won’t know about it either,” Cadet said. “Scientists, myself included, and government agencies need to do a better job [of communicating this issue]. “
The study refers to people with substance use disorder, but Cadet warned that anyone who uses drugs on the street, even once or twice, could be a victim of adultery. “You don’t have to meet the diagnostic criteria to suffer the consequences.”
The study had no funding. Gold and Cadet have no relevant financial information.
This article originally appeared on MDedge.com, which is part of the Medscape professional network.