Coming initially from the coca plant found primarily in South America, cocaine is synthesized into a white powder or a crystal form, called “crack,” to be used recreationally for an intense euphoric “high.” Cocaine is extracted from the coca plant leaves through a process that uses highly toxic chemicals, like gasoline for instance, which puts its purity level at about 50 percent right off the bat, the Drug Enforcement Administration (DEA) Museum publishes. The resulting cocaine hydrochloride power is then formed into bricks or dissolved in another potential toxin, such as acetone and/or hydrochloric acid, and heated to form the crystallized crack form. Cocaine production and distribution is a big business, and drug manufacturers and dealers often “cut” the drug with other cheaper agents in order to stretch the product out or to enhance its effects.

Common Cocaine Cutting Agents

In recent years, cocaine production has fallen globally, decreasing its availability within the United States, the US Department of Justice (DOJ) National Drug Intelligence Center (NDIC) reported in the National Drug Threat Assessment 2010. This decreased availability and production of the drug may make it more likely that producers and distributors will add adulterants, or additives, to the product in order to make it go further or to “bulk” it up.

The United Nations Office on Drugs and Crime (UNDOC) publishes the World Drug Report, which indicated in 2010 that the average cocaine purity on the street was around 50 percent. Actual purity of the drug can fluctuate greatly, but this is an average based on cocaine seizures around the world that year. The National Highway Traffic Safety Association (NHTSA) published that cocaine powder purity on the street typically ranges from 20 to 95 percent while crack cocaine generally ranges in purity from 20 to 80 percent on the street. This variation in purity and uncertainty in what is added to cocaine makes it a highly dangerous drug with unpredictable side effects.

Differentiating Pure Cocaine from Additives

Cutting agents used in cocaine may be based on their effects, on their appearance (visual similarity to actual cocaine), or both. Cocaine is a stimulant drug with local anesthetic properties. It increases dopamine levels in the brain and causes a rapid and short-lived burst of pleasure. It is also expensive and may be difficult to get. Other products or chemicals that are easier to obtain and have similar pharmacological or local numbing properties may then be used as cutting agents.

Cocaine powder is white and therefore may be cut with talcum powder, flour, or cornstarch at the street level, since these products are visually similar, the National Institute on Drug Abuse (NIDA) reports. Cocaine in its crystal, or “rock,” form may actually just be coasted with hairspray to make it stick together.

Specific Cutting Agents and Why They Are Used

The Western Journal of Emergency Medicine (West JEM) and BBC News report the following as known cocaine adulterants based on their type:

Visual dilutants are products that look similar to cocaine in its pure form and are used to “bulk” up the final product. These include:

  • Chalk
  • Talc
  • Ascorbic acid
  • Quinine
  • Boric acid
  • Laundry detergent
  • Laxatives
  • Meat tenderizer
  • Lactose and other sugars
  • Plaster of Paris
  • Creatine

Other stimulants are products with similar stimulant properties that may be cheaper and more readily accessible. These may be added to enhance the effects of cocaine and include:

  • Caffeine
  • Strychnine
  • Methylphenidate
  • Amphetamine

Local anesthetics are other pharmaceutical products that have similar numbing effects locally. As a result, they can pass a quick purity “taste,” test making them candidates for cutting agents. These include:

  • Lidocaine
  • Tetracaine
  • Benzocaine
  • Procaine

Illicit drugs are often added to cocaine to heighten or expand the euphoric “high” or other effects. These include:

  • Hashish
  • PCP
  • Marijuana
  • Heroin (called a “speedball”)
  • LSD

Other things may also be added to cocaine to augment the high, although it may not be clear how or why they are used. Phenytoin (PHT) is an anticonvulsant drug used to treat epilepsy that is sometimes also found in cocaine, for example, West JEM reports. Pain medications like phenacetin may also be used as a cocaine additive, the Centre for Public Health (CPH) publishes. Another drug rarely used in humans these days but potentially used to enhance the cocaine high, CPD reports, is levamisole, a medication designed to get rid of parasitic worms. It is most commonly used in veterinary practice these days.

Other toxins, chemicals, household products, drugs, or pharmaceutical products may also be used to cut cocaine. An individual can never be certain what is in the dose they are buying and/or taking. This makes cocaine a particularly dangerous drug as the additives, or cutting agents, may interact with the body in an unpredictable and unknown manner with potentially toxic results.

Cocaine abuse led to the most emergency department (ED) visits for an illicit drug in 2011, as over a half-million Americans sought medical treatment for an adverse reaction to the drug, the Drug Abuse Warning Network (DAWN) reports. This accounts for 40 percent of all ED visits involving an illicit drug that year.