Drugs sold illicitly are dangerous enough on their own; however, many of them are adulterated with various substances at every level of drug processing, so that everyone in the supply chain can make more money selling less product. However, when most people talk about “cutting” a drug, usually a powder like cocaine, it involves mixing a substance that appears similar to the drug into the supply during packaging.
Cutting agents may be seen as diluents, or substances that are inert on their own, but many of them are adulterants – ingredients that are pharmacologically active, so they will cause a person’s mind or body to react to the chemical’s presence.
In cocaine, different adulterants do different things, some of which are extremely dangerous.
Adulterants and Diluents in Cocaine
There are several active chemicals mixed into cocaine, although some diluents appear, too. The presence of these chemicals, whether they are technically drugs or inert ingredients, can be very harmful to a person who is struggling with cocaine addiction. According to the Public Health Institute (PHI) in the United Kingdom, most reports of adulterated cocaine or crack cocaine involve poisonings, indicating that the most common cutting agents are drugs.
- Levamisole: This substance is no longer available in the United States due to dangers the drug poses, but it is very often cut into cocaine. It was prescribed most often to treat parasitic worm infections in people and animals. It is still sometimes used in veterinary medicine; however, when it was originally used in 1966, it was supposed to increase the effectiveness of chemotherapy drugs by boosting the immune system.Levamisole has been linked with “flesh-eating” cocaine in the UK and some places in the US; this is caused by agranulocytosis, a condition in which the immune system crashes, and the body fails due to infections taking over. The Drug Enforcement Administration (DEA) initially found levamisole cut into cocaine in 2005, and since then, the number of bricks of cocaine tainted with levamisole being brought into the US has shot up from 2 percent to 71 percent.
- Phenacetin: A painkilling drug that was banned by the US in 1983, phenacetin has a white, powdery appearance much like that of cocaine. It can quickly reduce the amount of oxygen the blood can absorb, leading to death. It has also been linked to bladder cancer after long-term use.
- Procaine and lidocaine: Two synthetic derivatives of cocaine, these drugs are also often mixed into cocaine to cut it. Procaine developed before lidocaine in the early 1900s; procaine was the first synthetic cocaine derivative and intended to be a local anesthetic, too. When cut into cocaine, procaine enhances cocaine’s potency since they are closely related; this can lead to a rapid overdose or cardiac arrest.Lidocaine was originally developed in 1943, as a local anesthetic used to treat discomfort from skin conditions like sunburn, insect bites, poison ivy, or burns. The drug is not intended to be ingested internally, so it is very dangerous when it is consumed. If it is ingested by snorting, eating, smoking, or other means, it can cause cardiovascular damage and failure as well as trigger an overdose.
- Paracetamol/acetaminophen: An analgesic medicine that can reduce pain, fever, and swelling, this drug is a type of nonsteroidal anti-inflammatory drug (NSAID). Typically referred to as acetaminophen in the United States, and paracetamol throughout the UK and other countries, the drug is sold over the counter in small doses on its own or mixed with some other OTC drugs to treat a cold or the flu; in larger doses, it requires a prescription. Since it is whitish and can come as a powder, the drug gets cut into cocaine; small doses of acetaminophen do very little, but very large doses can cause liver failure, especially when mixed with alcohol.
- Amphetamine or methamphetamine: Because many amphetamines, like MDMA, and methamphetamines come in white or off-white powders, and are stimulant drugs like cocaine, they get cut into cocaine. They can cause overdose, heart failure, breathing problems, psychosis, hallucinations, and self-harm or violence toward others.
- Fentanyl: As the opioid epidemic gets worse, fentanyl is being mixed into all kinds of illicit drugs. Fentanyl was intended to be a painkiller to help those with chronic pain whose bodies have become tolerant to other long-acting opioids; however, the drug quickly found its way to the black market, and it has been mixed with heroin, sold in place of heroin, or sold as illicit prescription pills. People who take fentanyl with or instead of other opioids often don’t know what they’re taking, which can lead to overdose.Because illicit fentanyl is a white powder, it is also increasingly being cut into cocaine. The US Department of Health reported that, in 2016, the number of overdose deaths involving cocaine and fentanyl without heroin rose to 37 percent, up from 11 percent the year prior.
- Caffeine: A mild plant-based drug, caffeine is legal and acceptable to consume in most countries. Coffee, tea, and energy drinks are a huge portion of the market; however, mixing caffeine in any form with other drugs, most often alcohol, can lead to serious toxic consequences.Powdered caffeine is sold legally online or in some retail stores. Since it can be found as a white powder, it has become a common bulking agent in cocaine, which is also a plant-based stimulant drug. Caffeine’s presence in cocaine increases its side effects, including euphoria, making cocaine potentially more addictive. It also increases the risk of heart failure, seizures, anemia, and kidney damage.
- Sugars: Dextrose, lactose, and sucrose have all been found as bulking agents in cocaine. They cause nasal irritation and may increase the risk of blood clots.
- Sodium bicarbonate: Another inert bulking agent, sodium bicarbonate can somewhat increase the risk of blood clots.
- Lead: A metal that can be converted into a white powder, this substance has been associated with increased risk of cancer, breathing problems, heart disease, and other internal damage when it is present in the environment. Snorting it with cocaine or smoking it with crack cocaine increases the health risk of these drugs dramatically. A user is likely to experience abdominal cramping, headaches, anemia, muscle weakness, nausea and vomiting, seizures, renal failure, and coma.
While cocaine can be cut with several dangerous chemicals, the drug itself is dangerous. Even pure cocaine puts a person at risk of hyperthermia, psychosis, breathing problems, heart failure, liver and kidney damage, and death. People who struggle with cocaine abuse need help from medical professionals to overcome the addiction as soon as possible.