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Composition, purity and perceived quality of street cocaine in France
Abstract
There is little knowledge about the composition and cocaine content of street cocaine, nor about what users know about it.
373 cocaine users were face to face interviewed between May and December 2006 about the last sample of cocaine they had consumed and residual amounts of the substances actually used were analysed using gas phase chromatography coupled to mass spectrometry (GC-MS). Users rated the perceived quality of their product ("good", "average", "poor"), its "estimated percentage of cocaine" and any cutting agents it contained. Price, quantity, place of purchase (street, dealer's premise, appointment), mode of administration (sniffing, injection, smoking) and the supposed nature of the sample (natural, synthetic, no distinction ever made) were also reported. Perceived quality was modelled using multivariate multinomial regression.
The median cocaine content was 22%. Altogether, 343 samples contained cocaine, among which 75% contained at least one adulterant. The most frequently occurring were phenacetin (54% of the samples), caffeine (17%), paracetamol (14%), diltiazem and lidocaïne (11%). Users showed relatively poor discrimination concerning cocaine purity, and only 12% reported at least one of the detected adulterants. The major determinants of their perception of cocaine quality were: place of purchase, natural origin, price per gram, actual cocaine content and mode of administration.
The composition of street cocaine is largely unknown to users. Users' perceptions of cocaine quality are based partly on false beliefs and certain administration modes. This may contribute to favouring very risky practices. The effects of adulterants on users' health should be investigated.
... Illicit cocaine samples encountered by forensic laboratories worldwide more often than not differ significantly from the relatively pure drug formulation that can be achieved at illegal production sites. While cocaine production can easily obtain a product of over 80% (w/w) purity even under non-ideal conditions in clandestine production facilities [35], the average purity of cocaine seized in Europe is fluctuating between 50 and 70%, while in some countries like Switzerland and France even lower levels around 30% are encountered [5,17,42,43]. Along the supply chain, the product is diluted and mixed with numerous active and inactive ingredients. ...
... This is a common way to test if the drug is of good quality, thus these adulterants can help mask a poor quality or strongly diluted product [12,17,85,86]. A selection of seemingly random other drugs including for example the antihistamine hydroxyzine and calcium channel blocker diltiazem are used for cocaine adulteration, although it is often not clear why exactly these compounds are chosen [9,11,42,87,88]. The same applies to piracetam and boric acid [43]. ...
... This revealed that lidocaine, caffeine and phenacetin remained the most frequently encountered cocaine adulterants in Europe until around 2010 [9]. Especially phenacetin could be detected in around half of the cocaine samples analytically assessed in France and the Netherlands [42,87]. In 2004 and the years following, new pharmaceuticals would emerge as common cocaine adulterants. ...
Cocaine is one of the most widely used illicit drugs worldwide. Cocaine powders seized by the Police may contain numerous other substances besides the drug itself. These can be impurities originating from the coca plant or the production process, or be purposely added to the drug formulation as adulterants and cutting agents. In forensic laboratories, identification of cocaine is routinely done through GC-MS analysis, but other components are often ignored even if the method allows for their detection. Yet, they can provide valuable insight into the history of a seizure and its potential connection to other samples. To explore this idea, an extensive review of common impurities and adulterants encountered in cocaine is presented. Based on their incidence, concentration in the end product and compatibility with GC-MS methods, their overall usefulness as candidates for the statistical investigation of existing forensic data is evaluated. The impurities cis- and trans-cinnamoylcocaine, tropacocaine, norcocaine and N-benzoylnormethylecgonine as well as the adulterants lidocaine, procaine, tetracaine, benzocaine, caffeine, acetylsalicylic acid, phenacetin, ibuprofen, levamisole, hydroxyzine and diltiazem are promising candidates to provide additional forensic intelligence. Future research on optimized routine GC-MS methods, signal reproducibility, comparison, statistics and databases is suggested to facilitate this concept. Ultimately, such an approach may significantly advance the amount of information that is extracted from routine casework data, elucidate developments in the cocaine markets in the past and facilitate Police work in the future. Preliminary assessment of existing data from the forensic laboratory of has been included to show that the detection of the identified target impurities is feasible, and that small adjustments to the analysis method could significantly increase the detectability of these analytes in prospective drug screenings. Forensic intelligence based on retrospective data mining of cocaine containing case work samples may thus be realized with minimal additional laboratory efforts by using already available instrumentation, samples and data.
... [16][17][18][19] It is well known that illicit drugs may be adulterated with various substances, including various types of sugars, metals, caffeine, over-the-counter products such as acetaminophen, prescription medications, or illicitly manufactured substances such as fentanyl, fentanyl analogues, or methamphetamine. 8,11,16,17,[20][21][22][23] Our analysis revealed the presence of adulterants in clinical specimens of patients presenting to the ED for DOSM. Specifically, our analysis showed that fentanyl was not suspected in most (89%) encounters in which fentanyl was detected. ...
... Clinician awareness is important given the potential for unknown interactions between substances or complications due to specific substances. 3,8,20,21 Improving the knowledge of people who use drugs about the presence of highly potent adulterants in the local drug supply is one important way surveillance data can be used to inform harm reduction strategies and reduce morbidity and mortality from DOSM. 17,20 One study showed that although a high percentage of people who use drugs had knowledge of the risk of fentanyl overdose, 72% of people perceived their personal risk to be low or nonexistent. ...
... 3,8,20,21 Improving the knowledge of people who use drugs about the presence of highly potent adulterants in the local drug supply is one important way surveillance data can be used to inform harm reduction strategies and reduce morbidity and mortality from DOSM. 17,20 One study showed that although a high percentage of people who use drugs had knowledge of the risk of fentanyl overdose, 72% of people perceived their personal risk to be low or nonexistent. 24 Reasons for low or no perceived risk included not intending to use opioids and trusting the person who supplied the drugs. ...
Objectives
Increasing knowledge about the toxicology of drug overdose and substance misuse (DOSM) is important in improving our understanding of the epidemic. We describe the Minnesota Drug Overdose and Substance Use Pilot Surveillance Activity, which started collecting data on emergency department (ED) visits attributable to DOSM in 2017, with a focus on the toxicology results of a subset of clinical encounters.
Methods
From November 1, 2017, through January 30, 2020, we collected near–real-time data on DOSM-related ED encounters. The Minnesota Department of Health Public Health Laboratory tested leftover clinical specimens (blood and/or urine) for the presence of various substances for patients who died, were hospitalized, had an atypical clinical presentation, or were part of a local drug overdose cluster. Testing looked for >250 drugs or their metabolites, including those commonly misused (eg, methamphetamine, cocaine), prescription medications, synthetic cannabinoids and cathinones, and opioids. We describe characteristics of the overall group and a subgroup of clinical encounters with toxicology results.
Results
Specimens submitted from 6 EDs during the study period represented 239 clinical encounters. Methamphetamine was the most frequently detected substance (67.4%) but was suspected in only 45.6% of encounters. At least 1 opioid was detected in 42.5% of encounters but suspected in only 29.7%. Testing also detected potential adulterants and additives (eg, fentanyl, fentanyl analogues, levamisole) and showed frequent patient exposure to substances not reported by patients or suspected by clinicians. Nearly half (44.4%) of clinical encounters had >1 substance detected.
Conclusions
ED surveillance for DOSM encounters, enhanced by toxicology testing, can provide local situational awareness on overdoses, prevent potential mischaracterization of the true drug overdose epidemic, and inform harm reduction and drug overdose prevention efforts.
... According to Brazilian research on the chemical profile of street drugs [17][18][19], and findings of other countries [20][21][22], the purity of street cocaine seized commonly ranges from 5.5 to 99.9%. Cocaine was the only detected active compound between 29.6 and 40% of analyzed samples. ...
... There are many analytical procedures previously published for the identification and/or quantification of major cocaine adulterants in seized drugs [17][18][19][20][21][22] and several others for the bioanalysis of the same compounds investigated in our study, but with a focus on applications other than drug adulteration [25][26][27][28]. However, according to our knowledge, there are only three analytical procedures previously published for the simultaneous determination of more than five different cocaine adulterants in biological matrices with a focus in the toxicological analysis of drug users [15,29,30]. ...
... All the real samples contained at least two of the cocaine adulterants investigated in our study. It is in agreement with another Brazilian study published by our group using the nonconventional DLLME mode [15] and recent surveys worldwide [17][18][19][20][21][22]. Among the cocaine adulterants investigated, caffeine was one of the most widely found in the real samples and one of those found in the higher concentration. ...
This study aimed to determine simultaneously five major street cocaine adulterants (caffeine, lidocaine, phenacetin, diltiazem, and hydroxyzine) in human urine by dispersive liquid-liquid microextraction (DLLME) and high-performance liquid chromatography. The chromatographic separation was obtained in gradient elution mode using methanol:water plus trifluoroacetic acid 0.15% (v/v) (pH = 1.9) at 1 mL min⁻¹ as mobile phase, at 25 °C, detection at 235 nm, and analysis time of 20 min. The effect of major DLLME operating parameters on extraction efficiency was explored using the multifactorial experimental design approach. The optimum extraction condition was set as 4 mL human urine sample alkalized with 0.5 M sodium phosphate buffer (pH 12), NaCl (15%, m/v), 300 μL acetonitrile (dispersive solvent), and 800 μL chloroform (extraction solvent). Linear response (r² ≥ 0.99) was obtained in the range of 180–1500 ng mL⁻¹ with suitable selectivity, quantification limit (180 ng mL⁻¹), mean recoveries (33.43–76.63%), and showing relative standard deviation and error (within and between-day assays) ≤15%. The analytes were stable after a freeze-thaw cycle and a short-term room temperature stability test. This method was successfully applied in real samples of cocaine users, suggesting that our study may contribute to the appropriate treatment of cocaine dependence or with the cases of cocaine acute intoxication.
... Street drugs are typically modified by dilution, contamination, and adulteration (UNODC 2015;Evrard et al. 2010;Cole et al. 2010a, b;Broséus et al. 2016;Villar Núñez et al. 2017). Dilution refers to the addition of inert substances (diluents), contamination to the presence of by-products of the drug manufacturing process (contaminants), and adulteration involves the intentional addition of a pharmacologically active substance without the user being aware (adulterants). ...
... The knowledge of drug purity and the presence of adulterants are essential for the understanding of an overdosage, unexpected side effects (toxicity), and putative fatal reactions. Moreover, the presence of adulterants has provided relevant information to the investigation of traffic routes and drug profiling (Evrard et al. 2010;Cole et al. 2010a;UNODC 2015). However, little is known about the pharmacological interaction among different constituents (e.g., main drug and adulterants) present in the illicit drugs of abuse. ...
... One hundred percent of the samples (in numbers 306) contained cocaine while 90% (in numbers 274) were adulterated and only 10% (in numbers 32) showed high cocaine percentage and adulterants were not found. Among the most commonly used compounds to adulterate drugs (Cole et al. 2010a;Evrard et al. 2010), phenacetin (75.5%) and caffeine (64%) were highly frequent (in numbers 231 and 196 out of 306, respectively). The remaining analyzed samples revealed that CP could also contain other different substances such as aminopyrine, levamisole, lidocaine, and benzocaine. ...
Adulteration is a common practice in the illicit drugs market, but the psychoactive and toxic effects provided by adulterants are clinically underestimated. Coca-paste (CP) is a smokable form of cocaine which has an extremely high abuse liability. CP seized samples are sold adulterated; however, qualitative and quantitative data of CP adulteration in forensic literature is still scarce. Besides, it is unknown if adulterants remain stable when CP is heated. This study was designed to report the chemical content of an extensive series of CP seized samples and to demonstrate the stability (i.e., chemical integrity) of the adulterants heated. To achieve this goal, the following strategies were applied: (1) a CP adulterated sample was heated and its fume was chemically analyzed; (2) the vapor of isolated adulterants were analyzed after heating; (3) plasma levels of animals exposed to CP and adulterants were measured. Ninety percent of CP seized samples were adulterated. Adulteration was dominated by phenacetin and caffeine and much less by other compounds (i.e., aminopyrine, levamisole, benzocaine). In the majority of CP analyzed samples, both cocaine and caffeine content was 30%, phenacetin 20% and the combination of these three components reached 90%. Typical cocaine pyrolysis compounds (i.e., BA, CMCHTs, and AEME) were observed in the volatilized cocaine and CP sample but no pyrolysis compounds were found after isolated adulterants heating. Cocaine, phenacetin, and caffeine were detected in plasma. We provide current forensic data about CP seized samples and demonstrated the chemical integrity of their adulterants heated.
... Over the past two decades the following adulterants, which are 'per se' associated with levels of toxicity (Pawlik et al., 2015), have been found in cocaine seized by law enforcement agencies and/or PM toxicological assays in the UK and Western Europe: atropine, benzocaine, caffeine, diltiazem, ephedrine, hydroxyzine, levamisole, lidocaine/lignocaine, paracetamol, phenacetin, procaine (Brunt et al., 2009;Evrard et al., 2010;King, 1997;Schneider and Meys, 2011). There appear to have been increases in caffeine, diltiazem, hydroxyzine and levamisole since 2007 but a decrease in lidocaine over the years. ...
... The possibility of interactions between adulterants and cocaine is not well researched. Additional concerns are that: often durations of exposure are unknown (Brunt et al., 2009;Evrard et al., 2010); users are unable to detect specific adulterants (Evrard et al., 2010); the variable purity level and the wide range of adulterants can lead to unpredictable clinical effects (Evrard et al., 2010); and many of these adulterants are prescribed for oral ingestion in therapeutic treatment but pharmacokinetic properties such as absorption, bio-availability, distribution, metabolism and kinetics may be affected by other administration routes (Brunt et al., 2009;Pawlik et al., 2015). If cocaine is insufflated or smoked the adulterants will also be incorporated into the lung initially (Pawlik and Mahler, 2013), and may result in lung damage or disease (Hollinger, 1993;Kehrer and Kacew, 1985). ...
... The possibility of interactions between adulterants and cocaine is not well researched. Additional concerns are that: often durations of exposure are unknown (Brunt et al., 2009;Evrard et al., 2010); users are unable to detect specific adulterants (Evrard et al., 2010); the variable purity level and the wide range of adulterants can lead to unpredictable clinical effects (Evrard et al., 2010); and many of these adulterants are prescribed for oral ingestion in therapeutic treatment but pharmacokinetic properties such as absorption, bio-availability, distribution, metabolism and kinetics may be affected by other administration routes (Brunt et al., 2009;Pawlik et al., 2015). If cocaine is insufflated or smoked the adulterants will also be incorporated into the lung initially (Pawlik and Mahler, 2013), and may result in lung damage or disease (Hollinger, 1993;Kehrer and Kacew, 1985). ...
Cocaine-related deaths have increased since the early 1990s in Europe, including the UK. Being multi-factorial, they are difficult to define, detect and record. The European Monitoring Centre for Drugs and Drug Addiction commissioned research to: describe trends reported to Special Mortality Registries and General Mortality Registers; provide demographic and drug-use characteristic information of cases; and establish how deaths are identified and classified. A questionnaire was developed and piloted amongst all European Monitoring Centre for Drugs and Drug Addiction Focal Point experts/Special Mortality Registries: 19 (63%) responded; nine countries provided aggregated data. UK General Mortality Registers use cause of death and toxicology to identify cocaine-related deaths. Categorisation is based on International Classification of Diseases codes. Special Mortality Registries use toxicology, autopsy, evidence and cause of death. The cocaine metabolites commonly screened for are: benzoylecgonine, ecgonine methyl ester, cocaethylene and ecgonine. The 2000s saw a generally accelerating upward trend in cases, followed by a decline in 2009. The UK recorded 2700–2900 deaths during 1998–2012. UK Special Mortality Registry data (2005–2009) indicate: 25–44 year-olds account for 74% of deaths; mean age=34 (range 15–81) years; 84% male. Cocaine overdoses account for two-thirds of cases; cocaine alone being mentioned/implicated in 23% in the UK. Opioids are involved in most (58%) cocaine overdose cases.
... Most importantly, we relied on subjective market indicator data, which may partly reflect how embedded participants are within a drug network ( Dwyer & Moore, 2010 ). Perceived purity in particular is considered less reliable and may be affected by drug tolerance ( Dwyer & Moore, 2010 ) or price paid ( Evrard et al., 2010 ). However, research comparing toxicological analysis and subjective perceptions of cocaine purity found that after controlling for price paid, duration of use, and frequency of use, samples with higher cocaine content were more likely to be described as 'good', and those with lower content were more likely to be described as 'average' or 'poor' ( Evrard et al., 2010 ). ...
... Perceived purity in particular is considered less reliable and may be affected by drug tolerance ( Dwyer & Moore, 2010 ) or price paid ( Evrard et al., 2010 ). However, research comparing toxicological analysis and subjective perceptions of cocaine purity found that after controlling for price paid, duration of use, and frequency of use, samples with higher cocaine content were more likely to be described as 'good', and those with lower content were more likely to be described as 'average' or 'poor' ( Evrard et al., 2010 ). The data used in this study were collected from sentinel samples, so should not be considered representative of the drug market experiences of all people who use or inject drugs in Australia. ...
Background:
Changes to drug markets can affect drug use and related harms. We aimed to describe market trends of heroin, methamphetamine, cocaine and ecstasy in Australia following the introduction of COVID-19 pandemic-associated restrictions.
Methods:
Australians residing in capital cities who regularly inject drugs (n ∼= 900 each year) or regularly use ecstasy and/or other illicit stimulants (n ∼= 800 each year) participated in annual interviews 2014-2022. We used self-reported market indicators (price, availability, and purity) for heroin, crystal methamphetamine, cocaine, and ecstasy crystal to estimate generalised additive models. Observations from the 2014-2019 surveys were used to establish the pre-pandemic trend; 2020, 2021 and 2022 observations were considered immediate, short-term and longer-term changes since the introduction of pandemic restrictions.
Results:
Immediate impacts on market indicators were observed for heroin and methamphetamine in 2020 relative to the 2014-2019 trend; price per cap/point increased (β: A$9.69, 95% confidence interval [CI]: 2.25-17.1 and β: A$40.3, 95% CI: 33.1-47.5, respectively), while perceived availability (adjusted odds ratio [aOR] for 'easy'/'very easy' to obtain: 0.38, 95% CI: 0.24-0.59 and aOR: 0.08, 95% CI: 0.03-0.25, respectively) and perceived purity (aOR for 'high' purity: 0.36, 95% CI: 0.23-0.54 and aOR: 0.33, 95% CI: 0.20-0.54, respectively) decreased. There was no longer evidence for change in 2021 or 2022 relative to the 2014-2019 trend. Changes to ecstasy and cocaine markets were most evident in 2022 relative to the pre-pandemic trend: price per gram increased (β: A$92.8, 95% CI: 61.6-124 and β: A$24.3, 95% CI: 7.93-40.6, respectively) and perceived purity decreased (aOR for 'high purity': 0.18, 95% CI: 0.09-0.35 and 0.57, 95% CI: 0.36-0.90, respectively), while ecstasy was also perceived as less easy to obtain (aOR: 0.18, 95% CI: 0.09-0.35).
Conclusion:
There were distinct disruptions to illicit drug markets in Australia after the COVID-19 pandemic began; the timing and magnitude varied by drug.
... Forensic data support that drugs of abuse that are illegally sold are commonly diluted, contaminated, and adulterated (Broséus et al. 2016;Cole et al. 2011;Evrard et al. 2010;Villar Núñez et al. 2018). Depending on the origin of each drug (synthetic, semisynthetic, or natural), a specific process is chosen. ...
... Caffeine is one of the substances most frequently found in seized samples of cocaine hydrochloride, methamphetamine, amphetamine derivatives (e.g., MDMA and MDA), and synthetic cathinones (Cole et al. 2011;Kudlacek et al. 2017;Seely et al. 2013;Vanattou-Saïfoudine et al. 2012). Also, it was found in smoked forms of cocaine, like crack and cocaine paste (Abin Carriquiry et al. 2018;Cole et al. 2011;Evrard et al. 2010;Fukushima et al. 2014;Pawlik and Mahler 2001;López Hill et al. 2011;Prieto et al. 2015). Thus, forensic data about the drug purity and the presence of diluents, contaminants, or adulterants is essential to understand overdosage, unexpected side effects (toxicity), putative fatal reactions, or even the abuse liability of a drug. ...
In human, the pulmonary inhalation route is one of the most effective and rapid forms for drug delivery with therapeutic, medical, and recreational purposes. In addition to being a noninvasive method, the extensive irrigated lung surface turns extremely beneficial when drug delivery for pulmonary use is chosen to study the systemic effect of different drugs. Due to different issues, however, this route of administration is not very often used to evaluate the effects of drugs in animals; however, here we provided methodological information applying this route of administration combined with traditional approaches.Coca paste (CP) is an illicit drug of abuse commonly used in several countries of South America, and likewise crack, it is classified as a smoked cocaine form. In humans, CP consumption induces a fast and strong dependence in addition to other physiological alterations. Yet, these other factors, which collaborate in defining the clinical profile of CP consumers, continue under study. Furthermore, until recently there was no preclinical data so far showing the effects induced by the pulmonary inhalation of CP using traditional behavioral and neurochemical tools, such as the open field test and in vivo brain microdialysis technique, respectively. In this work, the open field test was used for the acute motor and exploratory activity assessment. In vivo brain microdialysis is a widely known neurochemical approach used for monitoring neurotransmitter extracellular levels in discrete brain areas of freely moving rats. Considering that increases in dopamine neurotransmission induced by cocaine and other drugs of abuse in the nucleus accumbens are related to their rewarding properties, we designed a novel methodological procedure to measure the extracellular dopamine levels in the nucleus accumbens of freely moving rats during and after the passive inhalation of different volatilized CP samples. The pharmacological relevance of the major components of CP samples, cocaine and caffeine (main active adulterant), is highlighted on the behavioral and neurochemical outcomes. Our findings pointed out the relevance of the route of administration and the chemical composition of CP preparations in smoked cocaine abuse liability and place them as the main contributing factors.Key wordsCocaineCaffeineAddictionRoute of administrationNucleus accumbens
... These mentioned techniques allow obtaining data about impurity profile on seized cocaine. There are a wide number of studies and surveys about chemical profile of cocaine hydrochloride mainly in Europe, Australia and North America (Darke et al., 2005;Evrard et al., 2010). On the contrary, in South America there are not many studies about the composition of street cocaine, in that aspect, the mayor number of publications about this issue are made in Brazil and Colombia with very alarming results in terms of the wide range purity of cocaine and the extensive adulteration founded in tested samples (Garzon et al., 2009;Magalhães et al., 2013;Fukushima et al., 2014;Maldaner et al., 2016). ...
... Fig. 1 shows purity profile over 10 years comparing evolution of cocaine concentration (%w/w) from 2006 to 2016. Purity has gradually steady about 55% w/w to 2009; this trend has also been reported in several countries in Europe and Brazil in South America (Evrard et al., 2010). ...
Context: Cocaine is one of the most worldwide consumed drugs of abuse. Determinate purity and adulteration profile of cocaine is very useful from the point of view of toxicology, public health, trends of misuse and for police enforcement, in order to establish the routes of drugs dealers. Aims: To evaluate the purity profile of cocaine hydrochloride in Chile over 10 years; classify main adulterants and diluents added to cocaine, for this purpose we used collected data from all tested samples since 2006 to 2016. Methods: In this study were used several analytical methods based in different techniques. For quantitative analysis samples were tested by Gas Chromatography with Flame Ionization Detector and High-Performance Thin Layer Chromatography. In order to confirm doubtful or extensively adulterated samples a confirmatory analysis by GC/MS was carried out. Results: Results of this study are very alarming due to cocaine purity decreased since 2009 this fact corresponds with that cocaine has been progressively adulterated and diluted with compounds such as levamisol, caffeine, local anaesthetics, and carbonates. These events make very important this type of studies of composition of the street drug. Conclusions: Cocaine is extensively adulterated, with substances that enhance the harm to the health of users, as in other countries in the region. According to our knowledge this is the first report in Chile about purity profile of cocaine hydrochloride in such a long period and with this large number of samples studied.
... These mentioned techniques allow obtaining data about impurity profile on seized cocaine. There are a wide number of studies and surveys about chemical profile of cocaine hydrochloride mainly in Europe, Australia and North America (Darke et al., 2005;Evrard et al., 2010). On the contrary, in South America there are not many studies about the composition of street cocaine, in that aspect, the mayor number of publications about this issue are made in Brazil and Colombia with very alarming results in terms of the wide range purity of cocaine and the extensive adulteration founded in tested samples (Garzon et al., 2009;Magalhães et al., 2013;Fukushima et al., 2014;Maldaner et al., 2016). ...
... Fig. 1 shows purity profile over 10 years comparing evolution of cocaine concentration (%w/w) from 2006 to 2016. Purity has gradually steady about 55% w/w to 2009; this trend has also been reported in several countries in Europe and Brazil in South America (Evrard et al., 2010). ...
Context: Cocaine is one of the most worldwide consumed drugs of abuse. Determinate purity and adulteration profile of cocaine is very useful from the point of view of toxicology, public health, trends of misuse and for police enforcement, in order to establish the routes of drugs dealers.
Aims: To evaluate the purity profile of cocaine hydrochloride in Chile over 10 years; classify main adulterants and diluents added to cocaine, for this purpose we used collected data from all tested samples since 2006 to 2016.
Methods: In this study were used several analytical methods based in different techniques. For quantitative analysis samples were tested by Gas Chromatography with Flame Ionization Detector and High-Performance Thin Layer Chromatography. In order to confirm doubtful or extensively adulterated samples a confirmatory analysis by GC/MS was carried out.
Results: Results of this study are very alarming due to cocaine purity decreased since 2009 this fact corresponds with that cocaine has been progressively adulterated and diluted with compounds such as levamisol, caffeine, local anaesthetics, and carbonates. These events make very important this type of studies of composition of the street drug.
Conclusions: Cocaine is extensively adulterated, with substances that enhance the harm to the health of users, as in other countries in the region. According to our knowledge this is the first report in Chile about purity profile of cocaine hydrochloride in such a long period and with this large number of samples studied.
... Regarding the illicit form, to increase profits, traffickers have tampered with or diluted the drug with other compounds, either inert or active substances, making up the "street drug". 10,31,32 Crack has a lower degree of purity than freebase because it carries cocaine hydrochloride adulterants, as well as resulting products and surplus from the extraction process, so that its purity percentage is reduced to 40% 10 The process of obtaining freebase involves a purification process prior to the formation of the final product which in fact makes it purer than crack. Street drugs can generally be marketed almost pure, adulterated, diluted or contaminated. ...
... Street drugs can generally be marketed almost pure, adulterated, diluted or contaminated. 4,[32][33][34][35][36][37][38][39][40][41] It is well known that tampering is generally a widespread phenomenon in illicit drug market. The obvious purpose is to increase the amount of the final product, which involves mixing various substances. ...
... The same occurred for hydroxyzine where sensitivity could not be calculated regarding the absence of TP or FP samples. Regarding GC-MS, the results of accuracy were higher than 90% for all compounds, as expected, since this is a more rugged laboratory-based, benchtop instrument, not intended for regular transportation and true field deployment, which has been well characterized and optimized over many tears for both controlled substance and adulterant testing [5,14,17,48]. ...
... In general, the large variety of cocaine content found is data (22.7-100%) is compatible with studies in other countries. In France, the cocaine content described by Dujourdy and Besacier ranged from 20-30% [49] and Evrard et al., two years later, found a mean cocaine content of 27%, (median 22%) [48]. Other European countries like Italy and Belgium presented cocaine content ranged from 80-90% [50] and 0.2-99%, (mean 50.6%) [5], respectively. ...
Cocaine is usually sold as a white powder and can contain several adulterants and diluents, known as cutting agents. The cutting agents play an important role in the identification of trafficking routes, and they can also modify or intensify signs and symptoms of drug intoxication increasing the risk to the health's user. The purpose of this work was to quantify cocaine and cutting agents in 116 illicit samples from NMS Labs, Willow Grove, PA, U.S. Gas chromatography – mass spectrometry (GC–MS) and handle-portable gas chromatography toroidal ion trap mass spectrometry (GC–TMS) were used as screening methods A liquid chromatography tandem mass spectrometry (LC–MS/MS) method was developed and validated for the quantification of cocaine, levamisole, benzocaine, phenacetin, hydroxyzine, theophylline, diltiazem, acetaminophen and caffeine. Cocaine-d3 and caffeine-d3 were used as internal standards. The method was shown to be precise, accurate and linear over a range of 50–2000 ng/mL for all analytes. Cocaine was the only detected compound in 16.37% (n = 19) of the samples. Between the identified cutting agents, levamisole was the most abundant substance found (79.31% of the total samples, amounts ranging from 0.2 to 74.3%), followed by phenacetin (18.96%, 0.3–46.8%), caffeine (12.06%, 0.2–32.2%), hydroxyzine (9.48%, 0.7–13.8%) and benzocaine (5.17%, 0.4–58.3%). GC–TMS was considered suitable to be used as a tool in forensic analysis as a screening method for cocaine, benzocaine, phenacetin, hydroxyzine and caffeine with restrictions to be used for levamisole, while GC–MS presented good results in screening analysis for cocaine, levamisole, benzocaine, phenacetin, hydroxyzine and caffeine.
... Adulteration is a common practice in the illicit drugs of abuse market, and involves the intentional addition of a pharmacologically active substance without the user being aware (Pawlik and Mahler, 2001;Evrard et al., 2010;Cole et al., 2011). Caffeine is one of the substances most frequently found in seized samples of psychostimulants, including cocaine hydrochloride and smoked forms of cocaine, such as crack and CP (Evrard et al., 2010;Lopez-Hill et al., 2011;Fukushima et al., 2014;Prieto et al., 2015). ...
... Adulteration is a common practice in the illicit drugs of abuse market, and involves the intentional addition of a pharmacologically active substance without the user being aware (Pawlik and Mahler, 2001;Evrard et al., 2010;Cole et al., 2011). Caffeine is one of the substances most frequently found in seized samples of psychostimulants, including cocaine hydrochloride and smoked forms of cocaine, such as crack and CP (Evrard et al., 2010;Lopez-Hill et al., 2011;Fukushima et al., 2014;Prieto et al., 2015). Taking into account that sleep disturbances are common symptoms associated with cocaine and CP use and withdrawal (Jeri, 1978(Jeri, , 1982bBrower et al., 1988;Weddington et al., 1990;Triaca and Cardeillac, 2009;Pascale et al., 2014), the presence of adulterants in these drugs is a significant issue to consider to understand their effects. ...
Caffeine is a common active adulterant found in illicit drugs of abuse, including coca paste (CP). CP is a smokable form of cocaine mainly consumed in South America, produced during the cocaine-extraction process. CP has high abuse liability and its chronic consumption induces severe sleep-wake alterations. However, the effect of CP on the sleep-wake cycle and the effect of the presence of caffeine as an adulterant remain unknown. We studied the effect of an acute intraperitoneal injection of 2.5 and 5 mg/kg of a representative CP sample adulterated with caffeine (CP1) on the rat sleep-wake cycle. Compared with saline, administration of CP1 induced an increase in wakefulness and a decrease in light (light sleep) and slow wave sleep that was larger than the effects produced by equivalent doses of cocaine. Compared with CP1, combined treatment with cocaine (5 mg/kg) and caffeine (2.5 mg/kg), a surrogate of CP1, elicited similar effects. In contrast, a nonadulterated CP sample (CP2) produced an effect that was not different from cocaine. Our data indicate that caffeine produces a significant potentiation of the wakefulness-promoting effect of cocaine, suggesting that caffeine should be explored as a causal agent of clinical symptoms observed in CP users.
... Cocaine is routinely cut with a variety of agents, mainly phenacetin, levamisole, lidocaine, caffeine, and sugars (e.g., mannitol, lactose, or glucose), although several other compounds may be found in seized samples, depending on the producer and the country. For instance, in France, phenacetin and caffeine are the adulterants most frequently found in seizures, followed by levamisole and procaine [2]. Protocols for the positive identification of cocaine have thus to deal with the complexity of sample composition. ...
... Protocols for the positive identification of cocaine have thus to deal with the complexity of sample composition. If the target components are thermally stable between 265 and 300°C, the determination of the overall cocaine content can be addressed using GC-MS [2,3] on extracts. Otherwise, liquid phase separation [4] such as capillary electrophoresis [5], high-performance liquid chromatography [6], and direct analysis using ambient mass spectrometry [7,8] have been also widely employed to this purpose. ...
Seized samples of illegally produced cocaine have a very large variability in composition; a fact that may result in a challenge to their analysis. We demonstrate here a simple and fast method to detect the presence of cocaine in both hydrochloride and free-base forms in illicit drug samples by nuclear magnetic resonance (NMR) spectroscopy. This is achieved by combining the commonly used 1D spectra and diffusion-ordered spectroscopy and introducing the 2D maximum-quantum NMR approach to forensic analysis. The protocol allows the facile determination of the cocaine forms even in the presence of multiple adulterants. By relying on non-uniform sampling acceleration of 2D spectroscopy, the identification can be obtained in less than 3 min for 10 mg of product. Moreover, we show that intermolecular interactions of the sample constituents, while affecting the analysis result, do not interfere with the quality of the detection of the proposed protocol.
... Adulteration is a common practice in the illicit drugs of abuse market, and involves the intentional addition of a pharmacologically active substance without the user being aware (Pawlik and Mahler, 2001;Evrard et al., 2010;Cole et al., 2011). Caffeine is one of the substances most frequently found in seized samples of psychostimulants, including cocaine hydrochloride and smoked forms of cocaine, such as crack and CP (Evrard et al., 2010;Lopez-Hill et al., 2011;Fukushima et al., 2014;Prieto et al., 2015). ...
... Adulteration is a common practice in the illicit drugs of abuse market, and involves the intentional addition of a pharmacologically active substance without the user being aware (Pawlik and Mahler, 2001;Evrard et al., 2010;Cole et al., 2011). Caffeine is one of the substances most frequently found in seized samples of psychostimulants, including cocaine hydrochloride and smoked forms of cocaine, such as crack and CP (Evrard et al., 2010;Lopez-Hill et al., 2011;Fukushima et al., 2014;Prieto et al., 2015). Taking into account that sleep disturbances are common symptoms associated with cocaine and CP use and withdrawal (Jeri, 1978(Jeri, , 1982bBrower et al., 1988;Weddington et al., 1990;Triaca and Cardeillac, 2009;Pascale et al., 2014), the presence of adulterants in these drugs is a significant issue to consider to understand their effects. ...
... The overall prevalence of cocaine use in the total adult population in Europe is 3.7%, with at least 12 million Europeans reporting having used this drug in their lifetime (Brunt et al. 2009). A recent review of the literature reported the use of sugars (e.g., glucose, sucrose, lactose), talc, starch, and carbonates as diluents of cocaine ; currently, phenacetin, levamisole, caffeine, and lidocaine are considered the major adulterants in Europe (Broseus et al. 2015, Broseus, Huhtala, andEvrard, Legleye, and Cadet-Tairou 2010). Cocaine is one of the world's most widely used drugs (Michaud et al. 2014), and its toxic effects on the human body are well-documented. ...
... Interestingly, in our area, levamisole accounted for about one-third of adulterated samples, instead of the two-thirds shown in the United States (Chang, Osterloh, and Thomas 2010;Pendergraft et al. 2014), which probably reflects a different market for substances used for cutting illicit drugs Recent papers, in fact, reported the use of sugars (glucose, sucrose, lactose, etc.), talc, starch, and carbonates as diluents of cocaine , while phenacetin, caffeine, and lidocaine are common adulterants in Europe Broseus, Huhtala, and Esseiva 2015;Evrard, Legleye, and Cadet-Tairou 2010). Levamisole is used as an adulterant because it is an odorless powder with physical properties similar to cocaine (e.g., color, texture); it offers reasonable cost and availability, being widely used in veterinary medicine (Pawlik et al. 2015). ...
Cocaine use is increasing around the world and its purity is frequently altered through dilution, substitution, contamination, and adulteration. Sugars, talc, starch, and carbonates represent the principal diluents of cocaine, while phenacetin, levamisole, caffeine, and lidocaine are its major adulterants in Europe. Levamisole is used because it is an odorless powder, with physical properties similar to cocaine, and it has reasonable cost and availability, being widely used in veterinary medicine. For this study, we analyzed 88 cocaine samples. The seized cocaine analyzed showed an average purity of 55% and the most frequent adulterants identified were: levamisole (31.8%), caffeine (6.8%), lidocaine (2.3%), acetaminophen (2.3%), and phenacetin (1.1%). Our aim is the study of the presence of levamisole, over other adulterants in seized cocaine samples, due to its recognized human toxicity. The chronic use of levamisole-adulterated cocaine represents a serious public health issue because it may be responsible for side-effects such as dermal vasculopathy, leukoencephalopathy, leukopenia, agranulocytosis, pulmonary hemorrhage, multiple emboli, and several other effects. Moreover, aminorex can cause idiopathic pulmonary hypertension, presenting another harmful and mostly lethal side-effect from cocaine cut with levamisole. In conclusion, levamisole determination should be performed in routine toxicological analysis in deaths due to cocaine use.
... While we may assume that online forums facilitated finding information and sharing knowledge about illicit drugs more recently, the situation barely evolved. Indeed, more recently Evrard and al. [43] highlighted that from a user perspective, the perceived quality of the cocaine depends on information provided by the dealer and also on price. These factors continue to affect consumers after use, despite adjustment on the actual cocaine content [43]. ...
... Indeed, more recently Evrard and al. [43] highlighted that from a user perspective, the perceived quality of the cocaine depends on information provided by the dealer and also on price. These factors continue to affect consumers after use, despite adjustment on the actual cocaine content [43]. ...
Darknet markets, also known as cryptomarkets, are websites located on the Darknet and designed to allow the trafficking of illicit products, mainly drugs. This study aims at presenting the added value of combining digital, chemical and physical information to reconstruct sellers' activities. In particular, this research focuses on Evolution, one of the most popular cryptomarkets active from January 2014 to March 2015. Evolution source code files were analysed using Python scripts based on regular expressions to extract information about listings (i.e., sales proposals) and sellers. The results revealed more than 48,000 listings and around 2700 vendors claiming to send illicit drug products from 70 countries. The most frequent categories of illicit drugs offered by vendors were cannabis-related products (around 25%) followed by ecstasy (MDA, MDMA) and stimulants (cocaine, speed). The cryptomarket was then especially studied from a Swiss point of view. Illicit drugs were purchased from three sellers located in Switzerland. The purchases were carried out to confront digital information (e.g., the type of drug, the purity, the shipping country and the concealment methods mentioned on listings) with the physical analysis of the shipment packaging and the chemical analysis of the received product (purity, cutting agents, chemical profile based on minor and major alkaloids, chemical class). The results show that digital information, such as concealment methods and shipping country, seems accurate. But the illicit drugs purity is found to be different from the information indicated on their respective listings. Moreover, chemical profiling highlighted links between cocaine sold online and specimens seized in Western Switzerland. This study highlights that (1) the forensic analysis of the received products allows the evaluation of the accuracy of digital data collected on the website, and (2) the information from digital and physical/chemical traces are complementary to evaluate the practices of the online selling of illicit drugs on cryptomarkets.
... Even though phenacetin was, for a long time, used more often than acetaminophen, it was banned by different organizations due to its adverse effects on human health, including carcinogenic and kidney-damaging properties [6,7]. Interestingly, nowadays, it has been found to be one of the main cocaine adulterants worldwide [8,9]. ...
The solubility of active pharmaceutical ingredients is a mandatory physicochemical characteristic in pharmaceutical practice. However, the number of potential solvents and their mixtures prevents direct measurements of all possible combinations for finding environmentally friendly, operational and cost-effective solubilizers. That is why support from theoretical screening seems to be valuable. Here, a collection of acetaminophen and phenacetin solubility data in neat and binary solvent mixtures was used for the development of a nonlinear deep machine learning model using new intuitive molecular descriptors derived from COSMO-RS computations. The literature dataset was augmented with results of new measurements in aqueous binary mixtures of 4-formylmorpholine, DMSO and DMF. The solubility values back-computed with the developed ensemble of neural networks are in perfect agreement with the experimental data, which enables the extensive screening of many combinations of solvents not studied experimentally within the applicability domain of the trained model. The final predictions were presented not only in the form of the set of optimal hyperparameters but also in a more intuitive way by the set of parameters of the Jouyban–Acree equation often used in the co-solvency domain. This new and effective approach is easily extendible to other systems, enabling the fast and reliable selection of candidates for new solvents and directing the experimental solubility screening of active pharmaceutical ingredients.
... Con respecto a la concentración de fenacetina, se pudo corroborar resultados similares en estudios similares en el área suramericana y europea. (10,17,18) Sin embargo, no se detectaron sustancias que otros investigadores han reportado, tales como: la lidocaína, cafeína, paracetamol, diltiazem, ibuprofeno, manitol, hydroxyzin y Beta-Alanina. (18,19) La fenacetina tiene la potencialidad de causar nefropatía hipertensión, eventos como infarto cardíaco y accidente cerebrovascular; (20) además de haber sido asociada con el cáncer de hígado y riñon. ...
Consumption of cocaine represents an emerging health problem because it is an illicit psychotropic drug consumed among patients treated in emergency rooms, and it also generates other risks related to the components that may be present in it. The study was carried out with a quantitative, descriptive approach. The research aimed to characterize the inorganic samples of cocaine in the Forensic Chemistry Laboratory of a province in the Ecuadorian context during the period July-December 2016. The whole population of 90 samples was taken into account. The quantification of the chemical elements presented in the specimens was carried out through gas chromatography using a mass detector coupled to the equipment. It was determined that half of the samples contained impurities sucah as cinnamoylcocaine, methylecgonine and tropococaine, benzoylecgonine and only 11.1% of the samples did not have alkaloidal impurities as results of the research. Regarding the presence of adulterants in the material analyzed, starch was the most used by cocaine drug dealers in the studied environment; the use of phenacetin, levamisole and aminopyrine could also be observed.
... It is unclear how the increase in purity influences the hazards of cocaine use. A previous study on composition, purity, and perceived quality of street cocaine showed that although users of cocaine were able to detect samples with an extremely high cocaine content, they were rarely able to tell the difference between adulterated cocaine and relatively pure cocaine [35]. Thus, if a user is consistently supplied with cocaine with the same profile, the risk of overdose is probably limited, while if a user is shifted unknowingly from low to high purity cocaine, it could have serious consequences. ...
Cocaine-related emergency department admissions are increasing, and cocaine seizures are at an all-time high in Europe. Our aim was to investigate the trends in purity and adulterants over time in cocaine available to cocaine users at street level in Denmark. We used a representative sample of cocaine seized at street level and analyzed by the national departments of forensic medicine between 2006 and 2019 (n=1,460). Latent profile analysis was used to classify the samples based on cocaine, levamisole, and phenacetin content. Low purity cocaine comprised most of the cocaine seizures in early years, but its share began to decline in 2013, and from 2016-2019, the high purity profile was dominant. While the total number of samples containing adulterants decreased, levamisole remained a common and dangerous adulterant. The findings underline the need to inform the public, medical doctors, and service providers for people with drug use disorders about the higher potency of street cocaine.
... Data from 2006 to 2014 presented by Brouséus et al. evidenced among drugs seizure in Switzerland a cocaine% of about 40% or slightly less, while heroin average active principles close to 10% until 2013, increasing up to 15% in 2014 [24]. Data published by Evrard et al. [25] for street cocaine in France evidence a lower active principle content (mean value: 22%) compared to the here presented data, but it must be underlined as the reference period is May to December 2006, so differences can be attributed to the yearly increase in active principle' contents. ...
The study presents results of toxicological analysis performed on seized material in Neapolitan area in the period from 2013 to 2018. A constancy in THC and heroin percentages is evidenced (%THC ~10% and ~11.5% for marijuana and hashish; heroine: 20%-24%), with mean values exceeding the European data. Data on cocaine revealed a constant increment of active principle percentage over the studied period (from 40% in 2013 to ~65% in 2018), with peak of 70% in 2017; also, number of samples exceeding the mean value increased over years. Active principles contents resulted higher than the ones reported in other Italian area ever the same period; marijuana was prevalent on hashish, confirming an Italian trend different from other European countries. A map of the Campania region evidenced two main “storage” districts, one corresponding to the city center and the second located in the northern part. If compared with literature data on the presence of local mafia, these areas are perfectly superimposable to those with the highest risk of homicides, thus confirming the degree of radicalization of local organizations and the relative weight of proceeds from drugs sale. Moreover, such radicalization within the territory seems to be the main reason of the absence of new psychoactive substances among the seized material.
... Buyers cite risks involved in the exchange such as the quality of substances, the reliability of the seller of these substances, and the likelihood of detection from law enforcement (Eck, 1995;Jacques et al., 2014;Reuter & Caulkins, 2004). Although, taking the quality of substances as an example, drug buyers may rely on basic sensory tests, and suggestions of quality from dealers and members of their peer group, these methods are less reliable, and are inaccurate in measuring the quality of drugs or detecting the inclusion of adulterants even for experienced users Evrard et al., 2010). Illicit drug market actors are not afforded, to any considerable degree, information to inform to support "rational" decisions as a result of competitive market structures. ...
Rational choice perspectives have been the dominant models used for conceptualizing the nature of exchanges in illicit drug markets, but various critiques have found these abstracted assumptions inadequate for understanding concrete illicit drug market activity. Considerably less, however, is known about key aspects of rationality in exchanges within online drug markets. Recognizing the inadequacies of an underlying homo economicus, we instead conceive drug market exchanges as complex assemblages, noting how exchanges are reconstructed in online spaces, and technological affordances may facilitate elements of rationality in drug exchanges. Adopting these notions allows us to argue that aspects of rationality can potentially contribute to an understanding of exchange practices in online markets, and that online channels can afford assumptions of utility-maximization, rich market information to guide decision-making, and anonymity in the exchange. In addition, consideration is given to the structural variability of online illicit drug markets, and that the affordance of rationality should be considered across a spectrum of applicability that takes into account the specifics of each dimension of online drug market (i.e. drug cryptomarkets, illicit online pharmacies, and “app-based” drug markets).
... Cocaine is one of the most powerful psychostimulants in which abuse and dependence continue eliciting public health problems, with no effective pharmacological or psychological therapies identified to date (Jordan et al. 2019;Rachid 2018). Besides, cocaine dependence could be faster and stronger depending on the form of consumption-e.g., snorted vs. smoked or intravenous route of administration- (Castaño 2000;Gossop et al. 1992;Hatsukami and Fischman 1996;Samaha and Robinson 2005), and the interaction with active adulterants, like caffeine (Abin Carriquiry et al. 2018;Broseus et al. 2016;Evrard et al. 2010;Fukushima et al. 2014;Sabogal and Urrego 2012). ...
In the last years, clinical and preclinical researchers have increased their interest in non-psychotomimetic cannabinoids, like cannabidiol (CBD), as a strategy for treating psychostimulant use disorders. However, there are discrepancies in the pharmacological effects and brain targets of CBD. We evaluated if CBD was able to prevent the locomotor sensitization elicited by cocaine and caffeine co-administration. The effect of CBD on putative alterations in the metabolic activity of the medial prefrontal cortex (mPFC) and nucleus accumbens (NAc), and its respective subregions (cingulated, prelimbic, and infralimbic cortices, and NAc core and shell) associated to the behavioral response, was also investigated. Rats were intraperitoneally and repeatedly treated with CBD (20 mg/kg) or its vehicle, followed by the combination of cocaine and caffeine (Coc+Caf; 5 mg/kg and 2.5 mg/kg, respectively) or saline for 3 days. After 5 days of withdrawal, all animals were challenged with Coc+Caf (day 9). Locomotor activity was automatically recorded and analyzed by a video-tracking software. The metabolic activity was determined by measuring cytochrome oxidase-I (CO-I) staining. Locomotion was significantly and similarly increased both in Veh-Coc+Caf- and CBD-Coc+Caf-treated animals during the pretreatment period (3 days); however, on day 9, the expression of the sensitization was blunted in CBD-treated animals. A hypoactive metabolic response and a hyperactive metabolic response in mPFC and NAc subregions respectively were observed after the behavioral sensitization. CBD prevented almost all these changes. Our findings substantially contribute to the understanding of the functional changes associated with cocaine- and caffeine-induced sensitization and the effect of CBD on this process.
... Furthermore, the surveys rely on users' perceptions of the drug injected and their willingness to report https://doi.org/10.1016/j.drugalcdep.2020.107909 Received 6 January 2020; Received in revised form 10 February 2020; Accepted 10 February 2020 the information (Evrard et al., 2010). Even if the main psychoactive substance is known to PWID, the presence of cutting agents are generally unknown or not reported (Broséus et al., 2015). ...
Providing information about substances injected can reduce the negative impact of illicit drug consumption and support people who inject drugs to make informed decisions. In Australia, information about drugs injected relies largely on periodic self-report surveys. For the first time, the analysis of the residual content of used injecting equipment was conducted in a supervised injecting facility (SIF) located in Sydney, Australia. The aim was to gain a better understanding of the substances injected by clients through: (1) chemical analyses of the content of used syringes; (2) comparison of these results with clients' self-reported drug use; and (3) assessing the usefulness of analysing other injecting equipment to detect substances used. During one week in February 2019, syringes and other injecting equipment were collected at the Sydney SIF. Their residual content was analysed by gas-chromatography/mass-spectrometry. Heroin was the most commonly detected substance (present in 51% of syringes), followed by methamphetamine (22%) and oxycodone (10%). In addition to the main psychoactive substance, cutting agents reported in the literature were also detected in used syringes. The main psychoactive substance identified by laboratory analysis reliably corresponded with users' self-reported drug type. Analytical confirmation of substances injected allows for the provision of better targeted harm reduction messaging based on timely and objective data. The approach used is amenable to clients and feasible in the Australian SIF context. Upscaling and wider implementation could be done through Needle and Syringe Programs, and would support the early detection of harmful substances entering drug markets and better inform harm reduction strategies.
... Like crack, the consumption of CP elicits a rapid and strong dependence due to smoke inhalation (Jeri 1984;Gossop et al. 1992;Samaha and Robinson 2005), and, in the case of CP, the presence of active adulterants in its content may collaborate in its abuse liability (López Hill et al. 2011;Prieto et al. 2016). As a common phenomenon in the illicit drugs market, substances including cocaine hydrochloride, crack, and CP are sold adulterated (Evrard et al. 2010;López Hill et al. 2011;Prieto et al. 2012;Sabogal and Urrego 2012;Fukushima et al. 2014;Broséus et al. 2016;Abin Carriquiry et al. 2018). Based on forensic data from drug-seized samples, we have reported that caffeine is one of the most common adulterants found in CPseized samples (Abin Carriquiry et al. 2018). ...
RationaleIn previous studies, we have demonstrated that seized samples of a smokable form of cocaine, also known as coca paste (CP), induced behavioral sensitization in rats. Interestingly, this effect was accelerated and enhanced when the samples were adulterated with caffeine. While the cocaine phenomenon is associated with persistent functional and structural alterations in the prefrontal cortex (PFC) and nucleus accumbens (NAc), the molecular mechanisms underlying the CP sensitization and the influence of caffeine remains still unknown.Objective
We examined the gene expression in NAc and mPFC after the expression caffeine-adulterated and non-adulterated CP locomotor sensitization.Methods
The locomotor sensitization was established in C57BL/6 mice, repeatedly treated with a CP-seized sample adulterated with caffeine (CP-2) and a non-adulterated one (CP-1). We then assessed the mRNA expression of receptor subunits of the dopaminergic and glutamatergic systems in the medial PFC (mPFC) and NAc. Other molecular markers (e.g., adenosinergic, endocannabinoid receptor subunits, and synaptic plasticity-associated genes) were also analyzed.ResultsOnly CP-2-treated mice expressed locomotor sensitization. This phenomenon was associated with increased Drd1a, Gria1, Cnr1, and Syn mRNA expression levels in the NAc. Drd3 mRNA expression levels were only significantly increased in mPFC of CP-2-treated group.Conclusions
Our results demonstrated that caffeine actively collaborates in the induction of the molecular changes underlying CP sensitization. The present study provides new knowledge on the impact of active adulterants to understand the early dependence induced by CP consumption.
... However, the hazards remained high because it showed very large purity variations (Fig. 3), increasing to a median value of 16.8% in 2017. Large variations in heroin purity have been associated with risk of overdose [34], as people using drugs do not know and do not perceive the purity of the substances they take [35]. Furthermore, in our investigation, heroin was the drug most often seized together with cocaine, which suggested that the injection of cocaine ("speedball") by people using heroin [36] was common. ...
Background:
The use of illicit substances represents one of the most difficult problems to confront in the health system. Drug use is a global problem but is not uniform throughout the world, within the same country and changes over time. Therefore, knowing the illicit substances that are used in a territory is essential to better organize health services in that specific geographical area. To this aim, we analysed 4200 samples confiscated from individuals who held them for personal use by police forces in the Italian provinces of Modena and Reggio Emilia from 2008 to 2017.
Methods:
The suspected samples were screened by gas-chromatography-mass spectrometry (GC-MS) and by liquid chromatography-tandem mass spectrometry (LC-MS/MS); all samples were subsequently analysed by gas chromatography-flame ionization detector (GC-FID) for quantitative analyses.
Results:
Cannabis was the most seized illicit substance (70.7%). Over the study period, the number of seizures of herb with a high content of Δ9-THC increased. The number of cocaine seizures remained stable (total 16.1%), but the median purity of seized cocaine increased to 75% in 2017. Heroin seizures decreased over time, but the median purity of seized heroin reached 16.8% in 2017. In almost all the years, heroin samples with a purity exceeding the 97.5 percentile were found. Especially from 2014, the range of seized substances increased and started to include synthetic cathinones, phenylethylamines, UR-144, LSD, psilocybe, prescription opioid and hypnotics. In two cases, tramadol together with tropicamide was seized. Most of the seizures involved male subjects and 82% of the seizures were from individuals younger than 35 years of age.
Conclusions:
The persistence of old illicit drugs and the rapid emergence of new psychoactive substances represented a serious challenge for public health in the studied Italian area. Some useful interventions might be: informing mainly young people about the possible complications of cannabis use; implementing standardized procedures to diagnose and treat cocaine-related emergencies in hospitals; increasing the distribution of naloxone to antagonize possible heroin overdoses; equipping laboratories to be able to identify the new psychoactive substances.
... A cocaína traficada nas ruas, apresentada comumente como pó branco, raramente é composta 100% por cocaína na sua forma de sal, cloridrato, [12,13] muitas vezes apresentando também cocaína na forma molecular (base), impurezas, decorrentes do método de obtenção [8], adulterantes, adicionados para mimetizar ou potencializar os efeitos da droga e diluentes, adicionados para diminuir a concentração da droga 6 , por isso, os compostos presentes na cocaína traficada podem estar relacionados ao cultivo da planta, ao método de obtenção, bem como às condições de armazenamento e transporte [4,13,14]. ...
A maior parte da cocaína traficada nas ruas apresenta substâncias produto dos processos de obtenção, diluentes adicionados para aumento do lucro, e adulterantes, adicionados para mimetizar ou potencializar os efeitos da droga. Estudos sobre o perfil químico de cocaína apreendida vem sendo explorados em vários países, e com destaque, no Brasil, objetivando não só conhecer o perfil da droga traficada, mas também relacionar características químicas com origens geográficas. Este trabalho investigou os componentes de 92 amostras de cocaína apreendidas na região de Araçatuba, no período de 2014 a 2015 empregando o método de extração líquido-líquido e análise por Cromatografia em fase Gasosa acoplada a detector por Espectrometria de Massas, em que foram detectados os adulterantes cafeína, lidocaína, fenacetina, levamisol, carisoprodol, aminopirina, benzocaína metotrimeprazina e cloridrato de cetamina. Também foram identificados os alcaloides éster de metilecgonidina, cinamoilcocaínas e norcocaína. A maior parte das amostras estava adulterada e apresentou o éster de metilecgonidina, substância formada a partir da degradação térmica da cocaína. Foram elaborados mapas georreferenciados baseados nos sítios das apreensões das amostras, em que se pode visualizar três principais núcleos de densidade de apreensões, localizados na cidade de Araçatuba.
Abstract
Most of street cocaine has substances derived from the processes of production, diluents added to increase profits, and adulterants added to mimic or potentiate the effects of the drug. Studies on the chemical profile and geographical origins of the seized cocaine have been explored in several countries, including Brazil. This work investigated the compounds present in 92 cocaine samples seized in the region of Araçatuba city, from 2014 to 2015 using the method of liquid-liquid extraction and analysis by Gas Chromatography coupled to Mass Spectrometry detector, in which were detected the adulterants caffeine, lidocaine, phenacetin, levamisole, carisoprodol, aminopyrine, benzocaine metotrimeprazine and ketamine hydrochloride. The alkaloids ecgonidine methyl ester, cinnamoylcocaines and norcocaine were also identified. Most of the samples were adulterated and presented ecgonidine methyl ester, a substance formed from the thermal degradation of cocaine. Georeferenced maps were made based on the sample seizure sites, showing the presence of three main hotspots in the city of Araçatuba.
... The most abundant impurity in cocaine samples (ahead of local anesthetics and phenacetine) was levamisole, an antihelminthic drug. These bulking agents have been found as impurities in cocaine in several reports (Bernardo et al., 2003;Broséus et al., 2015;Brunt et al., 2009;Evrard et al., 2010;Giné et al., 2014;Lapachinske et al., 2015;Vinkovic et al., 2018;Schneider and Meys, 2011). THC, MDMA and heroin were also found in our cocaine samples; these are not commonly found as adulterants in cocaine elsewhere. ...
Background:
Impurities in commonly used illicit drugs raise concerns for unwitting consumers when pharmacologically active adulterants, especially new psychoactive substances (NPS), are used. This study examines impurities detected in illicit drugs seized in one Australian jurisdiction.
Methods:
Queensland Health Forensic and Scientific Services provided analytical data. Data described the chemical composition of 9346 samples of 11 illicit drugs seized by police during 2015-2016. Impurities present in primary drugs were summarized and tabulated. A systematic search for published evidence reporting similar analyses was conducted.
Results:
Methamphetamine was the primary drug in 6608 samples, followed by MDMA (1232 samples) and cocaine (516 samples). Purity of primary drugs ranged from ∼30% for cocaine, 2-CB and GHB to >90% for THC, methamphetamine, heroin and MDMA. Methamphetamine and MDMA contained the largest variety of impurities: 22 and 18 variants, respectively. Drug adulteration patterns were broadly similar to those found elsewhere, including NPS, but in some primary drugs impurities were found which had not been reported elsewhere. Psychostimulants were adulterated with each other. Levamisole was a common impurity in cocaine. Psychedelics were adulterated with methamphetamine and NPS. Opioids were quite pure, but some samples contained methamphetamine and synthetic opioids.
Conclusions:
Impurities detected were mostly pharmacologically active adulterants probably added to enhance desired effects or for active bulking. Given the designer nature of these drug cocktails, the effects of the adulterated drugs on users from possible complex multi-drug interactions is unpredictable. Awareness-raising among users, research into complex multi-drug effects and ongoing monitoring is required.
... As Bancroft and Reid (2016) suggest, drug users often make judgements of drug quality based on colour, texture, smell and structure, and in offline 'street' drug markets these judgements tend to be unreliable, with limited opportunities for comparison and verification (Evrard, Legleye, & Cadet-Taïrou, 2010). Again, highlighting the 'visual' nature of many apps, a notable number of app using respondents claimed to be able to use photos and videos posted on social media apps or received via messenger to assess quality and claimed they could 'see' that a drug was unadulterated, safe and of a reasonable quality. ...
Background:
The use of new technology is frequently harnessed by drug suppliers to both increase profits and reduce risk. While a growing body of research has investigated drug sales through online pharmacies and cryptomarkets, despite growing media interest, no published research exists on how smartphone-enabled social media and messaging applications ('apps') are utilised in the drug economy. This study analyses the ways such apps (e.g. Snapchat, Instagram and WhatsApp) are utilised to supply and access drugs.
Methods:
Three data collection methods were employed: an international online survey of 358 drug users that had either used or considered using apps to access drugs; 'rapid' interviews (n = 20) with a similar population; and in-depth interviews (n = 27). Key issues explored were the perceived benefits and risks associated with sourcing drugs through apps, with specific attention paid to novel supply and purchasing practices.
Results:
Apps appear to provide a quick, convenient method for connecting buyer and seller. They were often viewed as a valuable intermediary option between cryptomarkets and street dealing, providing 'secure' features and the opportunity to preview product without the requirement for technical expertise. Apps are used in a range of novel and diverse ways, including as social networking spaces in which drugs are advertised, and as encrypted messaging services for communicating with known sellers and arranging transactions. Key anxieties related to potential for exposure to law enforcement and legitimacy of substances.
Conclusion:
Though 'social supply' through friends is still typically preferred and there is a degree of wariness toward app-mediated supply, our data indicate that apps are fast becoming a viable option for accessing drugs. Apps can provide an easily accessible platform that connects buyers with commercial drug suppliers and substances that may otherwise remain elusive. Potential harms can be reduced through the provision of information which demystify common-sense assumptions that apps are secure and that this 'visual' drug economy promotes safer purchasing practices.
... Based on the results from this study and other seized drug casework, it appears quinine could be resurging in popularity. Cocaine, as mentioned before, is commonly adulterated with phenacetin, levamisole, lidocaine, caffeine, diltiazem, hydroxyzine, and sugars (1-3,5-8, [10][11][12]14,16,56,64,68,72,73). The compounds able to be detected by the present method (all of them, except sugars) were found in these set of samples. ...
... Consequently, most consumption estimates are also based on raw grams, as that is what consumers are able to report. Consumers are usually unaware of the purity of the substances they purchase and tend to base their judgment of quality on place of purchase, price per gram, and their administration modes (e.g., insufflation, inhalation), thus making surveys useless with respect to this issue Evrard et al. 2010). ...
The chapter outlines the flow network approach (FNA), an innovative method for estimating illicit financial flows (IFFs). The FNA is specifically designed to estimate inward and outward IFFs related to the transnational trafficking of illicit goods. FNA also allows for the overall estimation of the gross value added related to transnational trafficking, from whence it becomes potentially possible to estimate money laundering-related IFFs. The resulting estimate permits the linking of IFFs to their predicate offenses, overcomes double counting issues, and enables cross-national and longitudinal comparisons. Moreover, it increases our understanding of illicit industries by giving us an insight into their economic scope. The chapter exploits the trafficking of cocaine as an illustrative example, but FNA can be applied to any other form of trafficking.
... Therefore, one of the users' main reasons for buying on the dark net instead of on traditional illegal markets (Van Hout and Bingham, 2013b, 2014; Barratt et al., 2016), namely, better quality, is not ensured and depends on the substance. As users' satisfaction does not necessarily reflect actual product quality (Evrard et al., 2010), the supposedly higher quality of drugs sold on the cryptomarkets compared to off-line markets needs further research (Aldridge et al., 2018). Finally, even when the purchase is a good deal in itself, delivery is still a major dilemma and buyers seem quite worried about it, as it entails the risk of drawing law enforcement attention (Aldridge and Askew, 2017;Tzanetakis et al., 2016). ...
Purpose
The purpose of this paper is to analyse dynamics amongst members to better understand in what terms and to what extent marketplace forums can be seen as new forms of harm reduction.
Design/methodology/approach
This is a qualitative analysis focused on conversations about psychoactive substances on the forum community of AlphaBay Market. A sample consists of 100 online threads. The data, collected in July 2016, were analysed by applying the grounded theory approach with the support of Atlas.ti.
Findings
Conversations in the marketplace forum focus mostly on the purchase. Concerns and disputes are voiced in a significant proportion of them, and interactions are affected by a climate of distrust where stigmatisation processes can emerge between users of different drug categories. This casts a certain amount of doubt on the thesis that marketplace forums – like online forums – are new forms of harm reduction and peer-led communities.
Research limitations/implications
The study focuses on only one marketplace forum. Other such forums should be analysed to corroborate its findings.
Practical implications
Harm reduction interventions in the online environment should take different form according to the forum type, and take the differences and boundaries that separate users of different substances into account.
Originality/value
Thanks to its infrequently used qualitative approach, the study provides a more thorough understanding of the relationships on marketplace forums.
... Although there are many studies about the quantification of contaminants of cocaine seized in different countries [7][8][9][10][11][12][13][14][15][16][17][18][19], less works on the quantification of cocaine, adulterants and contaminants in samples seized in Brazil have been published. Goulart Jr. [20] determined the cocaine content and the main adulterants in samples of cocaine supplied by the Brazilian Federal Police, which were seized in different regions of Brazil in 2009 to 2011. ...
This work presents the development of analytical methodologies to determine cocaine, its major adulterants (acetaminophen, diltiazem, caffeine, lidocaine and phenacetin), lead and manganese in 17 samples of cocaine-derived drugs seized by the Civil Police of the state of Rio de Janeiro, Brazil, during the year 2013. Cocaine and major adulterants were determined by high-performance liquid chromatography with diode array detection (HPLC-DAD), whereas the inorganic contaminants were determined by graphite furnace atomic absorption spectrometry (GFAAS). Approximately 80% of the analyzed samples contained at least one adulterant above the limit of quantification, whereas metals (Pb and/or Mn) did in almost all the samples. The data obtained from the small set of analyzed samples allowed the application of a hierarchical cluster analysis (HCA), which indicated that the samples could be classified according to their chemical composition.
... Interviews with cryptomarket customers highlight product quality as a key reason for accessing drugs in this way (22)(23)(24). User satisfaction, however, is at best a weak indicator of product quality (25). Testing the content and purity of drugs provides a more robust benchmark. ...
Commentary to: Will growth in cryptomarket drug buying increase the harms of illicit drugs?
... Interviews with cryptomarket customers highlight product quality as a key reason for accessing drugs in this way [22][23][24]. User satisfaction, however, is at best a weak indicator of product quality [25]. Testing the content and purity of drugs provides a more robust benchmark. ...
Background and aim: Cryptomarkets—on-line, anonymous market-places for illicit goods and services that specialize mainly in drugs—account for a small but rapidly growing share of the illicit drug market in many countries. Policy responses so far are based generally on the assumption that their rise will only increase drug harms. In this contribution for debate, we question this assumption. Methods: We provide a narrative review of the emerging literature connected to drug cryptomarkets. We use MacCoun & Reuter’s formula to understand the effect of population-level increases in use on total harm as depending on the level of harm associated with each unit of use. We then consider the potential for cryptomarkets to increase or decrease the harms and benefits related to each unit of drug use, with specific attention to the quality of drugs sold and the non-drug-related harms and benefits for customers. Results: It is likely that
cryptomarkets will increase both the amount and the range of substances that are sold. However, we argue that the effects on harms will depend upon whether cryptomarkets also increase the quality and safety of products that are sold, provide harm-reducing information to consumers and reduce transactional conflict involved in drug purchasing.
Conclusions: There is an emerging and rapidly growing evidence base connected to the macro and micro harms and benefits of cryptomarkets for drug users. Future researchers should use appropriately matched comparative designs to establish more firmly the differential harms and benefits of sourcing drugs both on- and off-line. While it is unlikely that the on-line drug trade can be eradicated completely, cryptomarkets will respond to regulation and enforcement in ways that have complex, and sometimes unanticipated, effects on both harms and benefits.
... Similiarly, Evrard, Legleye, and Cadet-Taïrou (2010) have described how within the street market, perceived quality of cocaine is dependent on its price and information provided by the dealer. Concerns were evident within these communities with regard to unpleasant effects of synthetic cannabinoids and inconsistent content of MDMA, often containing other NPS such as MDPV, Methylone and 4-MMA. ...
Background:
The continual diversification of new psychoactive substances (NPS) circumventing legislation creates a public health and law enforcement challenge, and one particularly challenged by availability on Hidden Web cryptomarkets.
Methods:
This is the first study of its kind which aimed to explore and characterise cryptomarket forum members' views and perspectives on NPS vendors and products within the context of Hidden Web community dynamics. An internal site search was conducted on two cryptomarkets popular with NPS vendors and hosting fora; Alphabay and Valhalla, using the search terms of 40 popular NPS in the seven categories of stimulant/cathinone; GABA activating; hallucinogen, dissociative, cannabinoid, opioid and other/unspecified/uncategorised NPS. 852 identified threads relating to the discussion of these NPS were generated. Following exclusion of duplicates, 138 threads remained. The Empirical Phenomenological Psychological method of data analysis was applied. Four themes and 32 categories emerged.
Results:
120 vendors selling NPS were visible on Alphabay, and 21 on Valhalla. Themes were 'NPS Cryptomarkets and Crypto-community interest in NPS'; 'Motives for NPS use'; 'Indigenous Crypto Community Harm Reduction'; and 'Cryptomarket Characteristics underpinning NPS trafficking', with two higher levels of abstraction centring on 'NPS vendor reputation' and 'NPS transactioning for personal use'. NPS cryptomarket characteristics centred on generation of trust, honesty and excellent service. Users appeared well informed, with harm reduction and vendor information exchange central to NPS market dynamics. GABA activating substances appeared most popular in terms of buyer interest on cryptomarkets. Interest in sourcing 'old favorite' stimulant and dissociative NPS was evident, alongside the sequential and concurrent poly use of NPS, and use of NPS with illicit drugs such as MDMA.
Conclusion:
Continued monitoring of new trends in NPS within Surface Web and cryptomarkets are warranted. A particular focus on the rising market in prescribed benzodiazepine and Z-hypnotic drugs should be included.
... The specific adulterants used are selected depending on the type of drug of abuse and how it is consumed. Caffeine is one of the substances most frequently found in seized samples of psychostimulants, including cocaine hydrochloride and even in smoked forms of cocaine, like crack and coca-paste (CP) (Pawlik and Mahler 2001;Evrard et al. 2010;Cole et al. 2011;López-Hill et al. 2011;Fukushima et al. 2014;Prieto et al. 2015). It has been suggested that caffeine is added not only to increase the weight and volume but also to mimic or potentiate the stimulant and the reinforcing effects of cocaine (Cole et al. 2011;Broséus et al. 2016). ...
Oral, intraperitoneal, or intravenous have been the common routes of administration used to study the behavioral and neurochemical pharmacology of caffeine, one of the most widely used psychoactive substances worldwide. We have reported that caffeine is an active adulterant frequently found in coca-paste (CP)-seized samples, a highly addictive form of smokable cocaine. The role of caffeine in the psychostimulant and neurochemical effects induced by CP remains under study. No preclinical animal studies have been performed so far to characterize the effects of caffeine when it is administered through the pulmonary inhalation route. Caffeine (10, 25, and 50 mg) was volatilized and rats were exposed to one inhalation session of its vapor. The stimulant effect was automatically recorded and plasmatic levels of caffeine were measured. Caffeine capability (50 mg) to increase extracellular dopamine (DA) levels in nucleus accumbens shell was also studied by in vivo microdialysis in non-anesthetized animals. A dose-dependent stimulant effect induced by volatilized caffeine was observed and this effect was directly related with caffeine plasmatic levels. A significant increase in the extracellular DA was achieved after 50 mg of volatilized caffeine exposure. This is the first report showing pharmacological acute effects of caffeine through the pulmonary inhalation route of administration and suggests that this could be a condition under which caffeine can elevate its weak reinforcing effect and even enhance the psychostimulant effect and abuse liability of smokable adulterated psychostimulant drugs.
... Over recent years, several methods for the determination of the purity of street cocaine have been published and several bodies have published guidelines or standard methods. Analysis by GC-MS was proposed by Broséus et al. [4], Evrard et al. [5] and Magalhães et al. [6]. Further, published research articles by Floriani et al. [7] and Scheider and Meys [8] in addition to the United Nation Office on Drugs and Crime [9] suggested high-performance liquid chromatography coupled with a diode array detector as a reliable qualitative and quantitative separation technique for the analysis of cocaine. ...
The purity of street cocaine is an important parameter in drug research and for forensic purposes, as it can be used to group samples, determining their origin, and to assess the monetary value of a drug sample. Current methods require batch processing of samples, as calibration curves need to be run. In this paper, a method is presented for the quantification of cocaine by single injection, avoiding the need for a calibration curve by using multiple, differently isotopically labeled internal standards. Using this fast method, results can be reported immediately after analysis and fully open-access mass spectrometric analysis becomes possible. The method was fully validated, with recoveries compared to certified standards of 99–101 % and to an accredited method from an independent laboratory of 86–117 %. Precision was tested both interday and intraday on three levels and all relative standard deviations were lower than 6.1 %. A linear response was found down to a purity of 1.3 %. The total analysis time for a single sample was approximately 30 min. The method was applied to 106 cocaine samples collected from a large UK music festival. Cocaine purity ranged from 1.3 to 78.8 %, with a mean of 43.1 %. This was comparable to other studies of UK cocaine samples. Our new approach has the potential to be applied to simple quantification of a variety of analytes in biological and non-biological samples.
... Adulterant refers to pharmacologically active ingredients while diluents refer to inert substances. Several forensic studies have reported that caffeine is one of the most common psychoactive adulterants found in illicit drugs of abuse (Cole et al. 2011) such as cocaine, either in its snorted (hydrochloride) or smoked forms (cocapaste or crack) (Evrard et al. 2010;López-Hill et al. 2011;Prieto et al. 2015). Caffeine is believed to be added to increase the weight and volume but also to mimic or potentiate the psychostimulant and the reinforcing effects of cocaine. ...
Rationale
Caffeine is one of the psychoactive substances most widely used as an adulterant in illicit drugs, such as cocaine. Animal studies have demonstrated that caffeine is able to potentiate several cocaine actions, although the enhancement of the cocaine reinforcing property by caffeine is less reported, and the results depend on the paradigms and experimental protocols used.
Objectives
We examined the ability of caffeine to enhance the motivational and rewarding properties of cocaine using an intravenous self-administration paradigm in rats. Additionally, the role of caffeine as a primer cue during extinction was evaluated.
Methods
In naïve rats, we assessed (1) the ability of the cocaine (0.250–0.125 mg/kg/infusion) and caffeine (0.125–0.0625 mg/kg/infusion) combination to maintain self-administration in fixed ratio (FR) and progressive ratio (PR) schedules of reinforcement compared with cocaine or caffeine alone and (2) the effect of caffeine (0.0625 mg/kg/infusion) in the maintenance of responding in the animals exposed to the combination of the drugs during cocaine extinction.
Results
Cocaine combined with caffeine and cocaine alone was self-administered on FR and PR schedules of reinforcement. Interestingly, the breaking point determined for the cocaine + caffeine group was significantly higher than the cocaine group. Moreover, caffeine, that by itself did not maintain self-administration behavior in naïve rats, maintained drug-seeking behavior of rats previously exposed to combinations of cocaine + caffeine.
Conclusions
Caffeine enhances the reinforcing effects of cocaine and its motivational value. Our results highlight the role of active adulterants commonly used in cocaine-based illicit street drugs.
Fingerprint analysis is widely used in forensic science, primarily for individualization. However, fingerprints are rich with other information pertaining to an individual’s activities; several studies have used matrix-assisted laser desorption/ionization-time of flight (MALDI-ToF) to determine these factors but have been hampered by issues such as the choice of matrix and the time-consuming preparation of samples. Consequently, most analyses are performed using high performance liquid chromatography (HPLC) triple quadrupole instruments which offer high levels of sensitivity and fragment information. These instruments are, however, low resolution which means the mass spectral data can only be expressed to 2 decimal places and require further supporting information such as retention time to ascertain the compounds in the fingerprint. This is especially true if the compounds in question are isobaric. We report a rapid and accurate method of identifying individuals that have been in contact with commonly found cutting agents via latent fingerprint analysis using liquid chromatography electrospray quadrupole time-of-flight mass spectrometry (LC-ESI-qToF-MS). This is the first publication to utilize LC-ESI-qToF-MS instrumentation in both positive and negative modes, obtaining exact mass data used to identify and confirm the presence of cutting agents in latent fingerprints. High resolution mass spectral data have been obtained, which can be reported to 4 decimal places and compared to the theoretical exact mass data of each individual component to within a 5 part per million (ppm) error limit.
Cocaine is a naturally occurring psychostimulant drug available worldwide. Drug trafficking networks adulterate pure cocaine with cutting agents to increase their earnings. This study presents a descriptive statistical analysis of the cutting agents found in 2118 cocaine samples that were seized in the Northern Region of Colombia (in the period 2015–2017). The data used in this study was drawn from the GC-MS analytical reports of the National Institute of Legal Medicine and Forensic Sciences –Colombia, Northern Region. Results showed diverse cutting agents in seized cocaine samples, from which the most commonly used are caffeine, phenacetin, lidocaine, imidazole and levamisole. In addition, cocaine samples showed different mixtures of the above cutting agents, predominantly caffeine/phenacetin and caffeine/lidocaine/phenacetin mixtures.
The analysis of illicit drugs faces many challenges, mainly regarding the production of timely and reliable results and the production of added value from the generated data. It is essential to rethink the way this analysis is operationalised, in order to cope with the trend toward the decentralization of forensic applications. This paper describes the deployment of an ultra–portable near-infrared detector connected to a mobile application. This allows analysis and display of results to end users within 5 s. The development of prediction models and their validation, as well as strategies for deployment within law enforcement organizations and forensic laboratories are discussed.
Forensic analysis relates to the development of analytical methods from laboratory applications to in-field and in situ applications to resolve criminal cases. There has been a rapid expansion in the past few years in this area, which has led to an increase in the output of literature. This is the first book that brings together the understanding of the analytical techniques and how these influence the outcome of a forensic investigation.
Starting with a brief introduction of the chemical analysis for forensic application, some forensic sampling and sample preparation, the book then describes techniques used in forensic chemical sensing in order to solve crimes. The techniques describe current forensic science practices in analytical chemistry and specifically the development of portable detectors to guide the authorities in the field.
The book provides an excellent combination of current issues in forensic analytical methods for the graduates and professionals. It will cover the essential principles for students and directly relate the techniques to applications in real situations.
The chapter provides a critical exploration of the limitations of the proposed flow-network approach, its underlying data, and the assumptions that are involved in its usage. At the same time, it examines at length the calculi required to perform the analysis through recourse to examples and reasoning about the proceeds generated from cocaine trafficking. The step-by-step description of the entire methodology is driven by the fact that the illegality of trafficking activities makes it difficult to estimate their overall size and value, a point which forces one to adopt numerous assumptions. The chapter concludes by arguing that only by carefully assessing the data, underlying assumptions, and limitations of the adopted method can researchers correctly interpret the results and continue to refine the methods.
This article contributes to the growing literature on the use of computer-mediated communications to research illicit markets. In it, we conduct an analysis of the British cannabis market using data crowdsourced from a publicly available platform, PriceofWeed.com. Crowd-sourced transaction data present some new insights into the British cannabis market. First, this study has tracked the trafficking flow of cannabis within the UK. Second, it shows the extent to which a quantity discount is granted to consumers. Third, it discusses purchasing habits of cannabis users. Conclusions suggest new areas of application of crowdsourcing to research hard to reach and deviant populations.
An office paper-based colorimetric device is proposed as a portable, rapid, and low-cost sensor for forensic applications aiming to detect phenacetin used as adulterant in illicit seized materials such as cocaine. The proposed method uses white office paper as the substrate and wax printing technology to fabricate the detection zones. Based on the optimum conditions, a linear analytical curve was obtained for phenacetin concentrations ranging from 0 to 64.52 µg mL‒1, and the straight line was in accordance with the following equation: (Magenta percentage color) = 1.19 + 0.458 (CPhe/µg mL‒1), R² = 0.990. The limit of detection was calculated as 3.5 µg mL‒1 (3σ/slope). The accuracy of the proposed method was evaluated using real seized cocaine samples and the spike-recovery procedure.
Thin layer chromatography is a simple, easy and cheap technique widely used in Brazilian forensic laboratories, being a screening test for the separation and identification of illicit drugs, such as cocaine and its adulterants. Herein, paper chromatography using Dragendorff reagent (revealing agent) was employed to analyze cocaine and its adulterants (levamisole, lidocaine, caffeine, and phenacetin). Positive results, i.e. visualization of the orange color, were only observed for cocaine, lidocaine and levamisole. Paper spray ionization mass spectrometry (PS-MS) was applied on revealed spots for construction of a quantification model, for which some figures of merit were determined such as linearity, limit-of-detection (LOD), limit-of-quantification (LOQ) and accuracy. The results showed that the PS-MS in positive-ion ionization mode, PS(+)-MS, is an efficient technique for direct analysis of the chromatographic spots on office-type paper revealed by Dragendorff reagent. The method presented linearity greater than 0.98 and LODs of 6.51 g mL-1, and 13.53 g mL-1 for cocaine, and levamisole, respectively, and 0.35 mg mL-1 for lidocaine. The PS(+)MS was also applied to quantify cocaine in ten street crack samples, where there was no statistically significant difference between the PS(+)MS and gas chromatography with flame ionization detector (GC-FID) data at a significance level of 5%.
The predominant methods currently used for illicit production of cocaine are described. For illicit natural cocaine (i.e., from coca leaf), this includes production of coca paste from coca leaf via both the solvent and acid extraction techniques, purification of coca paste to cocaine base, and conversion of cocaine base to cocaine hydrochloride. For illicit synthetic cocaine (i.e., synthesized from precursor chemicals), the classic five-step synthetic route used in all clandestine laboratories seized to date is summarized. The origins of the most common alkaloidal impurities and processing/synthetic by-products typically identified in illicit natural, illicit synthetic, and pharmaceutical cocaine are discussed. Forensic differentiation of exhibits arising from the various production methods are addressed both in terms of overall product purity and the presence/absence of these impurities and by-products.
Copyright © 1993 Central Police University.
The notion that street drugs have been adulterated/diluted by all seas of dangerous substances such as Vim, Ajar, ground-glass, brick-dust and even rat-poison is a common one. Moreover, it is in fact a practice believed to be true by those involved with the researching of drug issues, the treatment and rehabilitation of drug users, the policing of drug users and the educating of drug users (cf: Coomber 1996) as well as by the users themselves. As this paper will show it is also thought to happen and be perpetrated by those who are deemed to be responsible for such adulteration/dilution, the dealers themselves. This however does not accord with the forensic evidence, or, as are the concerns of this paper with the practice or experience of individual drug dealers. This paper suggests, on the evidence of interviews with drug dealers at different levels of the drug distribution chain that less adulteration/dilution actually occurs than previously thought and that when it does happen 'on the street' it is of a relatively benign character.
Les données du Baromètre santé 2005 présentées dans ce numéro de Tendances permettent d'actualiser les niveaux d'usage des différentes substances licites et illicites ; l'examen par produit est l'occasion de documenter pour la première fois un certain nombre de questions inédites relatives à l'alcool et au cannabis.
Behavioral economics examines conditions that influence the consumption of commodities and provides several concepts that may be instrumental in understanding drug dependence. One such concept of significance is that of how delayed reinforcers are discounted by drug dependent individuals. Discounting of delayed reinforcers refers to the observation that the value of a delayed reinforcer is discounted (reduced in value or considered to be worth less) compared to the value of an immediate reinforcer. This paper examines how delay discounting may provide an explanation of both impulsivity and loss of control exhibited by the drug dependent. In so doing, the paper reviews economic models of delay discounting, the empirical literature on the discounting of delayed reinforcers by the drug dependent and the scientific literature on personality assessments of impulsivity among drug-dependent individuals. Finally, future directions for the study of discounting are discussed, including the study of loss of control and loss aversion among drug-dependent individuals, the relationship of discounting to both the behavioral economic measure of elasticity as well as to outcomes observed in clinical settings, and the relationship between impulsivity and psychological disorders other than drug dependence.
This article describes an investigation of illicit drugs at street level in six selected police districts in different regions of Denmark. The investigation was carried out during a 6-year period from 1995 to 2000. During the period, a total of 1244 samples were examined, as about 200 samples were seized each year. A total of 94% of the seized samples were familiar drugs: heroin base, heroin hydrochloride, cocaine hydrochloride and amphetamine sulphate. Only 2% of the samples contained designer drugs. From having constituted 53% of the samples in 1995, the frequency of heroin base fell during the period to 27% of the samples in 2000. The frequency of heroin hydrochloride was unchanged. In the same period, the frequency of cocaine hydrochloride increased from 10% of the samples in 1995 to about 25% of the samples in 2000. Apart from a few exceptions, cocaine had the same extension in all regions of Denmark after 1996. Amphetamine was more frequent in the west of Denmark, while heroin hydrochloride was more frequent in central Denmark. The purity of heroin base was lower in the period 1997–1999 than in the other years. During the entire period, the purity of cocaine hydrochloride and amphetamine sulphate fell, while the purity of heroin hydrochloride was unchanged. No significant differences between the various regions of Denmark were detected during the period in the purity of heroin hydrochloride, heroin base, cocaine hydrochloride or amphetamine sulphate. MDMA was the most frequent designer drug, but other types of designer drugs such as MDA and MDE and the less common PMA, PMMA and MBDB were also found.
This article first appeared as FSS Technical Note No. 780 (Accession No. 71900), January 1993.
Information on the purity of illegal drugs is used for various purposes including: valuation for sentencing; profiling and sample comparison; and studies of the economics of the illicit market. The most commonly-used measure for powders is the arithmetic mean purity, but this statistic has several drawbacks. In the case of amphetamine, the mean (10% in 1995) has been consistently higher than the mode (4% in 1995), and it is a function of seizure size, region and time. Heroin purity, as measured by the diamorphine content (mean=42% in 1995) could also be an unreliable guide to potency if other opium alkaloids and `active' adulterants are present. The mean purities of cocaine and crack in 1995 were 51% and 85%, respectively. A further source of confusion can arise when a distinction is not made with respect to the chemical form of the drug (i.e. salt or base).
Historically, United States drug policy has focused on use reduction; harm reduction is a prominent alternative. This paper aims to provoke and inform more debate about the relative merits of these two. Since harm is not necessarily proportional to use, use reduction and harm reduction differ. Both terms are somewhat ambiguous; precisely defining them clarifies thinking and policy implications. Measures associated with use reduction goals are poor; those associated with harm reduction are even worse. National goals influence the many decentralized individuals who collectively make drug policy; clearly enunciating goals makes some policy choices transparent and goals serve a variety of purposes besides guiding programmatic decisions. We recommend that the overall objective be to minimize the total harm associated with drug production, distribution, consumption and control. Reducing use should be seen as a principal means of attaining that end.
Behavioral economics examines conditions that influence the consumption of commodities and provides several concepts that may be instrumental in understanding drug dependence. One such concept of significance is that of how delayed reinforcers are discounted by drug dependent individuals. Discounting of delayed reinforcers refers to the observation that the value of a delayed reinforcer is discounted (reduced in value or considered to be worth less) compared to the value of an immediate reinforcer. This paper examines how delay discounting may provide an explanation of both impulsivity and loss of control exhibited by the drug dependent. In so doing, the paper reviews economic models of delay discounting, the empirical literature on the discounting of delayed reinforcers by the drug dependent and the scientific literature on personality assessments of impulsivity among drug-dependent individuals. Finally, future directions for the study of discounting are discussed, including the study of loss of control and loss aversion among drug-dependent individuals, the relationship of discounting to both the behavioral economic measure of elasticity as well as to outcomes observed in clinical settings, and the relationship between impulsivity and psychological disorders other than drug dependence.
We develop a dynamic optimal control model of a fashion designer's challenge of maintaining brand image in the face of short-term profit opportunities through expanded sales that risk brand dilution in the longer-run. The key state variable is the brand's reputation, and the key decision is sales volume. Depending on the brand's capacity to command higher prices, one of two regimes is observed. If the price markups relative to production costs are modest, then the optimal solution may simply be to exploit whatever value can be derived from the brand in the short-run and retire the brand when that capacity is fully diluted. However, if the price markups are more substantial, then an existing brand should be preserved. It may even be worth incurring short-term losses while increasing the brand's reputation, even if starting a new brand name from scratch is not optimal.
The squirrel monkey is a reliable model for the cardiovascular effects of cocaine in that it mimics the human response to cocaine; low to moderate doses of cocaine produce a sustained pressor effect and tachycardia. Pretreatment experiments have indicated the importance of α-1 and β-1 adrenoceptor mechanisms in mediating the pressor and tachycardiac effects of cocaine, respectively. Little support for a role of dopaminergic mechanisms in the hemodynamic effects of cocaine has been found. Toxicity to cocaine is often observed hours after its administration, pointing to a potential role of the cocaine metabolites. Studies on the direct effects of a variety of cocaine metabolites indicate that their cardiovascular effects do not necessarily mimic those produced by cocaine, and therefore these differing effects of the metabolites should be considered when evaluating the cardiovascular toxicity of cocaine. Further, as these metabolites are present in the body for long periods of time, these results suggest a role of the metabolites in producing toxicity long after cocaine administration. Finally, studies using both dopaminergic and calcium channel antagonists indicate that the pharmacological mechanisms involved in the cardiovascular effects of cocaine are not the same as those involved in its behavioral effects.
Cocaine is frequently used, especially among adolescents and by men between the age of 25 and 44. Many of them are able to use cocaine in normal day-to-day life, without any problems. Reduced prices of cocaine and other recreational drugs such as MDMA (ecstasy) and gamma hydroxybutyrate (GHB) has led to an increased incidence of intoxications with these drugs. Since the production of cocaine is illegal, it may be impure and mixtures with other drugs such as atropine may occur. The treatment of patients with an acute cocaine intoxication can be complicated. Combination of cocaine with other drugs results in clinical pictures which are difficult to discriminate and that may have important consequences for treatment.
To report on trends in the content and adulterants present in street cocaine (powder) in the Netherlands and to describe the associated health hazards.
Drug consumers handed in samples of cocaine powder from 1999 to 2007 for analysis. Reports were compiled of users' experiences with the samples received. MEASUREMENTS AND ANALYSIS: Linear regression analysis was used to assess the trend in adulterated cocaine powder across the study period, and comparison of reported adverse effects of adulterated with those of unadulterated cocaine by Fisher's exact test.
There has been a statistically significant upward trend in the occurrence of adulterated cocaine powder over the years. Adulterated cocaine was associated more frequently with reported adverse effects than unadulterated cocaine. Phenacetin, hydroxyzine and diltiazem appeared to be three adulterants contributing to these adverse effects.
An increase in adulterants was detected in the analysed cocaine powder between 1999 and 2007. This increase is associated with relatively more adverse effects with cocaine use. The cardiac and hallucinatory effects that were reported more frequently are not understood clearly. Adverse effects are likely to be due to several factors, including interactions of adulterants with cocaine and the route of administration.
To investigate the incidence and correlates of cocaine injection initiation and the impacts of daily cocaine injection among a cohort of injection drug users.
Among 1603 participants, from May 1996 to December 2005, risk factors for initiation of cocaine injection among baseline heroin users were determined by Cox proportional hazards regression and correlates of daily cocaine injection by generalized estimating equations.
Of the 238 individuals who had never injected cocaine, 200 (84%) had at least one follow-up visit and 121 (61%) consequently initiated into cocaine injection, yielding an incidence density of initiation into cocaine injection of 21.9% (95% confidence interval (CI): 17.9-25.8) per 100 person-years. In a multivariate model, Downtown Eastside (DTES) residence (adjusted hazard ratio (AHR)=2.46, 95% CI: 1.68-3.60), incarceration (AHR=1.50, 95% CI: 1.01-2.24), requiring help injecting (AHR=1.57, 95% CI: 0.99-2.49), and binge drug use (AHR=1.82, 95% CI: 1.22-2.73) remained associated with initiation into cocaine injection. DTES residence (adjusted odds ratio (AOR)=1.99, 95% CI: 1.62-2.46), unstable housing (AOR=1.28, 95% CI: 1.04-1.53), incarceration (AOR=1.29, 95% CI: 1.04-1.60), sex trade involvement (AOR=1.46, 95% CI: 1.15-1.85), requiring help injecting (AOR=2.11, 95% CI: 1.73-2.58)), borrowing syringes (AOR=1.81, 95% CI: 1.35-2.43) and binge drug use (AOR=2.16, 95% CI: 1.81-2.58) were independently associated with daily cocaine injection.
The baseline prevalence and subsequent incidence of initiation into cocaine injection was high. Daily cocaine injection was independently associated with a number of health and social harms, including elevated HIV risk behavior.
This paper presents a general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies. The procedure essentially involves the construction of functions of the observed proportions which are directed at the extent to which the observers agree among themselves and the construction of test statistics for hypotheses involving these functions. Tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interobserver agreement are developed as generalized kappa-type statistics. These procedures are illustrated with a clinical diagnosis example from the epidemiological literature.
The toxic effects of cocaine are enhanced in the presence of lidocaine.
Male Sprague-Dawley rats weighing 200 to 300 g.
Animals received intraperitoneal injections of cocaine (10, 20, 35, or 50 mg/kg), lidocaine (30 or 40 mg/kg), or a combination of all doses of cocaine given simultaneously with 30 or 40 mg/kg lidocaine. The incidence and time to seizure and death were recorded in these groups and compared by chi 2 and analysis of variance analyses, respectively.
At doses of 30 or 40 mg/kg, lidocaine does not induce seizures or death. The effect of simultaneous injection of both cocaine and lidocaine was to dramatically increase the incidence of both seizures and death over that of cocaine alone. The incidence of seizures in animals receiving 35 mg/kg cocaine alone was 10%; this increased to 50% and 80% with the addition of 30 and 40 mg/kg lidocaine, respectively (P less than or equal to .05; P less than or equal to .01). Death did not occur in animals receiving 35 mg/kg cocaine alone; the addition of 30 and 40 mg/kg lidocaine resulted in death in 30% and 60% of animals, respectively (P less than or equal to .01 each group). Similarly, in rats receiving 50 mg/kg cocaine, the incidence of death increased from 0% to 60% and 80% with 30 and 40 mg/kg lidocaine, respectively (P less than or equal to .01).
In the rat, overall toxicity of cocaine is significantly increased with simultaneous exposure to lidocaine.
Five cases of acute poisoning by scopolamine bought as cocaine, are reported. All the cases presented a serious anticholinergic syndrome which needed physostigmine administration. The presence of scopolamine in urine and the specimen sniffed was demonstrated in all the cases.
Diltiazem, a benzothiazepine calcium channel antagonist, was given to six healthy men as a single 60 mg oral dose 120 min before IV injection of cocaine (0.2 mg/kg) in a double-blind, placebo-controlled, two-session study. Diltiazem alone produced no significant effects. Cocaine increased blood pressure, heart rate, pupil size and subjective "high" ratings, and decreased skin temperature. Diltiazem pretreatment diminished the cocaine effect on skin temperature, but did not otherwise alter the response to cocaine. Calcium channel antagonists diminish the effects of cocaine in vitro and in animals. Dosage considerations may be critical because of the differential sensitivity of various tissues to calcium channel antagonists.
Fifteen cases of presumed cocaine intoxication were evaluated in the emergency room (ER) at a city hospital over a four-day period. This series is unique in that many of these patients were from a similar area of the city, in some cases had the same street address, were regular abusers of cocaine, and presented to the ER with similar symptoms of tachycardia, dilated pupils, marked confusion, bizarre and sometimes violent behavior, psychosis, and hallucinations. Many of these symptoms were present several hours after drug use. Samples of a white powder presumed by the patients to be cocaine were obtained from two patients and analyzed by gas-liquid chromatography. Neither sample contained cocaine, but rather revealed atropine, benzocaine, and procaine. The signs and symptoms of cocaine, amphetamine, and atropine intoxication are reviewed and the problems of drug analysis and differential diagnosis of drug intoxication are discussed.
The effects of calcium channel entry blockers on cocaine and amphetamine-induced behavioral responses were investigated. Cocaine and amphetamine produced dose-dependent increases in locomotor activity and stereotyped behavior with a maximum response at 40 and 1.2 mg/kg, respectively. The 1,4-dihydropyridine nimodipine and the benzothiazepine diltiazem were more effective in inhibiting cocaine (20 mg/kg)-induced responses than amphetamine (0.6 mg/kg)-induced responses. At doses of cocaine and amphetamine that caused seizures and death, nimodipine, nitrendipine and diltiazem did not offer any protection; rather, they potentiated the toxicities produced by these psychomotor stimulants.
Historically, United States drug policy has focused on use reduction; harm reduction is a prominent alternative. This paper aims to provoke and inform more debate about the relative merits of these two. Since harm is not necessarily proportional to use, use reduction and harm reduction differ. Both terms are somewhat ambiguous; precisely defining them clarifies thinking and policy implications. Measures associated with use reduction goals are poor; those associated with harm reduction are even worse. National goals influence the many decentralized individuals who collectively make drug policy; clearly enunciating goals makes some policy choices transparent and goals serve a variety of purposes besides guiding programmatic decisions. We recommend that the overall objective be to minimize the total harm associated with drug production, distribution, consumption and control. Reducing use should be seen as a principal means of attaining that end.
In recent years, emergency physicians have encountered a growing number of patients who present with anticholinergic toxicity after using adulterated heroin. Anticholinergic poisoning caused by adulterated cocaine is far less common. This report describes the case of a 39-year-old man who arrived in the emergency department several hours after the nasal insufflation of cocaine. Classic symptoms of anticholinergic toxicity were evident on examination, including dry, flushed skin, agitation, tachycardia, mydriasis, and absence of bowel sounds. Treatment included intravenous fluids and lorazepam, with resolution of symptoms over several hours. Urine samples revealed the presence of cocaine metabolites as well as the anticholinergic drug atropine, and infrequently encountered adulterant of cocaine. Anticholinergic poisoning is reviewed, and the physical examination findings that distinguish this syndrome from the closely related sympathomimetic syndrome typical of cocaine are detailed. Current treatment recommendations for anticholinergic poisoning are summarized.
Illicit cocaine samples (156), seized on Rome's illegal market between January 1996 and June 1997, were examined. Both the purity of the cocaine and the presence of substances employed for dilution were determined for each sample. Adulterants were found in many of the street samples analysed. Lidocaine (average 14.7%) followed by caffeine (average 9%) proved to be the adulterants most frequently encountered in the cocaine samples.