Adulterants in crack cocaine in Brazil

Abstract

Introduction Brazil is the world’s biggest consumer of crack cocaine, and dependence is a major public health issue. This is the first study to investigate the prevalence of potentially harmful adulterants present in hair samples from Brazilian patients with crack cocaine dependence. Method We evaluated adulterants in hair samples extracted by convenience from 100 patients admitted at the 48 hour-observation unit of Centro de Referência de Álcool, Tabaco e Outras Drogas (CRATOD), Brazil’s largest center for addiction treatment. A cross-sectional analysis was performed with the data obtained. Results Adulterants were found in 97% of the analyzed hair samples. The most prevalent adulterant was lidocaine (92%), followed by phenacetin (69%) and levamisole (31%). Conclusion Adulterants were widely prevalent in hair samples from crack users treated at CRATOD: at least one adulterant was present in virtually all the hair samples collected. This points to a need to monitor adverse effects in the clinical setting in order to provide this high-risk group of patients with prompt and effective care related to the acute and chronic complications associated with these adulterants.

The Emerging Role of Toxic Adulterants in Street Drugs in the US Illicit Opioid Crisis

“…Mounting evidence suggests that overdoses, severe health consequences, and even death can occur as a result of the toxic and potentially synergistic effects of multiple toxic adulterants in combination with illicitly manufactured drugs of abuse. 22,[25][26][27] Moving forward, physicians and other clinicians in emergency departments, urgent care centers, primary care settings, and substance abuse treatment facilities will need to be increasingly aware of the role of toxic adulterants in how patients who take street drugs present. They will also need to be increasingly mindful that toxic adulterants can cause unusual drug interactions, complications, and medical conditions, all of which may increase the risk of opioid-related overdose and death.…”

Rapid and robust on‐scene detection of cocaine in street samples using a handheld near‐infrared spectrometer and machine learning algorithms

“…Conventionally, simple colorimetric tests are used to obtain a first indication of whether a substance contains a frequently occurring illicit compound. 4,7 The most commonly used indicative test for cocaine in seized material is the Scott or Ruybal test that produces a blue color from a cobalt(II)thiocyanate complex formed in the presence of cocaine. 8,9 In addition to test solutions prepared in the forensic laboratory, a large variety of commercial test kits based on this complex are manufactured in the form of pouches, ampules, swabs, and wipes.…”

“…Conventionally, simple colorimetric tests are used to obtain a first indication of whether a substance contains a frequently occurring illicit compound 4,7 . The most commonly used indicative test for cocaine in seized material is the Scott or Ruybal test that produces a blue color from a cobalt(II)thiocyanate complex formed in the presence of cocaine 8,9 .…”

Calix[n]arene-based immunogens: A new non-proteic strategy for anti-cocaine vaccine

“…Increment in the number of cocaine users from14 million in 1998 to 18 million in 2017, was noted by the United Nations Office on Drugs and Crime, which corresponds to nearly 0.4% of the world population aged 15–64 [11] . Brazil occupies the first and second places in the rank of crack consumption (smoked form of cocaine) and cocaine traffic, respectively [12] , [13] , [14] , [15] .…”