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What do we know about the adulteration of illicit drugs?
Claire Cole, Honorary Lecturer, Centre for Public Health, Liverpool John Moores University
Abstract
Background: It is well understood that illicit drugs
typically contain other substances in addition to the actual drug,
however, the presence of other substances are not always intentional.
Additional substances are often intentionally added to bulk,
complement or enhance the drug effects whereas unintentional
substances are the result of manufacturing, production or storage
techniques. It has been suggested that the prohibition of drugs and
the underground development, manufacture and distribution has had
unintended public health consequences due to the varying strengths and
purity of illicit drugs and the consumption of contaminants and adulterants.
Methodology: A systematic desktop review strategy was performed for
electronic sources and relevant websites. The findings are a
combination of evidence from peer reviewed journal articles,
international drug reports, forensic analysis reports and policy documents.
Results: Despite some poor methods of analysis these findings show
that typically illicit drugs contain (either intentionally or
unintentionally and dependent upon the illicit drug) caffeine,
laxatives, pain relief medications (both for human and veterinary use) and precursor chemicals.
Other biological agents are created during the manufacturing process.
Conclusion: The findings indicate that there are serious risks
associated with the bulking, adding to and contamination/adulteration
of illicit drugs with non-toxic or non-harmful substances, which can
become harmful as a result of production, transportation or
preparation for administration. Harm reduction messages about the harm
of contaminants/adulterants require continuation considering the
serious public health implications. Case reports should conform to
standardised reporting formats with key information included in order
to further the evidence base and allow reliable comparisons of cases.
This research reinforces the IHRA position regarding the reduction of
adverse health effects of illicit drug use through information and
guidance regarding illicit drug contamination and adulteration. This
presentation will be a culmination of the systematic desktop review
from an international multi-disciplinary perspective.
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Biography
Claire Cole is an Honorary Lecturer at the Centre for Public
Health (CPH) at Liverpool John Moores University. Claire started her
career in research in 2003 as a student with the Institute for Child
Care Research (ICCR) at Queens University Belfast working on the
Belfast Youth Development Study. Since then Claire has worked on
various substance use studies in Northern Ireland and as a
statistician with the Northern Ireland Statistics and Research Agency
(NISRA). Having previously been employed as a Senior Researcher with
CPH from 2006 to 2010 where she led research and evaluation projects,
she returned to Northern Ireland and is currently employed as an
Addiction Training Officer at Wave Trauma Centre, Belfast. Claire's
research interests include drug adulteration and contamination, drug use and social exclusion, and trauma and addiction.
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