Author:
Galust Henrik,Seltzer Justin A.,Hardin Jeremy R.,Friedman Nathan A.,Salamat Jeff,Clark Richard F.,Harmon Jennifer
Abstract
Abstract
Background
The opioid overdose crisis is one of the worst public health crises ever to face the US and emerging evidence suggests its effects are compounded by the presence of drug adulterants. Here we report our efforts to characterize the adulterants present within the local fentanyl supply of San Diego County, obtained from undifferentiated drug samples seized by local law enforcement over the calendar year 2021.
Methods
Thirty-two participating local law enforcement agencies across San Diego submitted 4838 unknown individual illicit drug samples (total of 312 kg) to the San Diego County Sheriff’s Department Regional Crime Laboratory for identification.
Results
Qualitative analysis of these samples via FTIR and GC-MS identified methamphetamine (38.7%), fentanyl (20.8%), diacetylmorphine (heroin) (10.2%), codeine (5.8%) and alprazolam (4.3%) as the most common illicit substances and the presence of 52 unique adulterants. The most common adulterants included 4-methylaminoantipyrine (4-MAAP) (10.9%), mannitol (9%), acetaminophen (8.5%), methamphetamine (4.2%), diacetylmorphine (heroin) (3.6%), tramadol (1.9%), and xylazine (1.7%). Several additional pharmacologically active adulterants and contaminants of interest were also identified.
Conclusion
This analysis is vital for public health use and harm reduction efforts at the level of the individual consumer. Continued direct surveillance of the drug supply is necessary for the detection of potentially harmful adulterants that may pose serious threats to the public.
Publisher
Springer Science and Business Media LLC
Reference33 articles.
1. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Accessed January 11, 2023. https://www.samhsa.gov/data/ Retrieved.
2. Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2023. Accessed May 21, 2023. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
3. Singh VM, Browne T, Montgomery J. The emerging role of toxic adulterants in Street drugs in the US Illicit Opioid Crisis. Public Health Rep. 2020;135(1):6–10.
4. Levine M, Meyn A, Krotulski A, Logan B, Amaducci A, Hughes A, Schwarz E, Pizon A, Wax P, Brent J, Manini. A. 71 adulteration of Illicit drugs in Emergency Department patients with Acute Opioid overdose: a Multicenter Cohort. Ann Emerg Med 78. S29. 1.
5. Kariisa M, Patel P, Smith H, Bitting J. Notes from the field: xylazine detection and involvement in drug overdose deaths — United States, 2019. MMWR Morb Mortal Wkly Rep. 2021;70:1300–2.
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