What is the role of adulterants in the development of cocaine toxicity?

Updated: Sep 01, 2018
  • Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD  more...
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Answer

Adulterants are added to cocaine intentionally or are left over from the manufacturing process. Substitutes are compounds that have pharmacologic properties similar to those of cocaine and that are used in its place. Many of these substances cause pulmonary and systemic reactions when taken intravenously, by insufflation, or by smoking; they may, therefore, substantially contribute to the toxicity of cocaine use.

Among the substances used to cut cocaine are the following:

  • Local anesthetics (eg, procaine, lidocaine, tetracaine)
  • Other stimulants (eg, amphetamine, caffeine, methylphenidate, strychnine)
  • Lysergic acid diethylamide (LSD)
  • Phencyclidine (PCP)
  • Phenytoin
  • Heroin
  • Marijuana
  • Hashish

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