The process of lacing heroin with other drugs and substances commonly referred to as “cutting” has long been a common practice for heroin manufacturers, suppliers, and dealers, as a way to stretch their heroin supply and make more money.
Often, heroin is cut at multiple points throughout the distribution process with a wide array of different additives or “fillers.” Heroin is almost never just heroin and can contain anything from laundry detergent to rat poison to other opioids.
Heroin is already a dangerous and potent opioid that can cause a rapid overdose. Heroin abuse can also quickly escalate to addiction and overdose. The different additives and drugs that are laced into heroin make it even riskier to use and can cause all kinds of extremely serious, potentially lethal health complications, as well as increase the chances of a fatal overdose.
Common Drugs and Substances Laced Into Heroin
Heroin can and generally is laced with a variety of substances that range from non-intoxicating substances that would be otherwise harmless if not ingested to other drugs, some of which even deadlier than heroin to straight poison.
Household powders commonly used as “fillers” include:
- Talcum powder
- Baking soda
- Powdered milk
Other drugs often mixed in with heroin include:
- Over-the-counter (OTC) painkillers
- Quinine (medication used to treat malaria)
- Opioid painkillers like OxyContin or morphine
- Synthetic opioids like fentanyl and carfentanil
Poison substances laced into heroin include:
- Laundry detergent
- Strychnine (rat poison)
- Boric acid
Why Lace Heroin With Other Substances?
There are many different reasons why illicit drug manufacturers lace heroin with different drugs and other substances. It’s an easy way to make it cheaper to produce, to make up for lack of purity, and sometimes even by accident.
Heroin typically comes in three different forms, depending on how it is going to be taken, e.g., snorted, smoked or injected: a black tar-like substance, a brown-white powder, and a clear solution. It is surprisingly easy for drug makers to hide different additives and pass it off as pure heroin.
In fact, this is done with such a high frequency that, according to a research study from Johns Hopkins University, any given dose of street heroin can be anywhere between three and 99 percent pure, although there is basically no such thing as pure heroin.
Household powders like the previously mentioned cornstarch, talcum powder, and baking soda are all similar in consistency and appearance as heroin when it is in its powdered form. While some heavy, chronic users can tell if heroin has been cut with these substances based on smell or color, other, newer users can be more easily fooled. These substances are used to cut heroin to dilute it so they can sell more of it and increase their profits.
They will then also attempt to make this diluted heroin stronger with cheaper additives, such as caffeine, (OTC) medication, and even strychnine, which is mainly used to make rat poison but also, in small doses can act as a stimulant and has even been involved in athletic doping scandals.
Drug makers can also go in the other direction as well, lacing heroin with other drugs that are both more potent as well as easier and cheaper to produce. Heroin is at least partially naturally derived, whereas fentanyl is completely synthetic and can be made in a lab, which already makes it cheaper to make, and, because it’s roughly 50 times stronger than heroin, they don’t have to make nearly as much fentanyl as heroin.
By replacing a significant portion of a given dose of heroin with fentanyl, drug makers can not only save money in terms of manufacturing, but they also can sell more at smaller doses as well as make up for any drop in effectiveness caused by diluting it with substances like cornstarch.
Finally, some substances may find their way into heroin completely by accident. While lead is now widely known to be extremely toxic to humans and, therefore, used in significantly fewer products than it was in decades past, it has still managed to find its way into marijuana, methamphetamine, and heroin. This is generally assumed to be unintentional and a result of poor manufacturing, but in some cases, it’s possible that lead may be added to increase the weight of a shipment of heroin and, therefore, make it appear more valuable.
Does Lacing Heroin With Other Drugs Make It More Dangerous?
Whether it’s drugs like fentanyl or common household products like cornstarch, essentially every kind of additive that gets put into heroin makes it more dangerous to use. While many dealers who use flour or talcum powder will do so under the impression that they are harmless and won’t actually have any effect. When heroin is snorted this typically true, but if the powder melted down to be injected, then it becomes a different story.
Some of these powders are water soluble, meaning they will mix with heroin as it is melted and put into a syringe. However, some substances, including cornstarch, will not dissolve and instead clump up when injected into the bloodstream and clog up blood vessels that lead to the kidneys, liver, lungs, or brain.
This clumping can also cause clots to form in the veins and arteries, which can lead to them bursting and collapsing. If the clot forms in an artery that leads to the heart, it can also cause a potentially fatal stroke or heart attack.
Stimulants, either mild ones like caffeine or extremely poisonous ones like strychnine, can mask heroin’s depressant effects, which can lead to someone taking more heroin than they usually would and overdosing. Stimulants can also hide the symptoms of an overdose, which means a delay in someone getting medical treatment and a much higher chance of brain damage or death.
If there’s enough strychnine in a dose of heroin to cause strychnine poisoning, a user can expect to experience muscle pain and spasms, rigidity in their jaw and limbs, and intense feelings of anxiety.
Lead poisoning is even more dangerous, as it can lead to muscle weakness, anemia, seizures, coma, and even death.
Finally, there’s fentanyl. In the past few years, fentanyl has been increasingly found in heroin, causing overdose death rates to soar in response. According to the National Institute on Drug Abuse (NIDA), in 2017, of the nearly 50,000 overdose deaths caused by opioids, while roughly 33 percent involved heroin, about 60 percent were fentanyl-related.
As little as 2 milligrams, basically the weight of a snowflake, is enough to kill someone. It is extremely difficult to accurately measure anything less than a gram when attempting to introduce it into another drug, which is why the result is often an overdose.
There’s no way for someone buying heroin to know how much of a given dose may contain fentanyl, or even have fentanyl at all, and so they will take as much heroin as they usually would and then overdose, sometimes almost immediately, and often fatally.