Cocaine
{Coke, Charlie, Snow, Crack Rock}
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Common substitutes and adulterants
Sometimes the drugs we think we are buying turn out to be something very different. Knowing of the common substitutes that dealers swap them for and adulterants they add in is an easy way to protect yourself and your friends. Here are some of the most common things other than cocaine found in recreational samples.
Levamisole
Levamisole is used to treat inflammatory conditions and cancer but in a small proportion of people it is extremely harmful, even at low doses. Over the past years, it’s been found in the majority of tested cocaine samples in Europe and the U.S, so be careful. Read more here.
Local anaesthetics (e.g. lidocaine)
Local anaesthetics are similar to cocaine and can trick you into thinking that the batch is very pure by increasing the numbing effect on your nose and mouth. Unfortunately they can also increase the toxic effects of cocaine, such as changes in heart rhythm or seizures.
Phenacetin
Phenacetin is a nonsteroidal anti-inflammatory drug (or NSAID). It’s occasionally added because it makes the powder look shiny and tastes bitter (like cocaine → so the Tongue test can't help to detect this adulterant).In high doses it can damage your kidneys and increase your risk of cancer.
Caffeine
Caffeine pills are relatively cheap and white, so they’re commonly crushed and mixed into cocaine powder. Caffeine is also a stimulant so it will add strain on your heart and can slightly increase your risk of overstimulation/overdose.
How to test your cocaine
The absolute best way to test your cocaine is to get it tested by a proper agency with a spectrophotometer (like The Loop). Sadly, that’s quite rare. The next best thing is using a reagent testing kit. Although they aren’t perfect, they can give you a good idea of whether your cocaine is contaminated, but can’t tell you anything about strength. Get one here.
If you don’t have a reagent testing kit then there are still some ways to check your cocaine powder for some adulterant drugs. These are not ideal, but can still give you help a bit.
Tongue test – place a small amount of cocaine around your gum and lip. Pure cocaine should cause a numb feeling in that area, and should have a bitter taste.
Melting test – melt a small amount of cocaine. Pure cocaine will melt almost immediately. If it takes longer or some parts melt faster or slower than others, your cocaine may be mixed with other substances.
References: Kudlacek et al. 2017; Prieto, 2019; Larocque and Hoffman, 2012
References
What is cocaine? [Internet]. National Institute on Drug Abuse. 2020 [cited 11 April 2020]. Available from: <https://www.drugabuse.gov/publications/research-reports/cocaine/what-cocaine>
Cocaine [Internet]. MedlinePlus. 2016 [cited 11 April 2020]. Available from: <https://medlineplus.gov/cocaine.html>
Kudlacek O, Hofmaier T, Luf A, Mayer FP, Stockner T, Nagy C, Holy M, Freissmuth M, Schmid R, Sitte HH. Cocaine adulteration. Journal of chemical neuroanatomy. 2017 Oct 1;83:75-81.
Prieto A. DRUG ADULTERANTS AND THEIR EFFECTS ON THE HEALTH OF USERS: A CRITICAL REVIEW [Internet]. Cicad.oas.org. 2019 [cited 11 April 2020]. Available from: <http://www.cicad.oas.org/oid/pubs/Final%20ENG%20Drug%20adulterants%20and%20their%20effects%20on%20the%20health%20of%20users%20-%20a%20.._.pdf>
Larocque A, Hoffman RS. Levamisole in cocaine: unexpected news from an old acquaintance. Clinical Toxicology. 2012 Apr 1;50(4):231-41.
What are the short-term effects of cocaine use? [Internet]. National Institute on Drug Abuse. 2016 [cited 11 April 2020]. Available from: <https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-short-term-effects-cocaine-use>
Jewell T. What Happens If You Do Cocaine Once? [Internet]. Healthline. 2019 [cited 11 April 2020]. Available from: <https://www.healthline.com/health/what-happens-if-you-do-coke-once>
Cocaine [Internet]. DrugFacts. 2018 [cited 11 April 2020]. Available from: <https://www.drugabuse.gov/publications/drugfacts/cocaine>
Tashkin DP. Airway effects of marijuana, cocaine, and other inhaled illicit agents. Current opinion in pulmonary medicine. 2001 Mar 1;7(2):43-61.
Brand HS, Gonggrijp S, Blanksma CJ. Cocaine and oral health. British dental journal. 2008 Apr;204(7):365.
Novak SP, Kral AH. Comparing injection and non-injection routes of administration for heroin, methamphetamine, and cocaine users in the United States. Journal of addictive diseases. 2011 Jul 1;30(3):248-57.
How is cocaine used? [Internet]. National Institute on Drug Abuse. 2016 [cited 11 April 2020]. Available from: <https://www.drugabuse.gov/publications/research-reports/cocaine/how-cocaine-abused>
Cocaine [Internet]. DanceSafe. [cited 11 April 2020]. Available from: <https://dancesafe.org/cocaine/>
Cocaine [Internet]. PsychonautWiki. 2020 [cited 11 April 2020]. Available from: <https://psychonautwiki.org/wiki/Cocaine>
Burnett L. Cocaine Toxicity [Internet]. Medscape. 2018 [cited 11 April 2020]. Available from: <https://emedicine.medscape.com/article/813959-overview#a4>
Center for Substance Abuse Treatment. Treatment for stimulant use disorders. Figure 5-1: Effects of Route Administration for Cocaine and MA. 1999 [cited 11 April 2020]. Available from: <https://www.ncbi.nlm.nih.gov/books/NBK64323/table/A59093/>
r/2cb - can I take cocaine on 2cb? [Internet]. Reddit. 2019 [cited 2020Apr17]. Available from: <https://www.reddit.com/r/2cb/comments/aexpuf/canitakecocaineon_2cb/>
2C-x [Internet]. PsychonautWiki. [cited 11 April 2020]. Available from: <https://psychonautwiki.org/wiki/2C-x>
Concurrent Alcohol And Cocaine Abuse [Internet]. DrugAbuse.com. American Addiction Centers; 2019 [cited 2020Apr17]. Available from: <https://drugabuse.com/taking-drugs-alcohol/drug-cocaine/>
Herbst ED, Harris DS, Everhart ET, Mendelson J, Jacob P, Jones RT. Cocaethylene formation following ethanol and cocaine administration by different routes. Experimental and clinical psychopharmacology. 2011 Apr;19(2):95.
Alston R. Mixing Cocaine and Other Stimulants [Internet]. The Recovery Village Palm Beach at Baptist Health. 2020 [cited 11 April 2020]. Available from: <https://www.floridarehab.com/drugs/cocaine/related/mixing-cocaine-and-stimulants/>
Hutchinson S. Mixing Benzos and Cocaine - Is it Safe? [Internet]. River Oaks. 2019 [cited 11 April 2020]. Available from: <https://riveroakstreatment.com/prescription-drug-abuse/benzo/mixing-with-cocaine/>
Volkow ND, Wang GJ, Fowler JS, Hitzemann R, Gatley SJ, Dewey SS, Pappas N. Enhanced sensitivity to benzodiazepines in active cocaine-abusing subjects: a PET study. American Journal of Psychiatry. 1998 Feb 1;155(2):200-6.
Foltin RW, Fischman MW, Pedroso JJ, Pearlson GD. Marijuana and cocaine interactions in humans: cardiovascular consequences. Pharmacology Biochemistry and Behavior. 1987 Dec 1;28(4):459-64.
Dean A. Illicit drugs and drug interactions. Australian Pharmacist. 2006;25(9):684.
r/DMT - DMT and Cocaine? [Internet]. Reddit. 2017 [cited 2020Apr18]. Available from: <https://www.reddit.com/r/DMT/comments/5zveye/dmtandcocaine/>
DMT [Internet]. Rehab Spot. [cited 11 April 2020]. Available from: <https://www.rehabspot.com/drugs/hallucinogens/dmt/>
Cocaine and dxm: A dangerous mix? [Internet]. Bluelight. 2010 [cited 2020Apr18]. Available from: <https://www.bluelight.org/xf/threads/cocaine-and-dxm-a-dangerous-mix.511051/>
Lautieri A. Dextromethorphan Effects [Internet]. DrugAbuse.com. [cited 11 April 2020]. Available from: <https://drugabuse.com/dextromethorphan/effects-use/>
de Knegt VE, Breindahl T, Harboe KM, Møller GL, Børresen ML. Gamma‐hydroxybutyrate and cocaine intoxication in a Danish child. Clinical case reports. 2016 Mar;4(3):228.
How Long Does GHB Stay in Your System? [Internet]. American Addiction Centers; 2017 [cited 2020Apr18]. Available from: <https://americanaddictioncenters.org/ghb-abused/how-long-in-system>
Cocaine and Ketamine: Calvin Klein Club Drug [Internet]. Allure Detox. [cited 12 April 2020]. Available from: <https://www.alluredetox.com/cocaine-ketamine-calvin-klein/>
r/ketamine - Mixing ketamine with cocaine? [Internet]. Reddit. 2019 [cited 2020Apr18]. Available from: <https://www.reddit.com/r/ketamine/comments/bee5yj/mixingketaminewith_cocaine/>
Ingraham C. What it's like to be high on kratom, according to the people who use it [Internet]. The Washington Post. The Washington Post; 2016 [cited 2020Apr18]. Available from: <https://www.washingtonpost.com/news/wonk/wp/2016/09/16/what-its-like-to-be-high-on-kratom-according-to-the-people-who-use-it/>
Yazzie R. Kratom Drug Interaction Concerns: Be Aware Of These Combinations [Internet]. Addameer Health Network. Addameer Health; 2018 [cited 2020Apr18]. Available from: <https://addameer.info/kratom-drug-interactions/>
r/Drugs - Kratom and Cocaine... Simultaneously [Internet]. Reddit. 2019 [cited 2020Apr18]. Available from: <https://www.reddit.com/r/Drugs/comments/8eo4bz/kratomandcocaine_simultaneously/>
Santos-Longhurst A. What Happens When You Mix Cocaine and LSD? [Internet]. Healthline. 2020 [cited 12 April 2020]. Available from: <https://www.healthline.com/health/cocaine-and-lsd>
10 Facts About Cocaine [Internet]. Drug Policy Alliance. 2018 [cited 12 April 2020]. Available from: <https://drugpolicy.org/sites/default/files/cocainefactsaugust2018_1.pdf>
Harris D, Everhart T, Jacob III P, Mendelson J, Jones R. A Phase 1 Trial of Pharmacologic Interactions between Transdermal Selegiline and a 4-hour Cocaine Infusion [Internet]. Medscape. 2009 [cited 12 April 2020]. Available from: <https://www.medscape.com/viewarticle/713732>
Sympathomimetics (Indirect & Mixed Acting)/MAOIs Interactions [Internet]. WebMD. [cited 12 April 2020]. Available from: <https://www.webmd.com/drugs/2/drug-7367/cocaine-bulk/details/list-interaction-details/dmid-87/dmtitle-sympathomimetics-indirect-mixed-acting-maois/intrtype-drug>
r/Drugs - Combining Mushrooms and Cocaine? [Internet]. Reddit. 2015 [cited 2020Apr18]. Available from: <https://www.reddit.com/r/Drugs/comments/29d5xs/combiningmushroomsand_cocaine/>
Magic Mushrooms - Combinations [Internet]. Magic Mushrooms Net. [cited 12 April 2020]. Available from: <http://www.magic-mushrooms.net/paddos/Combinations.html>
r/cocaine - Cocaine and Nitrous Oxide(NOS)? [Internet]. Reddit. 2017 [cited 2020Apr18]. Available from: <https://www.reddit.com/r/cocaine/comments/5i3tk8/cocaineandnitrous_oxidenos/>
Combinations - Cocaine & Nitrous, Together At Last? [Internet]. Drugs-Forum. 2016 [cited 18 April 2020]. Available from: <https://drugs-forum.com/threads/cocaine-nitrous-together-at-last.26411/>
O'Dell LE, George FR, Ritz MC. Antidepressant drugs appear to enhance cocaine-induced toxicity. Experimental and clinical psychopharmacology. 2000 Feb;8(1):133
Kouri EM, Lundahl LH, Borden KN, McNeil JF, Lukas SE. Effects of oral contraceptives on acute cocaine response in female volunteers. Pharmacology Biochemistry and Behavior. 2002 Dec 1;74(1):173-80.
Contraceptive and recreational drugs interactions [Internet]. International Energy Control. 2017 [cited 12 April 2020]. Available from: <https://energycontrol-international.org/contraceptive-and-recreational-drugs-interactions/>
Drug Interactions between Advil and cocaine nasal [Internet]. Drugs.com. [cited 12 April 2020]. Available from: <https://www.drugs.com/drug-interactions/advil-with-cocaine-nasal-1310-782-3966-0.html>
Mixing ibuprofen with cocaine : cocaine [Internet]. Reddit. 2017 [cited 18 April 2020]. Available from: <https://www.reddit.com/r/cocaine/comments/5olyzk/mixingibuprofenwith_cocaine/>
Combinations - Ibuprofen and cocaine high [Internet]. Drugs-Forum. 2010 [cited 18 April 2020]. Available from: <https://drugs-forum.com/threads/ibuprofen-and-cocaine-high.132769/>
Houchens N, Czarnik S, MacK M. How Should a Patient with Cocaine-Associated Chest Pain be Treated?. Hospitalist. 2013 Apr;2013(4).
McCord J, Jneid H, Hollander JE, de Lemos JA, Cercek B, Hsue P, Gibler WB, Ohman EM, Drew B, Philippides G, Newby LK. Management of cocaine-associated chest pain and myocardial infarction: a scientific statement from the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology. Circulation. 2008 Apr 8;117(14):1897-907.
Tanda G, Kopajtic TA, Katz JL. Cocaine‐like neurochemical effects of antihistaminic medications. Journal of neurochemistry. 2008 Jul;106(1):147-57.
Banks ML, Andersen ML, Murnane KS, Meyer RC, Howell LL. Behavioral and neurochemical effects of cocaine and diphenhydramine combinations in rhesus monkeys. Psychopharmacology. 2009 Aug 1;205(3):467-74.
Molina DK, Hargrove VM. Fatal cocaine interactions: a review of cocaine-related deaths in Bexar County, Texas. The American journal of forensic medicine and pathology. 2011 Mar 1;32(1):71-7.
Burnett L. How are dystonic reactions treated in cocaine toxicity? [Internet]. Medscape. 2018 [cited 12 April 2020]. Available from: <https://www.medscape.com/answers/813959-120764/how-are-dystonic-reactions-treated-in-cocaine-toxicity>
Drug combinations [Internet]. TripSit. [cited 18 April 2020]. Available from: <https://wiki.tripsit.me/wiki/Drug_combinations>
Goldstein RA, DesLauriers C, Burda A, Johnson-Arbor K. Cocaine: history, social implications, and toxicity: a review. InSeminars in diagnostic pathology 2009 Feb 1 (Vol. 26, No. 1, pp. 10-17). WB Saunders.
How can we reduce the harms associated with using cocaine? [Internet]. Drug Policy Alliance. [cited 11 April 2020]. Available from: <http://www.drugpolicy.org/drug-facts/cocaine/reduce-harms>
Hartney E. Harm Reduction Strategies When Using Cocaine [Internet]. Verywell Mind. 2020 [cited 11 April 2020]. Available from: <https://www.verywellmind.com/harm-reduction-tips-for-cocaine-users-21993>
Cocaine -- Reduce the Harms [Internet]. Our Health Service. 2018 [cited 11 April 2020]. Available from: <https://www.hse.ie/eng/services/news/media/pressrel/cocaine-reduce-the-harms.html>
How is cocaine addiction treated? [Internet]. National Institute on Drug Abuse. 2016 [cited 12 April 2020]. Available from: <https://www.drugabuse.gov/publications/research-reports/cocaine/what-treatments-are-effective-cocaine-abusers>
Brody J. PERSONAL HEALTH; Addiction: A Brain Ailment, Not a Moral Lapse [Internet]. The New York Times. 2003 [cited 12 April 2020]. Available from: <https://www.nytimes.com/2003/09/30/health/personal-health-addiction-a-brain-ailment-not-a-moral-lapse.html>
Brazier Y. Everything you need to know about cocaine [Internet]. Medical News Today. 2017 [cited 12 April 2020]. Available from: <https://www.medicalnewstoday.com/articles/234239#quick_facts>
Egred M, Davis GK. Cocaine and the heart. Postgraduate medical journal. 2005 Sep 1;81(959):568-71.
Frazer KM, Richards Q, Keith DR. The long-term effects of cocaine use on cognitive functioning: A systematic critical review. Behavioural brain research. 2018 Aug 1;348:241-62.
What are the long-term effects of cocaine use? [Internet]. National Institute on Drug Abuse. 2016 [cited 12 April 2020]. Available from: <https://www.drugabuse.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use>
Estroff TW, Gold MS. Medical and psychiatric complications of cocaine abuse with possible points of pharmacological treatment. Advances in alcohol & substance abuse. 1985 Sep 1;5(1-2):61-76.
Morton WA. Cocaine and psychiatric symptoms. Primary care companion to the Journal of clinical psychiatry. 1999 Aug;1(4):109.
Buddy T. How Long Does Cocaine Stay in Your System? [Internet]. Verywell Mind. 2020 [cited 12 April 2020]. Available from: <https://www.verywellmind.com/how-long-does-cocaine-stay-in-your-system-80231>
Smith ML, Shimomura E, Paul BD, Cone EJ, Darwin WD, Huestis MA. Urinary excretion of ecgonine and five other cocaine metabolites following controlled oral, intravenous, intranasal, and smoked administration of cocaine. Journal of analytical toxicology. 2010 Mar 1;34(2):57-63.
Countries [Internet]. Emcdda.europa.eu. [cited 13 April 2020]. Available from: <http://www.emcdda.europa.eu/countries_en>
Put your brand in front of thousands monthly and support the growth of harm reduction.