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Internet pseudoscience: Testing opioid containing formulations with tampering potential.
Jennifer P Pascali1, Paolo Fais2, Fabio Vaiano1
1Forensic Toxicology Division, Department of Health Sciences, University of Florence, Largo Brambilla 3, Florence, Italy.
Journal of Pharmaceutical and Biomedical Analysis
|February 19, 2018
Summary
Recreational drug users tamper with medications, risking fatal opioid toxicity and liver damage from residual paracetamol. Home-extracted opioids rarely exceed 90% purity, leaving dangerous levels of associated drugs.
Area of Science:
- Forensic Chemistry
- Pharmacology
- Toxicology
Background:
- Internet forums detail drug tampering methods for recreational use.
- Tampering aims to increase drug availability or enhance effects.
- Recreational misuse of tampered drugs can lead to severe toxicity and fatalities.
Purpose of the Study:
- To assess the tampering risk of opioid formulations combined with paracetamol or dexketoprofen.
- To analyze extraction procedures found on the internet for drug misuse.
- To evaluate the effectiveness of common home-extraction techniques.
Main Methods:
- Analyzed opioid-containing tablets, suppositories, cough syrup, and transdermal patches.
- Employed "Cold water extraction" and "Acid/base extraction" methods.
- Utilized liquid chromatography-tandem mass spectrometry (LC-MS/MS) for analysis.
Main Results:
- Opioid recoveries rarely exceeded 90% in home-prepared extracts.
- Up to 60% of paracetamol remained in the final opioid preparations.
- Declared extraction efficiencies of >99% for opioids and complete paracetamol removal were not achieved.
Conclusions:
- Tampering does not guarantee safer drug preparations.
- Significant health risks persist due to unremoved paracetamol and variable opioid content.
- Home drug extraction poses risks of opioid toxicity and chronic paracetamol-induced liver damage.
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