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Heroin Purity and Cutting Agents

Teen male hands cutting heroin line with a razor blade on a smart phone screen  

Heroin is a semi-synthetic opioid drug that is derived from the natural opioid morphine. Heroin cutting agents have long been used to increase dealer profits because many of the cutting agents in drugs are far less expensive than heroin. Other reasons for using cutting agents include increasing bioavailability (how well the body can effectively use a drug), complementing the effects of heroin or reducing its unwanted side-effects (for example, adding diphenhydramine, the active ingredient in Benadryl, to reduce heroin-induced itching).

Heroin cutting agents have traditionally been inert or relatively innocuous substances like baking soda. In recent decades, devastatingly dangerous drugs like warfarin, the active chemical in rat poison, and lethal synthetic opioids like fentanyl and carfentanil have become common heroin adulterants. Even in the absence of these cutting agents, heroin is a profoundly dangerous drug. When warfarin or fentanyl is added to heroin, the risks associated with heroin use increase dramatically.

During the teenage and young adult years, the brain is undergoing substantial physical and chemical changes. Heroin can cause very serious structural and functional brain damage and increase the risk of the future development of substance use disorders. Although heroin use among teenagers is low, the already alarming risks associated with heroin use are substantially increased for teens. Dangerous cutting agents are a “known unknown” in heroin and further increase the risk of short- and long-term damage and even death in teenagers who use it.

The Purity of Illicit Drugs

Heroin is a product of the opium poppy plant, which is cultivated largely in Asia, Colombia, and Mexico. Recent years have seen record crops of the opium poppy and, as a result, heroin production has increased. In the U.S., there are two general types of heroin available: “Raw” heroin, which is relatively pure, and “scramble,” which can be so adulterated that heroin is a minor ingredient.

According to the Drug Enforcement Administration, heroin purity has fluctuated between approximately 30% and 40% pure between 2012 and 2016. Other studies have found that the purity of “street” heroin in the U.S. averages between 7-10%.

What Is Heroin Cut With?

Heroin is cut with a number of products, ranging from inert and relatively safe products like baking soda to dangerous, even lethal synthetic opioids like fentanyl.

Common heroin cutting agents include:

  • Baking soda
  • Powdered milk
  • Sugar
  • Starch
  • Baby laxative
  • Quinine
  • Lactose
  • Mannitol
  • Inositol
  • Acetaminophen
  • Laundry detergent
  • Talcum powder
  • Caffeine
  • Lidocaine
  • Warfarin (used in rat poison)
  • Fentanyl and fentanyl derivatives
  • Carfentanil
  • Other opioids
  • Benzodiazepines

The Dangers of Drug Cutting Agents

Until recently, heroin was among the most potent of all readily available opioids. In recent years, however, fentanyl and carfentanil have easily surpassed heroin in terms of potency, addictive capacity, and lethality. Fentanyl and carfentanil are both fully synthetic opioids that are astonishingly powerful and immensely addictive.

Because they are synthetic, fentanyl and carfentanil are cheaper and easier to produce than heroin, which requires morphine extraction from cultivated poppy plants and further purification in order to obtain the finished product, which is then smuggled into the U.S. Consequently, fentanyl and carfentanil have been used as cutting agents in order to increase drug yields and dealer profits.

Heroin is among the most deadly illicit drugs known to man, and fentanyl is 50 times more potent than heroin. Carfentanil is an astonishing 5,000 times more potent than fentanyl and, until it was discovered by drug dealers, was used exclusively by veterinarians as an elephant tranquilizer. Twenty micrograms of carfentanil is a lethal dose for an adult man; for reference, a single grain of table salt weighs between 60-100 micrograms.

The inclusion of fentanyl and carfentanil in heroin has proven to be an incredibly dangerous development for heroin users, and fentanyl has been strongly implicated as a major driver of opioid-related fatalities in recent years. Interviews with people who have used heroin regularly underscore the danger of heroin use in the modern era: “Well, really, using heroin right now is touch and go. It’s like Russian roulette because they put all sorts of things in the drugs today.”

Finding Help for Heroin Addiction

Heroin is a powerfully addictive drug, and overcoming heroin use disorders can be very challenging. Most people who are struggling with heroin use find that professional rehab offers the most effective way to successfully achieve sobriety.

Medication-assisted treatment (MAT) is often an important component of long-term recovery from heroin use disorders. The goal of MAT is to replace heroin with another opioid that can mimic the chemical effects of heroin in the brain without producing the physiological high that is associated with heroin use. Methadone and buprenorphine are common MAT drugs that have proven to be very successful in curbing withdrawal symptoms and allowing people in recovery to maintain successful home and work lives.

Young people with heroin use disorders face unique challenges that are best addressed by addiction specialists in a teen drug rehab environment. If you are concerned that your teenager is using heroin or another substance, contact Next Generation Village to learn how our comprehensive rehab programs can help your teen overcome substance use and regain control of his or her life.

Medical Disclaimer: Next Generation Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.


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