Should meth burn clear

Dirty drug : It is with these dangerous substances that dealers stretch cocaine

Dark eyes under gray hair. The man pinches them as he - very carefully - pours white powder into a test tube. Then a colorless liquid. Acrid stench creeps through the hot summer air.

The mixture bubbles over the lighter, suddenly there are two liquids, the lower one clear, the upper one milky. The cook smiles. With a little ammonia, he turned street cocaine into crack.

He puts the oily milk on a handkerchief. It dries quickly in the heat. Now there are crystals lying there, thick and apricot-pink like expensive rock salt. He quickly drops it into his silver pipe. Thick smoke rises. The eyes turn upwards. The man who calls himself Ali on the street is gone again, very far away.

The former officer came to Germany from Iran 40 years ago. He's been on cocaine for almost as long. The high from smoking comes quickly - and is over very quickly. This is how cocaine unfolds its greatest potential for dependence.

That is why Ali smokes many times a day. He's emaciated. His lungs whistle. And yet Jürgen Kempf, forensic toxicologist at the Freiburg University Clinic, says: "Crack is better than its reputation."

The commonplace white makes it easy for dealers

From a chemical point of view, "crack" is the actual cocaine. The plant matter from the leaves of the coca bush is resinous. It does not dissolve in water, but it burns well. In contrast, the white powder that the dealers sell as cocaine is actually cocaine hydrochloride. It is created when acid is added to the coca paste.

This powder coke is not only more practical because it can be absorbed through the nasal mucous membranes or dissolved in water and injected into the veins. Its everyday whiteness also makes it easy for those who want to stretch the drug with other substances. Because many chemical substances look exactly the same.

Anyone who smokes crack at least knows what they're taking, says Kempf. But sniffing or injecting cocaine is like pharmacological Russian roulette.

So far, nobody has been interested in the stretch fabrics

Ali mostly consumes near Hamburg Central Station, in a special smoking room at the drug aid facility Drob Inn. That is the connection to Kempf. Like other addicts, Ali occasionally donates a few crumbs of his dearly bought substance there so that the chemist on the other end of the republic can tear it apart. Such samples also come to Freiburg from institutions in Berlin. Also from Frankfurt, Munich and Nuremberg.

The study is part of the DRUSEC project (here as PDF). It is the first systematic analysis in Germany of the substances with which the most widespread hard drugs cocaine and heroin are mixed for street sales. "In everyday police work, such tiny amounts are destroyed without being analyzed," says Kempf. "And even with larger finds, it is only about the purity content." Because that is important for the sentence. "That is why the accompanying substances have always been neglected in the analyzes that have been customary up to now."

Cocaine is usually a cocktail of substances of concern

Medically, that could have been a big mistake. Because the first, as yet unpublished results of the study show a worrying picture, especially for cocaine. The Tagesspiegel was able to see the preliminary results with the Hamburg material in advance.

While heroin was only diluted there with substances that anyone can buy in the pharmacy - the pain reliever paracetamol and the stimulant caffeine - the "cocaine" was mostly offered to customers as a cocktail of different substances of concern. Either mixed with drugs that were withdrawn from the EU market decades ago because of their organ-damaging side effects. Or with prescription-only substances which, because of their effect on the psyche, should only be taken under medical supervision.

The current drug dealers' favorite filler appears to be phenacetin. With up to 60 percent of the drug mixture tested, it was the most important additive in Hamburg. Phenacetin is a pain reliever that was discovered by Bayer in 1888. Because it also has a euphoric effect, factory owners distributed it to their workers in the Wilhelmine era to increase sales.

As a result, the "phenacetin kidney" became a household name among doctors. The material not only makes you insensitive to pain and happy. With prolonged use, it destroys fine structures in the kidney and can lead to failure of the organ.

A substance is only permitted in animals

The deworming agent levamisole is often found in Hamburg cocaine; in some samples it made up up to nine percent. In the EU it is only approved in veterinary medicine because of its side effects. The most feared, because it is life-threatening, is pulmonary hypertension.

Taken over a long period of time, levamisole causes the white matter in the brain to change. Those who are slowly poisoned become lethargic and have gaps in their memory. Some people also have a permanent decrease in white blood cell counts. Anyone who suffers from such agranulocytosis can die from mild infections.

According to the US drug agency DEA, levamisole is one of the substances that the cartels in Central and South America are already adding "ex works". Probably, researchers suspect, because levamisole amplifies and prolongs the effects of cocaine.

Cocaine has a sustainability problem: the intoxication only lasts a few minutes, and addicts quickly get used to a dose. Ali, the man with the silver crack pipe, puts it this way: "When you use coke for the first time, it knocks you up through the ceiling, straight to heaven. But you come back down just as quickly. And you try again and again. But it's never as incredible as the first time. "

Levamisole can actually help against this hole, at least for a while: It increases the secretion of the addictive messenger substance dopamine in the brain and extends the breakdown time of cocaine in the nerve cells. And one of its metabolic products is itself stimulating. This effect sets in exactly when that of the cocaine wears off.

Stretching is supposed to make consumption easier

The aim of almost all substances currently added is to "pleasantly" supplement the effects of cocaine. This is the conclusion of the authors of a Swiss study from 2016, for which the researchers analyzed international drug finds. The forensic scientists from the University of Lausanne write: "It's about imitating or increasing the effects of cocaine - and about making it easier to use."

It is particularly noteworthy that previous studies have also found two substances in cocaine that speak for some technical understanding among cocaine sellers: diltiazem and hydroxyzine. Diltiazem is a calcium channel blocker. It works against high blood pressure and is usually used to treat heart disease. The drug counteracts the heartbeat accelerating effect of cocaine.

Hydroxyzine, in turn, can be prescribed for anxiety, for example. At the same time it works against severe itching. That also fits surprisingly well: Psychiatrists know of a very special psychosis from cocaine patients. Addicts panic because they feel persecuted. They often scratch themselves bloody because they think insects are crawling under their skin: the so-called dermatozoa delusion. Those who can dampen these side effects with hydroxyzine make cocaine psychosis a little more bearable for their regular customers.

How harmful are the admixtures?

But is the amount of excipient cocainists sniff or inject actually enough to harm them? According to the European drug monitoring authority EMCDDA and other addiction researchers, the amount of coke consumed varies - depending on the severity of the addiction - between around ten and 400 grams per year. If you take too much cocaine all at once, your heart can stop.

However, it is unclear how the health of living coke ovens is. For example, whether there is an amount consumed that puts a strain on the heart with regular use. The question of what long-term effects the extenders have is just as open.

What there is, however, is an investigation into the remainder of the additive in cocaine deaths. It comes from Evelyn Pawlik, biochemist in forensic toxicology at the University Hospital Düsseldorf. Pawlik looked for traces of other chemicals in the blood and lung tissue of cocaine addicts who had been autopsied in forensic medicine.

"Until now, people who have died from drugs have often simply assumed that the damage to internal organs such as the heart or lungs can be traced back to drug abuse," she says. The stretch fabrics, however, have been assigned a subordinate role. But that is very naive. "When users sniff straight cocaine, a substance like levamisole, of all things, which damages the lungs, comes into direct contact with lung tissue. We found this in all of the bodies we examined."

The researcher found a substance in every second death

During the autopsy of ten men and one woman, Pawlik found a total of five different diluents, wildly mixed up, sometimes in conspicuously high concentrations, sometimes in the lungs, sometimes in the blood. The researcher suspects that eight people died directly as a result of drug use and that excipients played a role in at least seven as co-triggers. Pawlik even found a substance in every second death: lidocaine, which is chemically closely related to cocaine.

It is popular with dealers because, like cocaine, it numbs the mucous membranes when sniffed and the injection site when injected. So it simulates particularly pure material. And: unlike other extenders, lidocaine ends up in the beige crystals when cooking cracks.

If these are then smoked, lidocaine flows directly into the lung tissue - where it effectively inhibits breathing and can lead to death. Admittedly, this was not the case with any of the eleven people in Pawlik's study. But she warns that even with crack it is still far from clear what role admixtures play in the toxic effects.

Ali bobs one leg and lets the silver pipe slide through his hands. He tells of his "cocaine-eating monster" that has nested deep inside, it waits there and then suddenly crawls through the whole head like a hungry octopus. The minutes that pass while cooking must become unbearable for him. And yet he is ironic, always taking the time to do it.

"It could well be that crack is not completely clean either," says Ali. "But at least it's not that dirty." He becomes aware of the dealers' bullshit every time he cooks the cocaine powder: Most of the time, more than half of the substance remains in the test tube.

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