ArticleBMJ case reports2021
Serious health threats of novel adulterants of the street heroin: a report from India during the COVID-19 pandemic.
Article in BMJ case reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Analysis of Illicit Street Heroin Seized in Pakistan by Gas Chromatography-Mass Spectrometry (GC-MS) for Identification of Adulterants and Impurities.International journal of analytical chemistry · 2026Article
- Comparative Analysis of Benchtop NMR and HPLC-UV for Illicit Drug Mixtures.Magnetic resonance in chemistry : MRC · 2025Article
- Delirium during early abstinence from street heroin: An uncommon but probable withdrawal feature?Indian journal of psychiatry · 2025Article
- Molecular Insights and Clinical Outcomes of Drugs of Abuse Adulteration: New Trends and New Psychoactive Substances.International journal of molecular sciences · 2022Review
- Psychosis-like symptoms and seizure in a case of complicated opioid withdrawal from heroin use.Industrial psychiatry journalArticle
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Authors and funding
3 authors.
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Abstract
The COVID-19 pandemic and a consequent nationwide lockdown in India for several weeks had restricted the access to street heroin and treatment for substance abuse. Use of cutting agents to increase the volume or psychoactive effect has been widely practised under such circumstances. Our patient with opioid use disorder chased heroin with an unknown cutting agent to enhance psychoactive effect from the limited quantities of heroin. He suffered from an abrupt onset sedation, weakness, postural imbalance, slurred speech, cognitive dysfunctions and disinhibited behaviour. Symptoms rapidly reversed following abstinence and initiation of buprenorphine-naloxone. Gas chromatography-mass spectrometric analysis of the adulterant revealed high concentrations of benzodiazepines and barbiturates, alongside the usual cutting agents-caffeine and acetaminophen. Abrupt reduction in availability of 'street drugs' in conjunction with poor healthcare access can lead to the use of novel adulterants with potentially serious clinical and public health implications.
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