What Types of Cutting Agents Are Used in Drug Manufacturing?

Illicit drugs may often contain cutting agents that can dilute the substance’s purity or enhance its effects. Some of the most common adulterants include:

• Fentanyl.
• Levamisole.
• Benzocaine.
• Lidocaine.
• Phenacetin.
• Baby powder.
• Caffeine.
• Chloroquine.
• Aspirin.

Read on to learn more about cutting agents that are added to certain drugs and how this process increases the risks of using illicit drugs, making them even more dangerous than their 100% pure counterparts.

Different Types of Drug Cutting Agents

The use of cutting agents is rampant—a trend driven by drug dealers seeking to stretch their profits by mixing drugs with cheaper (and often, more harmful) ingredients.

The Drug Enforcement Administration (DEA) estimates that 4 out of every 10 counterfeit pills purchased on the street contain a lethal dose of fentanyl.¹

Additionally, a study conducted in Europe tested 524 random samples of cocaine. Of the samples, only 10% contained pure cocaine, with 5% containing no cocaine at all. The remaining 445 samples all contained at least 1 or more cutting agent.²

Below is a breakdown of the different types of most commonly encountered cutting agents.

Fentanyl as a Cutting Agent

Fentanyl is a common cutting agent in counterfeit pills, cocaine, heroin, methamphetamine, and MDMA. It is the most dangerous drug threat we are facing as a nation right now.³

In 2021, the Centers for Disease Control (CDC) reported more than 100,000 overdose deaths, making it the deadliest year in U.S. history. At least 66% of those deaths were related to synthetic opioids like fentanyl.³

Fentanyl is about 50 times more potent than heroin and 100 times more potent than morphine. Just 2 mg, equivalent to a few grains of salt, is considered a lethal amount.³

The DEA has recently seen a sharp increase in fentanyl as a cutting agent in prescription pills illegally purchased on the street or online. These pills include fake, but very real-looking versions of prescription opioids such as oxycodone (Oxycontin, Percocet), hydrocodone (Vicodin), and alprazolam (Xanax); or stimulants like amphetamines (Adderall).⁴

Drug dealers use it as a cutting agent because of its extremely powerful effects and low cost. This poses a serious risk of overdose and death to anyone using any type of illicit drug that could be laced with fentanyl.⁵

Levamisole as a Cutting Agent

Levamisole is a cutting agent commonly found in cocaine. The DEA estimates that trace amounts of levamisole may be present in as much as 69%–80% of cocaine being smuggled into the United States.⁶

Levamisole bears a close resemblance to high-quality cocaine and is available at a low cost. Evidence also suggests that a metabolite of levamisole called aminorex may have some stimulant or amphetamine-like properties, which could potentially create an added high when snorted and explain why dealers frequently use it as a cutting agent.²

Hyped by the media as the faulty ingredient in so-called “flesh-eating cocaine,” levamisole has a number of known and serious side effects including:⁶

• Skin rot or gangrene.
• Blood clots and embolism.
• Psychosis.
• Kidney damage.
• Heart disease.

While skin rot or gangrene is a potential risk of levamisole use, studies show that it is rare and associated with chronic use at large doses. People who experience dermal necrosis after using cocaine cut with levamisole may also have a genetic predisposition that makes them more susceptible to the drug’s toxicity.⁶

Benzocaine as a Cutting Agent

Benzocaine is typically sold in powdered form and used in all sorts of everyday products a person might use for minor pain. These products include:

• Cough drops.
• Spray-on anesthetics.
• Pain-relieving ointments and gels.

Benzocaine works on contact, helping to narrow blood vessels and reduce the sensation of pain. In this regard, benzocaine is much like cocaine: It looks like the drug and works in the same way.

Documents released by the British government suggest that cocaine can be mixed with benzocaine in a one-to-one ratio, meaning diluting the cocaine’s purity by 50%.⁷

Lidocaine as a Cutting Agent

Lidocaine is another painkilling medication often sold in powdered form. People can apply it topically, or they can put it directly on a sore spot and feel almost immediate relief.

Dealers choose this substance as a cutting agent due to its lookalike qualities. It can also fool people on a taste test.

When people put cocaine mixed with lidocaine on the tongue, the tongue goes numb—a trait people use on the fly to determine drug purity.

Phenacetin as a Cutting Agent

Phenacetin is another substance sold as a white, crystalline powder. In the past, this substance was used as a painkiller in the United States but was ultimately discontinued.

Today this substance is considered quite dangerous. According to documents from the New Jersey Department of Health and Senior Services, phenacetin is a known carcinogen and unsafe to breathe, much less consume orally or nasally.⁸

Although Phenacetin is banned in the U.S., dealers might still be able to get it overseas. If they do, they may use it as a cutting agent in white, powdered drugs like cocaine and heroin to dilute the pure substances and maximize profits.

Baby Powder as a Cutting Agent

Baby powder may be used as a cutting agent in white, powdered drugs like cocaine. The prime ingredient in baby powder is talcum, which is a white, powdered substance.

Baby powder is also remarkably inexpensive, but tends to have a distinctive and pervasive smell.

Caffeine as a Cutting Agent

When most people think of caffeine, they think about the brown grounds used to brew a cup of coffee. But caffeine used as a cutting agent for cocaine or heroin is a completely different substance. It’s a powdered form that can be found in vitamin shops and online bodybuilding stores.

This form of caffeine like this can help people feel strong and invigorated, and its powdered form resembles powdered drugs like cocaine and heroin.

Several studies have found that caffeine may enhance the effects of cocaine. It also has a bitter taste, similar to pure cocaine.²

When caffeine is mixed with heroin, it causes the heroin to vaporize at a lower temperature, which could be used to the advantage of dealers and seen by people who smoke or inhale the drug as a potential benefit.⁹

Chloroquine as a Cutting Agent

Chloroquine is a white, powdered medication used to help people manage the symptoms of malaria. It is a relatively easy substance to find, especially in countries where malaria is active, and an inexpensive substance to purchase.

Chloroquine has long been used as a cutting agent for heroin, due to their close resemblance in color, consistency, and crystalline structure. Chloroquine looks very similar to what is known in South-West Asia as “crystal heroin” and may even be sold on its own, as fake or imitation heroin.⁹

Aspirin as Cutting Agent

Crushed aspirin pills are almost indistinguishable from powdered drugs like cocaine and heroin, and they may be used as a cutting agent in these drugs. Aspirin also has a slightly bitter smell and taste, which is another attribute dealers look for when trying to assess the purity of a substance they would like to purchase or test.

Aspirin is remarkably cheap to buy, and there are no limitations on how much a person can buy at any one time. But since cutting agents are so common, some countries have taken steps to make their purchase and use illegal.

Risks of Taking Drugs Cut With Other Substances

Taking drugs cut or mixed with other substances can increase the risk of serious health complications. Just as pure drugs can be dangerous, adulterated drugs can cause harm or even death.

Many substances used to dilute drugs for the purpose of bulking up supply and increasing profits (e.g., sugars and starches) have no physiological effects and pose minimal health risks.⁶

But other cutting agents do have physiological effects and are chosen by dealers because of their chemical and physical similarities to illicit drugs like cocaine and heroin. These substances can be extremely toxic.⁶

In addition to increasing a person’s risk of cancer and weakening the immune system, cutting agents may cause other life-threatening health conditions such as:¹⁰

• Heart attack.
• Stroke.
• Organ problems from overheating.
• Coma.
• Respiratory failure.

The most serious risk is the increased likelihood of overdose and death caused by cutting agents. As mentioned above, even a small dose of fentanyl can be deadly.^1,10

The danger often lies in the fact that people don’t know what ingredients are in a certain drug and may be unaware it contains a potentially lethal substance, like fentanyl.

The telltale signs of an opioid overdose are:¹⁰

• Coma.
• Pinpoint pupils.
• Respiratory depression (slow and shallow breathing).

How to Tell if a Drug Has Been Cut With Other Substances

It is almost impossible to tell if a drug has been cut with other substances. Dealers typically choose cutting agents because of their close resemblance to certain drugs, and many of these substances have no specific smell or taste.¹¹

For example, a counterfeit pill could contain a lethal amount of fentanyl, but a person would not be able to see, smell, or taste it.¹¹

The only way to test for cutting agents is in a lab, which makes it very unsafe to use or consume any drugs or pills that are not obtained through a licensed pharmacy.

For fentanyl detection, testing strips are available through many needle exchange programs and other public resources. However, availability varies from state to state, with some places classifying these kits as illegal drug paraphernalia.

To obtain fentanyl testing strips in the Tri-State Area, contact the New York and New Jersey departments of health.

Get Help for Addiction at Sunrise House

One way to avoid the potentially lethal effects of cutting agents is to stop using illicit drugs. If you or a loved one has lost control of their drug use, a professional addiction treatment program can help you begin the path to recovery.

Addiction is a progressive disease. If left untreated, it can worsen over time, along with its associated health risks.

At Sunrise House Treatment Center, we offer different levels of addiction care and tailor treatment plans to meet the individual needs of each patient.

Our inpatient rehab facility in New Jersey uses a combination of evidence-based and alternative therapies to address the many issues underlying addiction and teach patients more positive ways to cope.

For more information about our programs, ways to pay for drug rehab, or using insurance to pay for rehab, call us at . Our admissions navigators are available around the clock to answer your questions and start the admissions process.

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No matter what substance you’re using, there is hope, and addiction is treatable. Contact us today.