Drug dealers often mix the white powder with pharmacologically active substances.This can be more harmful than the drug itself.
Dark eyes under gray hair.The man pinches them as he – very carefully – pours white powder into a test tube.Then a colorless liquid.An acrid stench creeps through the hot summer air. Red Phosphorus Powder
The mixture bubbles over the lighter, suddenly there are two liquids, the bottom one clear, the top one milky.The cook smiles.With a little ammonia, he turned street cocaine into crack.
He maneuvers the oily milk onto a handkerchief.It dries quickly in the heat.Now there are crystals there, thick and apricot pink like expensive rock salt.He hastily plops 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 rush from smoking comes quickly – and is over very quickly.This is how cocaine develops its greatest potential for addiction.
That's why Ali smokes many times a day.He is emaciated.His lungs whistle.And yet Jürgen Kempf, a forensic toxicologist at the University Hospital of Freiburg, says: "Crack is better than its reputation."
Chemically speaking, “crack” is actually cocaine.The plant material from the leaves of the coca bush is resinous.It doesn't dissolve in water, but burns well.The white powder that dealers sell as cocaine is actually cocaine hydrochloride.It is created when acid is added to 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.His common knowledge also makes it easy for those who want to dilute the drug with other substances.Because many chemical substances look exactly the same.
Anyone who smokes crack at least knows what they are taking, says Kempf.But snorting or injecting cocaine is like pharmacological Russian roulette.
Ali mostly consumes near Hamburg's main train station, in a special smoking room at the drug help facility Drob Inn.That is the connection to Kempf.Like other addicts, Ali occasionally donates a few crumbs of his expensively purchased substance so that the chemist on the other side of the country can take it apart.Such samples also come to Freiburg from Berlin institutions.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 used to mix the most widespread hard drugs, cocaine and heroin, for street sales.“In everyday police work, such small quantities are destroyed without being analyzed,” says Kempf."And even with larger finds, it's all about the purity."Because it is important for the sentence."That's why the accompanying substances were always overlooked in the usual analyzes."
Medically speaking, this could have been a big mistake.The first results of the study, which have not yet been published, paint a worrying picture, especially for cocaine.The Tagesspiegel was able to see the preliminary results with the Hamburg material in advance.
While heroin there was only diluted with substances that anyone can buy in the pharmacy - the pain reliever paracetamol and the stimulant caffeine - "cocaine" was mostly offered to customers as a cocktail of various questionable substances.Either mixed with medications that were withdrawn from the EU market decades ago because of their organ-damaging side effects.Or with prescription substances that should only be taken under medical supervision because of their effect on the psyche.
The dealers' current favorite cutting edge 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 painkiller that was discovered in 1888 by the Bayer company.Because it also has a euphoric effect, factory owners in the Wilhelmine era distributed it to their workers to increase sales.
The “phenacetin kidney” then became a household name among doctors.The material not only makes you insensitive to pain and makes you happy.With prolonged use, it destroys fine structures in the kidney and can cause the organ to fail.
Hamburg cocaine often also contains the deworming drug levamisole; in some samples it made up up to nine percent.In the EU it is only approved for use in veterinary medicine because of its side effects.Pulmonary hypertension is the most feared because it is life-threatening.
When taken long-term, levamisole causes the white matter in the brain to change.Those who are gradually poisoned become lethargic and have memory lapses.In some people, the number of white blood cells also decreases permanently.Anyone suffering from such agranulocytosis can die from even minor infections.
According to the US drug agency DEA, levamisole is one of the substances that the cartels in Central and South America already add directly "ex works".Probably, researchers suspect, because levamisole enhances and prolongs the effects of cocaine.
Cocaine has a sustainability problem: the high only lasts a few minutes and addicts quickly get used to a dose.Ali, the man with the silver crack pipe, says it this way: "When you do coke for the first time, it blows you up through the ceiling, straight into the sky. But just as quickly you come back down. 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 release of the addictive neurotransmitter dopamine in the brain and extends the time it takes for cocaine to be broken down in the nerve cells.And one of its metabolic products has a stimulating effect itself.This effect sets in just as the cocaine wears off.
Complementing the effects of cocaine in a “pleasant” way is probably the goal of almost all currently added substances.This is the conclusion of the authors of a Swiss study from 2016, for which the researchers analyzed international drug discoveries.The criminal scientists from the University of Lausanne write: "It's about imitating or increasing the effects of cocaine - and about making consumption easier."
What is particularly noteworthy is that previous studies have also found two substances in cocaine that indicate some expertise among cocaine sellers: diltiazem and hydroxyzine.Diltiazem is a calcium channel blocker.It is effective against high blood pressure and is usually used to treat heart disease.The drug counteracts the heartbeat-increasing effect of cocaine.
Hydroxyzine, in turn, can be prescribed for anxiety, for example.At the same time it combats severe itching.This also fits surprisingly well: Psychiatrists know that cocaine patients have a very specific psychosis.The addicts panic because they feel persecuted.They often scratch themselves bloody because they think insects are crawling under their skin: the so-called dermatozoan madness.Anyone who can curb these side effects with hydroxyzine will make the cocaine psychosis a little more bearable for their regular customers.
But is the amount of cutting agents that cocaine addicts snort 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 at once, your heart can stop.
But it is unclear what the health status of the living cokeheads is.For example, whether there is a consumption amount that puts strain on the heart when used regularly.The question of what long-term effects the extenders have is just as open.
What there is, however, is an investigation into cutting agent residues in cocaine deaths.It comes from Evelyn Pawlik, biochemist in forensic toxicology at Düsseldorf University Hospital.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, when it comes to drug deaths, it has often simply been assumed that the damage to internal organs such as the heart or lungs was caused by drug abuse,” she says.The extenders, on the other hand, were assigned a subordinate role.But that is pretty naive."When users snort diluted cocaine, a substance such as levamisole, which damages the lungs, comes into direct contact with lung tissue. We found this in all the corpses examined."
During the autopsy of ten men and one woman, Pawlik found a total of five different cutting agents, mixed wildly together, sometimes in noticeably high concentrations, sometimes in the lungs, sometimes in the blood.The researcher suspects that eight people died directly from drug use and that extenders played a role as a contributing factor in at least seven.Pawlik even found one substance in every second death: lidocaine, which is chemically closely related to cocaine.
It is popular with dealers because, just like cocaine, it numbs the mucous membranes when snorted and the injection site when injected.This gives the illusion of particularly pure material.And: Unlike other extenders, lidocaine ends up in the beige crystals when crack is cooked.
If these are then smoked, lidocaine flows directly into the lung tissue - where it effectively inhibits breathing and can lead to death.This was not the case for 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 rocks one leg and lets the silver pipe slide through his hands.He talks about his "cocaine craving monster" that has nestled deep inside, it waits there and then suddenly crawls all over your head like a hungry octopus.The minutes that pass while cooking must be unbearable for him.And yet he is adamant about it and takes the time to do it every time.
“It’s possible that crack isn’t entirely clean either,” says Ali."But at least it's not that dirty."He becomes aware of the dealers' adulteration every time he cooks the cocaine powder: usually more than half of the substance remains in the test tube.
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