What's in this thing? Look at drug adulteration | QA goes purple

Pure heroin is extremely potent and extremely rare because the drug often contains fillers that extend the benefits and often offer stronger tops.

Sometimes these fillers are relatively harmless, like citric acid, which is added to facilitate the injection of the drug. Other fillers are toxic but not often fatal, such as talc, sugar, caffeine, aspirin or laxatives. Caffeine, for example, can mask the signs of an overdose, which increases the risk of brain damage. And some other substances do not dissolve properly, so particles can accumulate and block the arteries.

But some additives are extremely dangerous, such as rat poison and powerful and inexpensive synthetics such as fentanyl. These loads can lead to collapsed veins, tetanus, abscesses, permanent organ damage and death.

So why is the heroine cut off with all this? Because it allows a reseller to stretch the offer. Most of these additives look like heroin and are cheaper. Therefore, "cutting" the drug with less expensive additives lowers costs while increasing profits. And while heroin and fentanyl cost about the same price, the latter is much more profitable.

Once cut and diluted, a kilogram of heroin can bring in about $ 500,000. The same amount of fentanyl can yield over $ 1.2 million.

Cartels have begun to add even more powerful synthetic products, such as carfentanil, a deadly elephant tranquilizer. The chemical is so deadly that even the dealers of dark websites often put warnings on these products. Known as "rhinoceros," this deadly synthetic opioid is primarily made in China. Counterfeit medicines are often associated with medications.

Some drug users are looking for these synthetic drugs because of their potency, but very few know when a drug contains these deadly chemicals. Some consumers taste the drug before eating it and say that fentanyl is sweeter than heroin, but in general, people do not know what they are getting.

According to Johns Hopkins University, the purity of heroin ranges from 3% to 99%, making any lot unpredictable. And the decrease in purity has dramatically increased the number of overdoses and deaths.

In addition to its potency, about 50 times that of heroin, overdoses of fentanyl occur much faster than heroin overdoses. With heroin, an overdose is progressive; with fentanyl, it's instantaneous. Overdoses of fentanyl often cause what is called a "wooden chest", a form of paralysis in which the chest takes hold of the chest and where CPR is almost impossible.

Fentanyl is not a new medicine. In 2002, it became the most widely used synthetic opioid in medicine. Illicit use first appeared in the 1970s in the medical world, with a peak of overdose deaths in 2006. The number of deaths from fentanyl began to increase as of 2012, exploded between 2014 and 2016 and has now transformed the opioid crisis.