Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 29;24(1):923.
doi: 10.1186/s12889-024-18459-0.

Adulterants present in the San Diego county fentanyl supply: a laboratory analysis of seized law enforcement samples

Henrik Galust  1   2   3 , Justin A Seltzer  4   5   6 , Jeremy R Hardin  4   5   6 , Nathan A Friedman  4   5   6 , Jeff Salamat  7 , Richard F Clark  4   5   6 , Jennifer Harmon  7
Affiliations

Adulterants present in the San Diego county fentanyl supply: a laboratory analysis of seized law enforcement samples

Henrik Galust et al. BMC Public Health. .

Abstract

Background: The opioid overdose crisis is one of the worst public health crises ever to face the US and emerging evidence suggests its effects are compounded by the presence of drug adulterants. Here we report our efforts to characterize the adulterants present within the local fentanyl supply of San Diego County, obtained from undifferentiated drug samples seized by local law enforcement over the calendar year 2021.

Methods: Thirty-two participating local law enforcement agencies across San Diego submitted 4838 unknown individual illicit drug samples (total of 312 kg) to the San Diego County Sheriff's Department Regional Crime Laboratory for identification.

Results: Qualitative analysis of these samples via FTIR and GC-MS identified methamphetamine (38.7%), fentanyl (20.8%), diacetylmorphine (heroin) (10.2%), codeine (5.8%) and alprazolam (4.3%) as the most common illicit substances and the presence of 52 unique adulterants. The most common adulterants included 4-methylaminoantipyrine (4-MAAP) (10.9%), mannitol (9%), acetaminophen (8.5%), methamphetamine (4.2%), diacetylmorphine (heroin) (3.6%), tramadol (1.9%), and xylazine (1.7%). Several additional pharmacologically active adulterants and contaminants of interest were also identified.

Conclusion: This analysis is vital for public health use and harm reduction efforts at the level of the individual consumer. Continued direct surveillance of the drug supply is necessary for the detection of potentially harmful adulterants that may pose serious threats to the public.

Keywords: Adulterant; Contaminant; Drug abuse; Fentanyl; Forensic toxicology; Opioid; Pharmacosurveillance; Pharmacovigilance; Toxicology; Xylazine.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
39 individual drugs of abuse identified from 4838 submitted illicit drug samples
Fig. 2
Fig. 2
Most commonly identified illicit drugs by weight from among 4838 submitted samples
Fig. 3
Fig. 3
52 unique adulterants and contaminants identified within 1007 confirmed and analyzed fentanyl samples
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Accessed January 11, 2023. https://www.samhsa.gov/data/ Retrieved.
    1. Ahmad FB, Cisewski JA, Rossen LM, Sutton P. Provisional drug overdose death counts. National Center for Health Statistics. 2023. Accessed May 21, 2023. https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
    1. Singh VM, Browne T, Montgomery J. The emerging role of toxic adulterants in Street drugs in the US Illicit Opioid Crisis. Public Health Rep. 2020;135(1):6–10. doi: 10.1177/0033354919887741. - DOI - PMC - PubMed
    1. Levine M, Meyn A, Krotulski A, Logan B, Amaducci A, Hughes A, Schwarz E, Pizon A, Wax P, Brent J, Manini. A. 71 adulteration of Illicit drugs in Emergency Department patients with Acute Opioid overdose: a Multicenter Cohort. Ann Emerg Med 78. S29. 1.
    1. Kariisa M, Patel P, Smith H, Bitting J. Notes from the field: xylazine detection and involvement in drug overdose deaths — United States, 2019. MMWR Morb Mortal Wkly Rep. 2021;70:1300–2. doi: 10.15585/mmwr.mm7037a4. - DOI - PMC - PubMed