Interesting PubMed Article "New Illicit Opioid..."

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vicodelicious

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A new illicit opioid dependence outbreak, evidence for a combination of opioids and steroids.Koushesh HR, Afshari R, Reza.
Kushesh Rehabilitation Clinic, Shiraz, Iran.

Opioid abuse is common in Iran. In 2005, a new version of locally produced illicit opioid vials, so called Norgesic, appeared in the illicit market, which gained popularity rapidly and led to an improvement of stigmatizing the general appearance of dependent cases. Later, some cases suffered Cushing's-like problems. A prospective case series was designed to evaluate 18 Norgesic-dependent subjects who volunteered for abstinence therapy in a rehabilitation clinic from November 1, 2005, to December 30, 2005. In this study, we aimed to describe the clinical and paraclinical findings in detail and define the potential determinants of this Cushing's syndrome outbreak. History, physical examination, plasma cortisol level, and urine screen tests were used to describe the patients. All subjects were male with a mean (SEM) age of 29.8 +/- 1.6 years. The opioid-dependence period was 8.4 +/-0.9 years. In an average of 4.7 +/- 0.3 months, subjects increased their usage to 5.5 +/- 0.5 vials a day. Patients claimed to gain weight. Striae were seen in 38.9%, previously documented psychological problems in 33.3%, weakness in 27.8%, high systolic blood pressure in 22.2%, moon face in 16.7%, hirsutism in 11.1%, extensive dermal infection in 11.1%, gynecomastia in 5.6%, back pain in 5.6%, insomnia in 5.6%, and lack of potency in 5.6%. Their cortisol level, on average, was 4.8 +/- 1.1 mug/dL. Hepatitis C virus was positive in 22.2%. Urine-screening tests were positive for morphine and negative for buprenorphine. In conclusion, these new vials contain steroids as well as opioids. This combination could be more dangerous than opioids themselves.

PMID: 19514947 [PubMed - in process]


Interesting huh? I wonder what actual opioid is in this concoction and what steroid? Why would they put a steroid in there anyways...? What do you guys think?
 
ingannilo said:
wow. this was on pubmed?
Norgesic is a combination of asprin, caffine and an anticholinergic drug called orphenadrine: http://en.wikipedia.org/wiki/Orphenadrine

found here in five seconds via google:
http://en.wikipedia.org/wiki/Norgesic

is pubmed moderated? I thought it had accurate information? Norgesic is not an opiate.
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Yes I've heard of that drug orphenadrine, but I think they were talking about something else, in Iran I believe. I don't think ther're talking about the US "Norgesic". At leased I don't think....:\
 
Interesting.

You probably won't find any information on this 'Norgesic'. These are supposedly clandestinely produced vials of an opioid combined with a steroid. Could be anything. A more detailed article on the topic is required.
 
It says "illicitly produced" and "so-called" Norgesic (and thus not the brand name Norgesic as previously mentioned). Norgesic is probably a street "brand name."
 
Yes, we've come to the conclusion that this "Norgesic" is not the traditional "orphenadrine and aspirin" we know here in the US...8)
 
drug_mentor said:
Wonder why they would mix the two.

Maybe its to help steroid using athletes push through the pain barrier. lol
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Most cuts used in black market Heroin are pharmalogically active, and provide additive "bonus" effects. The 'Caine family, Quinine, Inositol, Sorbitol, Anti-Histamines, etc. There are a variety of ways these chemicals subjectively make the rush or high better to most users, but the common denominator is that they are all active chemicals when ingested- and those actions make opioids 'feel' better some how.

Most likely this is just another case of this. Another chemical that makes injected opioids better (whether the rush or overall high) added to an opioid and sold on the black market.
 
I don't think so. A steroid won't do this. I suspect it's what they had on hand to dilute it with. It's very odd.

Positive for morphine means it's probably some morphan-series opioid, not likely a close morphine derivative, but perhaps something like levorphanol.
 
Hammilton said:
I don't think so. A steroid won't do this. I suspect it's what they had on hand to dilute it with. It's very odd.

Positive for morphine means it's probably some morphan-series opioid, not likely a close morphine derivative, but perhaps something like levorphanol.
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I've never heard of "Illicitly manufactured ampoules". Maybe a dealer is taking pharmaceutical steroid ampoules and mixing whatever opioid into the ampoules then re-selling? I assume you're right about that.

But without knowing the exact chemicals involved, I'm not ready to rule out an additive chemical.
 
A steroid just wouldn't produce a better rush. Not a sex steroid though. There are steroids used as anaesthetics, like alfaxalone, but this isn't one of them.

I think you're right. I think these guys wanted to sell an injectable drug, that had the appearance of sterility and purity, knowing that it'd sell better and / or for more money. So they found some ampoules they could add their drug into, and did so. The choice of a sex hormone was a particularly bad one, though, given all the issues associated with that!

Ham
 
Plausible but not at all practical. Wouldn't common sense be to get saline vials and dope them? They'd be cheaper and less controlled.
 
Tchort said:
I've never heard of "Illicitly manufactured ampoules". Maybe a dealer is taking pharmaceutical steroid ampoules and mixing whatever opioid into the ampoules then re-selling? I assume you're right about that.

But without knowing the exact chemicals involved, I'm not ready to rule out an additive chemical.
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In the middle east they busted a million dollars worth of pre-made heroin vials. Mixed in water. I know it degrades....
 
smackem said:
In the middle east they busted a million dollars worth of pre-made heroin vials. Mixed in water. I know it degrades....
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I think this was in Afghanistan and they had pictures in one of the micrograms. I'll go look for it.

Edit (yep):
http://www.usdoj.gov/dea/programs/forensicsci/microgram/mg0508/mg0508.html

mg0508_fig4.jpg


The DEA Special Testing and Research Laboratory (Dulles, Virginia) recently received several submissions of sealed injection vials, each containing approximately 2 milliliters of yellow to golden colored liquids, purported heroin solutions (see Photo 3). The exhibits were seized by the Afghanistan Special Narcotics Force (ASNF) and DEA personnel at a residential complex in Farah Province, Afghanistan (located in the western part of the country, bordering Iran). In all, about 25 of the vials were submitted for analysis (there were over 200,000 such vials at the complex). Analysis via GC/FID, GC/MS, NMR, FTIR-ATR, and CE confirmed that the liquids were solutions of heroin hydrochloride in water (pH 4 - 5), varying from trace to 13 milligrams/milliliter (most were between 12 - 13 milligrams/milliliter). O6-Monoacetylmorphine was the primary component in solutions with low heroin concentrations, and it appears that in these cases the heroin hydrolyzed before the solution was analyzed. Pheniramine and caffeine were also found in some of the solutions. Based on investigative intelligence, it is believed that the vials were prepared as “ready-to-use” injectable heroin solutions. These were the first submissions of this type to the Special Testing and Research Laboratory.
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Injecting 4 pH liquid doesn't sound very fun.... =(
 
jim jones happens to know the answer to what a lot of you are wondering, which was why? anyone whos ever touched a weight knows that nubain and bodybuilding go hand in hand. im sure this is how the steroid/opiod combo came to be.
 
This doesn't seem to be nubain, though, if indeed that is the case, you're right.
 
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