Harm Reduction The Dirty Hit & Dirty Rush

[Tchort]

A 'dirty hit', also known as a 'dirty rush', is a phenomenon that is fairly well known among IDU's (Intravenous Drug Users); specifically Heroin addicts.

Dirty hits
You may like the drug, but a dirty hit can make you very sick. Take it from someone who’s been there...

“I’ve had a dirty hit that made me feel like my brain and skin were on fire, and that my head was going to explode. Dirty hits are dangerous and very frightening, so always use a new filter every time... your life may depend on it!” J.O.

http://www.saferinjecting.net/injecting-wheel-filters.htm

This is a very concise and accurate description of what a 'dirty rush/hit' feels like. Symptoms often include rapid heart beat, rise in blood pressure, dizziness, strong and painful 'pins & needles' sensation in different parts of body (usually the face and extremities), a flushing sensation, feeling overheated, general weakness, fever, chills, nausea, headache, etc.

There are numerous circumstances and substances that can cause these symptoms. This same article referenced above goes on to say:

Even reusing a filter four hours later is enough time for bacteria and fungi to appear and cause a dirty hit. Also, some think another hit can sort a dirty one out, but it will probably only make things worse.

Wheel filters fit between the syringe and needle tip and come in a range of sizes to suit your use. They are available for a small charge at all QuIHN NSPs. Staff can show you how to use them too. Remember viruses are too small to be filtered so filters are no excuse to reuse syringes or drop the hygiene standards! Hep C and HIV laugh in the face of even the finest wheel filter.

This is one possible cause of a dirty hit/rush. Another common cause also involves cotton filters (Qtips, cotton balls, tampons, cigarette filters), when pieces of cotton fiber enter the bloodstream- called Cotton Fever. Thankfully, "while it resembles the very serious condition sepsis in symptoms, Cotton Fever, if left untreated, will resolve itself usually within 12-24 hours."

http://en.wikipedia.org/wiki/Cotton_fever

Several substances found in street Heroin are themselves the cause of a dirty hit/rush. These substances are additives; they complement or intensify the effect of IV Heroin, and add to the bulk of the powder as a cutting agent, thus increasing the value.

Inositol

Common use as a "cutting" agent

Inositol is also commonly used as an adulterant (or cutting agent) in many illegal drugs, such as cocaine, methamphetamine, and sometimes heroin

http://en.wikipedia.org/wiki/Inositol

Inositol is related to the Vitamin B family, and is used clinically as a nutritional supplement. When added to Heroin as a cutting agent with additive effects, high doses of Inositol are often taken intravenously by IDU's. The effects of at least certain forms of Inositol are similar to that of Vitamin B3, Niacin.

[Niacin] can pose a risk of overdose, causing arrhythmias, metabolic acidosis, hyperglycemia, and other serious problems.

. . .

People taking pharmacological doses of niacin (1.5 - 6 g per day) often experience side-effects that can include dermatological complaints such as facial flushing and itching, dry skin, skin rashes including acanthosis nigricans. Gastrointestinal complaints, such as dyspepsia (indigestion) and liver toxicity (fulminant hepatic failure) have also been reported. Also reported include hyperglycemia, cardiac arrhythmias, birth defects, and orthostasis.

http://en.wikipedia.org/wiki/Niacin

Inositol Hexanicotinate is often sold as 'flush-free Niacin', providing the benefits of Niacin without the above mentioned side effects. However, this is mostly if not entirely false advertising.

In terms of adverse effects, inositol nicotinate potentially has types of reactions similar to those of niacin (eg, flushing, pruritis, gastrointestinal complaints, hepatotoxicity, hyperuricemia, and impaired glucose tolerance) because it is broken down to 6 niacin molecules. The intensity and severity of these adverse effects may be less than those of niacin, as the hydrolysis of inositol nicotinate into free nicotinic acid and inositol molecules takes place very slowly and peak serum levels of nicotinic acid are not achieved until about 10-12 hours after the dose.[1] However, this information is based mainly on the pharmacokinetics of the product, and actual clinical experience in the reported literature is not sufficient to justify this theoretical assumption.

http://www.medscape.com/viewarticle/447528

Quinine

Quinine has long been used as a cutting agent and additive to illicit Heroin.

Quinine is a bitter tasting powder extracted from the bark of the cinchona tree of South America. Quinine, used in medicine, became popular as an antimalaria drug, and in the 1940's drug pushers, concerned about their decreasing clientele from the epidemic of malaria sweeping the streets, added quinine to heroin. As a result of this new practice, the malaria outbreak in New York was reasonably controlled. The use of quinine in illicit preparations continues today, because quinine's bitter taste prevents heroin buyers from being able to judge the quality of heroin sold as well as adds to the "rush" of the heroin injection.

Although quinine is a relatively toxic drug, it has a "good" reputation in the addict population. However, studies of "heroin overdose" deaths indicate that quinine is often one of the primary agents responsible for these deaths. Allergic reactions to the drug can lead to pulmonary death through overstimulation of the central nervous system. Tne incidence of these kinds of deaths has always been the greatest in those areas of the country where "cutting" heroin with quinine is most
common.

http://www.friendslab.com/news_quinine.html

Sorbitol

Sorbitol is a chemical used as an artifical sweetener, laxative, and binder/filler used in many pharmaceutical products (including numerous OTC and RX pills that are injected by IDU's, such as Methadone syrup). It is also used as a cutting agent and possibly an additive in illicit Heroin (Source: Microgram, August 2007 issue).

Sorbitol solution: effects can be similar to a ‘dirty hit’: facial flushing, abdominal pain, nausea, vomiting and sweating. High levels may lead to kidney failure or kidney stones.

http://www.saferinjecting.net/injecting-methadone.htm

Other side effects of excess Sorbitol include "abdominal pain, gas, and mild to severe diarrhea. Sorbitol ingestion of 20 grams/day (g/d) as sugar-free gum has led to severe diarrhea leading to unintended weight loss of 24 lbs in a 114 lb woman; another patient required hospitalization after habitually consuming 30g/d. Sorbitol can also aggravate irritable bowel syndrome and fructose malabsorption.

Even in the absence of dietary sorbitol, cells produce sorbitol naturally. When too much sorbitol is produced inside cells, it can cause damage. Diabetic retinopathy and neuropathy may be related to excess sorbitol in the cells of the eyes and nerves. The source of this sorbitol in diabetics is excess glucose, which goes through the polyol pathway."

http://en.wikipedia.org/wiki/Sorbitol

Lidocaine, Procaine, Dibucaine, Tetracaine, etc

This class of chemicals are often used as cutting agents and additives in street Heroin. (Ex 1. P-Dope: http://weeklywire.com/ww/04-13-98/boston_feature_2.html )

Ex 2.

Analysis by the Wicomico County Police Crime Lab of drug paraphernalia
samples from Wicomico County and Somerset County revealed the following:

- 4/4 positive for fentanyl

- 4/4 positive for procaine

- 3/4 positive (very weakly) for heroin.

http://www.chesterfire.com/forum/viewtopic.php?t=2436

Overdose of these chemicals share many of the same symptoms as listed above;

Systemic exposure to excessive quantities of lidocaine mainly result in central nervous system (CNS) and cardiovascular effects – CNS effects usually occur at lower blood plasma concentrations and additional cardiovascular effects present at higher concentrations, though cardiovascular collapse may also occur with low concentrations. CNS effects may include CNS excitation (nervousness, tingling around the mouth, tinnitus, tremor, dizziness, blurred vision, seizures) followed by depression, and with increasingly heavier exposure: drowsiness, loss of consciousness, respiratory depression and apnoea). Cardiovascular effects include hypotension, bradycardia, arrhythmias, and/or cardiac arrest – some of which may be due to hypoxemia secondary to respiratory depression. (Rossi, 2006)

ADRs associated with the use of intravenous lidocaine are similar to toxic effects from systemic exposure above. These are dose-related and more frequent at high infusion rates (≥3 mg/minute). Common ADRs include: headache, dizziness, drowsiness, confusion, visual disturbances, tinnitus, tremor, and/or paraesthesia. Infrequent ADRs associated with the use of lidocaine include: hypotension, bradycardia, arrhythmias, cardiac arrest, muscle twitching, seizures, coma, and/or respiratory depression. (Rossi, 2006)

http://en.wikipedia.org/wiki/Lidocaine#Adverse_drug_reactions


While some of the chemicals listed above are capable of and often do add a pleasurable response when administered with Heroin intravenously to IDU's, overdosage, allergic reaction, drug interaction or an unknown cause can easily lead to a dirty hit/rush.

The similarity in symptoms between adverse effects, overdoses and regular side effects of the chemicals listed above, as well as with Cotton Fever and bacterial/fungal contamination of filters, makes it difficult for an IDU to recognise what is happening to them. A dirty hit/rush is a horribly uncomfortable, painful ordeal, and can last for a very long time. Depending on the exact circumstances of the dirty hit/rush (actual drugs injected, amount of drugs injected, whether filter contamination or cotton fever is involved, etc), it is possible that a serious health consequence, up to and including coma and death are possible results. If this happens, the best advice is to immediately inform someone, and seek the help of a medical professional, preferably in a hospital to get checked out.

 

[bingey]

very informative , im goin to see if we can link it in the directory

 

[Tchort]

A study was recently conducted on the abuse potential of a Niacin + Oxycodone tablet with the brand name Acurox (Oxycodone 40mg + Niacin 240mg). 30 non-dependant volunteers with a history of opioid abuse were given a dose every 48 hours or a placebo. The Niacin is obviously being added to this formulation to deter IV abuse, or to deter excessive consumption, as for the above mentioned reasons, Niacin will cause a dirty hit/rush after a certain point.

However, I am starting to think that a small or moderate dose of Niacin taken orally with a synthetic opioid (like Methadone) will cause sufficient Histamine release to possibly mimic the side effects of Morphine & Heroin.

 

[sixpartseven]

Excellent thread.

I remember the one and only "dirty hit" I've ever had. It looked like normal, dark brown heroin, but something about it told me that I shouldn't try shooting it (maybe it was the fact that my dealer had just said "you shouldn't try shooting it" 5 minutes before. I was sick, so what the fuck did he expect me to do?). My dealer told me something was wrong with it. He said another guy had just shot some and said it wasn't good. I had no idea how much of an understatement "wasn't good" was. If it was so bad, he wouldn't be selling it to me, right?

Wrong.

So anyways, me and my girlfriend at the time start prepping it. I finish first, as always, and start to shoot. I was on the phone with another dealer of mine when the rush hit (I can talk on the phone and prep/shoot up at the same time) and I told her I had to call her back. I hung up the phone, and started freaking out.

My heart was pounding, my chest muscles tightened and burning, my stomach about to unleash the breakfast I had put in it an hour earlier. And my head. Oh my god, my head. It felt like someone had placed it in a vice and was just cranking it closed, squeezing my head. My eyes really felt like they were being pushed out of their sockets from behind.

I look over at my girlfriend who just registered and was about to shoot. I yell at her for her to stop. It takes a few seconds for her to realize how much pain I am in, and she finally understands that she would be stupid to shoot this "dope." She rolls down the window and squirts it out.

The effects continued ALL DAY. I went home to wait for my girlfriend to make some money at work so we could go buy real dope and hopefully have it make me feel better. I sat at home for a few hours just puking and writhing in pain in bed. It was horrible. The worst experience of my life.

A few hours later, my girlfriend gets her lunch break at work and comes to pick me up so we can go get more dope. The dealer who sold me the bad shit told me he'd replace it with the good dope he had just got a few minutes earlier. We got to his house, bought 4 bags and got the 4 he had to replace (4 each), and prep it. My entire body was shaking from the effects of the dope from earlier, so it took a few minutes to hit a vein. It was the most frustrating few minutes of my life.

The (incredible, excellent, awesome) good dope finally kicked in (I shot all 4 bags), but it barely touched the effects of the bad dope. I did feel better, but my head still hurt and my heart was still racing, and my entire body was shaking. Over the course of the day, we did about 10 bags more each, and still, the effects were not completely gone.

The effects of the bad dope stuck around for TWO DAYS AFTER the day I shot it, so THREE DAYS total. Same for the other guy who shot it. For 3 days, we felt the pain from whatever was in that dope. To this day, I don't even have the slightest idea of what was in it, but for the time between shooting the bad dope and the time I finally got some good dope to shoot, I actually thought I was going to die. It was the one time in my life I was absolutely certain my life was ending.

I never want to feel that shit ever again.

 

[bingey]

^
sounds awful man , i had some shots which i considered dirty but i always got better after a few hours

 

[Tchort]

For a period of about two weeks I received poison Heroin from the only available dealer at the time. He was supplying me, my gf, and several of her friends. It looked and smelled the same as always (East Coast brown powder), but when water was added and sucked into a syringe the color was milky tan, similar to what liquid diarrhea looks like- not the normal dark brown.

Anyway, anywhere you injected this stuff, a large red bulge would form under the skin. It was extremely painful to the touch. It took over a week for each bump to go away; clothing touching it hurt terribly. We didn't have access to any other dope, so we kept shooting it until our guy got a new batch. It was the worst experience of my life.

However, something I left out from the list above is plain Morphine. Street Heroin often contains unreacted Morphine, or Heroin that has 'degraded' back to Morphine. The Histamine reaction to Morphine is stronger than it is with Heroin. A pins & needles sensation, warm flushing, rising heart beat, rise in blood pressure, etc (Histamine reactions) are more apparent, which some people find very uncomfortable, and/or unpleasant.

 

[Tchort]

I've found two other threads here on BL that seem to indirectly confirm the role of Sorbitol (and possibly other inactive pharmaceutical ingredients) in providing an additive physiological effect when injected with an opioid.

Both of these threads mention the injection (IV+IM) of Roxanol (Ethex Pharma brand of Morphine Concentrated Oral Solution 20mg/ml)

Inactive ingredients: ascorbic acid, citric acid, FD&C Blue
No. 1, FD&C Red No. 40, flavors, glycyrrhizin, propylene
glycol, purified water, saccharin sodium, sodium benzoate,
sodium gluconate, sodium phosphate dibasic, and sorbitol
solution.

Thread 1:

http://www.bluelight.ru/vb/showthread.php?t=281376&highlight=morphine+liquid+rush

Thread 2:

http://www.bluelight.ru/vb/showthread.php?t=383821&highlight=morphine+shoot

The first thread mentions being on Bupe daily, and getting definite effects from IM injection of Roxanol, the second thread mentions IV injection of a small amount of Roxanol and experiencing a rush.

Higher doses for the second user and an IV rather than IM administration for the first, I would imagine, would have resulted in a 'dirty rush/hit'. Hmm.

 

[Cane2theLeft]

While going through the 'pending deletion' forum I found a thread that linked this archived thread and thought it was very interesting. Tchort is a BLer I respect as much or more than any other and I'd like to bump this and see if we can get any other views or information on this phenomenon.

 

[dokomo]

I like this thread as well!

However, don't we now know that 'cotton fever' is actually caused by a bacterium endemic to cotton rather than cotton itself? Or am I mistaken?

 

[SmokeTrails]

ive always been under the impression that it is from bacteria... now from actual cotton particles.

 

[daddysgone]

Excellent thread.

I remember the one and only "dirty hit" I've ever had. It looked like normal, dark brown heroin, but something about it told me that I shouldn't try shooting it (maybe it was the fact that my dealer had just said "you shouldn't try shooting it" 5 minutes before. I was sick, so what the fuck did he expect me to do?). My dealer told me something was wrong with it. He said another guy had just shot some and said it wasn't good. I had no idea how much of an understatement "wasn't good" was. If it was so bad, he wouldn't be selling it to me, right?

Wrong.

So anyways, me and my girlfriend at the time start prepping it. I finish first, as always, and start to shoot. I was on the phone with another dealer of mine when the rush hit (I can talk on the phone and prep/shoot up at the same time) and I told her I had to call her back. I hung up the phone, and started freaking out.

My heart was pounding, my chest muscles tightened and burning, my stomach about to unleash the breakfast I had put in it an hour earlier. And my head. Oh my god, my head. It felt like someone had placed it in a vice and was just cranking it closed, squeezing my head. My eyes really felt like they were being pushed out of their sockets from behind.

I look over at my girlfriend who just registered and was about to shoot. I yell at her for her to stop. It takes a few seconds for her to realize how much pain I am in, and she finally understands that she would be stupid to shoot this "dope." She rolls down the window and squirts it out.

The effects continued ALL DAY. I went home to wait for my girlfriend to make some money at work so we could go buy real dope and hopefully have it make me feel better. I sat at home for a few hours just puking and writhing in pain in bed. It was horrible. The worst experience of my life.

A few hours later, my girlfriend gets her lunch break at work and comes to pick me up so we can go get more dope. The dealer who sold me the bad shit told me he'd replace it with the good dope he had just got a few minutes earlier. We got to his house, bought 4 bags and got the 4 he had to replace (4 each), and prep it. My entire body was shaking from the effects of the dope from earlier, so it took a few minutes to hit a vein. It was the most frustrating few minutes of my life.

The (incredible, excellent, awesome) good dope finally kicked in (I shot all 4 bags), but it barely touched the effects of the bad dope. I did feel better, but my head still hurt and my heart was still racing, and my entire body was shaking. Over the course of the day, we did about 10 bags more each, and still, the effects were not completely gone.

The effects of the bad dope stuck around for TWO DAYS AFTER the day I shot it, so THREE DAYS total. Same for the other guy who shot it. For 3 days, we felt the pain from whatever was in that dope. To this day, I don't even have the slightest idea of what was in it, but for the time between shooting the bad dope and the time I finally got some good dope to shoot, I actually thought I was going to die. It was the one time in my life I was absolutely certain my life was ending.

I never want to feel that shit ever again.

Yikes!! Sounds like an awful experience.
Glad you came out of it OK....eventually.

But let me say, for a smart guy, you seem to have some wrongheaded notions regarding "dirty hits", and specifically, what you think should "cure" a dirty hit.

A "dirty hit" is just an umbrella term for the reaction your body has, to any number of substances that can be introduced to your body and cause these symptoms. As mentioned, often the culprit is bacterial, or simply a small fiber of cotton that makes it into your bloodstream which then causes an immune response.

With that in mind, I am confused why you (or anyone else) would think that a hit of "good" heroin would cure a dirty hit. It just doesn't make sense.
Heroin ain't an antibiotic nor is it an anti-histamine.

Perhaps the symptoms of a dirty hit (nausea, chills, etc.) remind users of withdrawal, so they mistakenly think that a shot of good dope will clear them up.

Anyhow, just wanted to throw that out there because I could easily imagine someone OD'ing from shooting several shots of "good dope" in an attempt to cure their bad hit.

 

[gibby_420]

I am confused why you (or anyone else) would think that a hit of "good" heroin would cure a dirty hit. It just doesn't make sense. Heroin ain't an antibiotic nor is it an anti-histamine.

It sure ain't gonna make u feel any worse now is it?

What I mean is you're prolly gonna be dopesick by the time u get some good dope... so at least it'll cure that.

 

[OEandricearoni]

idk about dirty hits outside of cotton fever, never knew anyone who that happened to. I did get cotton fever once though, and it was god damn awful. I didn't know what the fuck was happening to me when it happened, but luckily, bluelight was the to reassure me I wasn't about to fuckin die....

 

[nanksta]

This is all good information

 

[Uber_Penguin]

I'm glad you put this up, I've never dealt with this phenomenon, only ever heard of it, and I've always been a little scared of it cause I never knew what exactly caused it or how it ran its course. Good stuff to know.

 

[Cane2theLeft]

With the responses and hits this has gotten, I'm definitely glad it was revived from the Archive and bumped! Again, kudos on ANOTHER excellent thread, Tchort.

 

[Captain.Heroin]

Great thread Tchort! I have never had a "dirty hit" before, but this will help a lot of Bluelighters for sure.

 

[Flexistentialist]

I like this thread as well!

However, don't we now know that 'cotton fever' is actually caused by a bacterium endemic to cotton rather than cotton itself? Or am I mistaken?

The term "cotton fever" is only used by people in America. "Cotton fever" refers to a specific bacteria that lives on cotton (Enterobacter agglomerans). Problem with referring to these reactions as "cotton fever" is that they frequently occur in people who are not using cotton at any stage of the injecting process. Using the term "cotton fever" confuses people who then assume that the cotton is somehow the culprit. In reality, it could be contamination from any stage of the injecting process inclduing bacteria on the surface of the skin, a cut in the gear, unsterile water source, contaminated filter etc.

The term "dirty hit" covers the whole range of possible causes for these types of reactions, and is probably a better way of describing it than "cotton fever".

 

[benzico]

I like this thread ive learned a lot more usefull information which is essential fof safe and better drug use. keep up the good work.

 

[opiatekrzy]

when i was doing heroin, some different batches provided different types of rushes, some were real heavy and droopy, some were energetic and mildly heavy with a short duration, while the heavy and droopy rushes lasted many hours longer, im guessing its some horse tranqulizer they cut it with sometimes...still feels like an opiate tho, who knows what they put in it...iv'e missed a bunch of times hitting my vein, ended up with the weak rush hitting me 3-5mins, itchingarm, large bump...just feeling "dirty" when i hit my vein im all good to go, but disappointed if i dont get high as i want, i never catch NODS EVER anymore, i been off that shit for awhile now, and am on suboxone...only methadone gives me a nod