Dosage form

See also: Routes of administration

Odors

Cannabis is sometimes diluted with lovely scents from terpenes found naturally in cannabis, to trick people that quality is superior.

Chemically synthesized substances are often odorless in their pure form. However, some impurities may have a desirable odor, which is exploited. For example, phenylacetone is used in the manufacture of methamphetamine and amphetamine, and has a flowery odor.

Color

Chemically synthesized substances are often white. Impurities may cause them to have subtle color tones, can often be extracted.

Extended release

Alcohol induced dose dumping (AIDD)

Alcohol may be dangerous to combine with modified-release dosage medications.

This dose dumping effect is an unintended rapid release of large amounts of a given drug, when administered through a modified-release dosage while co-ingesting ethanol. This is considered a pharmaceutical disadvantage due to the high risk of causing drug-induced toxicity by increasing the absorption and serum concentration above the therapeutic window of the drug. The best way to prevent this interaction is by avoiding the co-ingestion of both substances or using specific controlled-release formulations that are resistant to AIDD.

In vitro data suggest that some extended-release stimulants may experience dose dumping in the presence of alcohol. This is a concern because the ADHD patient population is at risk for alcohol abuse. The potential for dose dumping when taking extended-release stimulants with alcohol could lead to unintended and dangerous side effects for those with ADHD.

An example of an extended-release formula includes the methylphenidate medication brand Concerta.

Powder

Impurities

See also: Lacing

Surprisingly, a lot of cutting agents can be filtered by simple cold water extraction.

Wet powder

Excess fluid in the powder means that there is still some solvent in the product. In clandestine drug labs, drugs are often scooped into vacuum bags, and marketed as being premium quality that has to be stored in the freezer to avoid evaporation. Sometimes as much as 50% of the weight is solvents, which means that the powder will be twice as strong after evaporation. However, this can be checked with a milligram scale by weighing it, letting it evaporate, weighing it again to compare the values.

Paper blotters

Warning for paper blotters

The quantity of psychoactive substances in paper blotters prepared by someone else may vary wildly. There is no guarantee that even sheets are standardized. One way to get around this is to dissolve the blotters in alcohol and use volumetric liquid dosing with a microliter syringe to prepare new blotters. Make sure to use a clean syringe without any contamination.

• Buccal: Paper blotters
• Sublabial (under the lip): Paper blotters
• Sublingual: Paper blotters

Caution

• LSD does not readily cross the blood-brain barrier (BBB) when taken by injection. However, dissolved LSD blotters also contains the ink, which often contain heavy metals.

Uneven distributed substances in drug reservoirs

• Medical transdermal patches. It is not safe to calculate divided doses by cutting and weighing medical patches, because there's no guarantee that the substance is evenly distributed in the drug reservoir.
  • Fentanyl transdermal patches are designed to slowly release the substance over 3 days. It is well known that cut fentanyl transdermal consumed orally have cause overdoses and deaths.
• Single paper blotters injected from solvents in syringes may also cause uneven distribution in the drug reservoir.

Routes of administration notes

Nasal cavity

Powder for insufflation

For quick adsorption, crushed powder can be sifted with a fine strainer to make fine particles.

Completely dry powder can be difficult to snort and cause cough. Adding a little bit of water to increase the humidity can prevent that. This can be controlled by first drying the substance, and then by adding 20% of water of the substance weight, for example.

Inhalation

Nitrous oxide

Nitrous oxide cartridges are sold as whip cream charger cartridges, and they are used with a balloon connected to a whipping siphon (also called a cream whipper) or a nitrous cracker. The balloon is then filled with the nitrous oxide and then inhaled-exhaled from the balloon repeatedly to make it easier for the lungs to absorb as much oxygen and nitrous oxide as possible. One should never breathe nitrous oxide directly from a whipping siphon, as it may cause damage to the lungs. Death can result if it is inhaled in such a way that not enough oxygen is breathed in, such as inhalation from a gas mask, that may cause unconsciousness.

For more information, see: Recreational use of nitrous oxide (Wikipedia)

E-liquid vaping ingredients

Risks

Vaping-associated pulmonary injury (VAPI) is an umbrella term used to describe lung diseases associated with the use of vaping products that can be severe and life-threatening.

Suspected additives

Electronic cigarette refers to the practice of inhaling an aerosol from an electronic cigarette device, which works by heating a liquid that can contain various substances, including nicotine, tetrahydrocannabinol (THC), flavoring, and additives (e.g. glycerin (sold as vegetable glycerine (VG)), propylene glycol (PG)). The long-term health impacts of vaping are unknown.

Vegetable glycerine (VG), and propylene glycol (PG)

Vegetable glycerine (VG) was long thought to be a safe option. However, the carcinogen formaldehyde is known as a product of propylene glycol and glycerol vapor degradation, these ingredients may also cause lung inflamation.

Vitamin E acetate

On September 5, 2019, the Food and Drug Administration (FDA) in the US announced that 10 out of 18, or 56% of the samples of vape liquids sent in by states, linked to recent vaping related lung disease outbreak in the United States, tested positive for vitamin E acetate which had been used as a thickening agent by illicit THC vape cartridge manufacturers. On November 8, 2019, the Centers for Disease Control and Prevention (CDC) identified vitamin E acetate as a very strong culprit of concern in the vaping-related illnesses, but has not ruled out other chemicals or toxicants as possible causes. The CDC's findings were based on fluid samples from the lungs of 29 patients with vaping-associated pulmonary injury, which provided direct evidence of vitamin E acetate at the primary site of injury in all the 29 lung fluid samples tested. Research suggests when vitamin E acetate is inhaled, it may interfere with normal lung functioning. A 2020 study found that vaped vitamin E acetate produced exceptionally toxic ketene gas, and carcinogenic alkenes and benzene.

Injection

See Safer injection guide#Substances that are dangerous to inject

Smoking/vaping

Talc is an excipient often used in pharmaceutical tablets. Also, illicit drugs that occur as white powder in their pure form are often cut with cheap talc. Natural talc is cheap but contains asbestos, while asbestos-free talc is more expensive. Inhaled talc that has asbestos is generally accepted as being able to cause lung cancer if it is inhaled. The evidence about asbestos-free talc is less clear, according to the American Cancer Society.

Talc can be avoided by dissolving the substance in water, filtering and discarding non-dissolving particles with a syringe, and evaporating the water of the dissolved substances.

External links

• Dosage form (Wikipedia)
• 2019–2020 vaping lung illness outbreak (Wikipedia)
• Vaping-associated pulmonary injury (Wikipedia)