Adulterants & Cutting Agents

What a laboratory finds beside the drug rather than the drug itself. Three roles sit here: inert bulk that adds weight, such as mannitol, inositol and dimethylsulfone; mimics that counterfeit a buyer's quality check — procaine, lidocaine and benzocaine numb a gum the way cocaine does; and cuts that are pharmacologically active in their own right, including levamisole, phenacetin, diltiazem, quinine and the industrial light stabiliser BTMPS. Nothing generalises across those roles, and finding one tells a reader nothing about what else is in the same powder.

They are grouped by role, like inhalants by route, because the role is what carries the risk. Levamisole is an anthelmintic and phenacetin a withdrawn analgesic, but nobody meets either here as a medicine — they are met as a cut, and the harm that follows, agranulocytosis or kidney damage, belongs to the role rather than to the pharmacology it was named for.