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nalysis of Captagon Tablets in Saudi Arabia A Maha Al-Mazroua
Head of Dammam Regional Poison Control Center
Eastern Region – Ministry of Health -KSA
One of the basic knowledge in analytical toxicology field is the presence of
multiple unwanted adulterates substances in the
composition of illegal psychoactive substance manufacturing.
The adulterants materials have many side and toxic effects that may be exagerrated in some circumstances up to sudden death.
These adulterant substances are known as undesirable
contaminants, resulting from poor manufacturing or inappropriate
storage procedure.
On the other aspect; the adulterants may be chemicals with known their
therapeutic pharmacological uses, as to
increase the pharmacology effects of the active principle "adulteration by
quinine in heroine manufacturing, adulteration by
procainamide in cocaine preparation due to its local anesthetic
action and finally addition of caffeine to heroin to facilitate its
administration”.
The third category of adulterants substances type well known as
diluting adulterant substances, these substance are mainly added to
psychoactive substance; 1- to increase its volume or its amount, 2- to enhance
the effect of psychoactive substance or 3- to decrease the
concentration of active materials. Most of diluting substances are
characterized by low price. The diluting substances are mainly less
dangerous substances regarding health hazardous impacts.
Finally, the presence of adulterating material may be attributed to
detects in the manufactures cycle and/or storage
process. For example, the presence of variable forms of heavy
metals, micro-organisms and alkaloids in the composition of psychoactive substances are attributed to the previous
mentioned reasons.
The main aims of this study are; 1- to evaluate the pattern,
nature, amount, concentration , quality and types of
the adulterant materials in illegal black market
manufactured psychoactive drugs in our locality “Saudi
Arabia”, and 2-to clarify their variable health impacts.
Study Questions:
1- What are the characteristics of the locally seized
materials? What are the active principles present in
them?
2 - What are the adulterants added to seized psychotropic
substances, and what are the added health risks rising from
them?
3 - To what extent was seized psychoactive substances exposed to
fraud, bad storage procedure and inappropriate
environment for manufacturing?
0
10
20
30
40
50
60
70
80
90
100
Plants Powders Alcohols Marijuana Tablets
15
33
100 100 98
Types and Number of Samples
Total Samples Number 346
Results
No
Results
Active Ingredient Percentage in Investigated Tablets
49%
1%
38.8%
12% Methamphetamines
4-Methoxy Amphetamines
Amphetamines
No Active Ingredient
Results
Adulterants Types and Percentage in Investigated
Tablets
96.9%
93.9%
59.2% 57.1%
29.6%
16.3% 15%
4.1% 3.10% 2% 2% 1% 1% 1% 1%
%
Results
Absence of Amphetamine Presence of Amphetamine in aConsiderable Amount
Presence of Amphetamine inTrace Amount
12.2%
38.8%
49%
Presence & Concentration of Amphetamine in Investigated Tablets
%
Results
Frequency of Adulterant Substances in Investigated Tablets
Two Three Four Five Six Seven
10.2%
27.6%
36.7%
18.4%
6.1%
1%
%
Results
Active Ingredient Percentage in Investigated Hashish Samples
100% 100% 100% 100% 100% 100% 99% 83%
%
Results
Types & Frequency of Contaminated Heavy Metals in Hashish Samples
0%
10%
20%
30%
40%
50%
60%
70%
80%
ZincStrontium
AluminumManganese
IronBromine
73% 70%
69%
9% 8%
1%
Results
Types & Percentage of Bacterial Contamination in Hashish Samples
0%
2%
4%
6%
8%
10%
12%
14%
16%
16%
12%
8%
6%
1%
Results
Active Ingredient in Investigated Alcoholics Samples
EthanolEthyl Acetate
4-Methyl HexanIsobutanol
Methanol
99%
80% 83% 74%
24%
%
Results
Types and Percentage of Investigated Powder Samples
91%
9%
Di-Acetyl Morphine [Heroine]
Di-Ethyl Benzene Ethanamine[Methamphetamine]
Results
Active Ingredient Percentage in Investigated Powder Samples
87.90% 84.80%
81.80% 78.80%
9.10%
3% 3%
3% 3.00%
%
Results
87.9% 84.8%
75.8%
66.7%
57.7%
33.3%
18.2%
9.1%
6.2% 6.1% 6.1% 3.0% 3.0%
Types & Percentage of Adulterants in Investigated Powder
%
Results
Frequency of Adulterant Substances in Investigated Powder Samples
9.1% 9.1%
3.0% 1.0%
15.2%
33.3%
18.3%
9.1%
No Adulterants Two Types Three Types Four Types Five Types Six Types Seven Types Eight Types
Results
85.8% 85.7% 85.7% 85.7%
42.9%
28.6%
Active Ingredient Percentage in Investigated Plant Samples
Results
Frequency of Adulterant Substances in Investigated Plant Samples
• Phenmetrazine 87.5% Adulterant
• Zinc 9%
• Aluminium 9% Heavy Metats
• Coumarine 25%
• 6 Methyl Coumarine 12.5% Insecticides
•Lecleriac Abecarboxylate 12.5% * Enterobacter Aerogenes 25%
•pseudomonas Aerogenosa 25% * Pseudomonous Oryzihabit ANS 25%
•Klebsiella Pneomoinia 62.5%
Bacterial Contaminetion
Results
• Absent Adulterant
• Zinc 0%
• Aluminium 3% Heavy Metats
• Absent Insectivides
• No Growth
Bacterial Contaminetion
Frequency of Adulterant Substances in Investigated Plant Samples
During Daily practice in Dammam Regional Poison Control Center,
multiple seizures were referred in the form of tablets. Most of these
tablets were discovered to be containing stimulant ingredients
related to amphetamine group by analytical confirmatory toxicology results.
One of the most famous seized tablets was Captagon (it is the trade
name of Fenethylline). Fenethylline is composed of
amphetamine and 7-ethyl Evilline. Both amphetamine and 7-ethyl Evilline are synthetic stimulants substances. After attended
commercial manufacturing of the Captagon due to its causative effect
of dependency, its industry was turned into black market.
In the black market of Captagon manufacture, both scientific specialist and non specialist work in this field; just only by following a
specific preparatory traditional manufacturing
protocol with multiple risks of health impacts carried by them.
After complete analytical toxicological procedures by all screening
and confirmatory procedures, a great analytical
toxicological fact was raised, {No Fenethylline} in all sized tablets,
i.e. no active principle of Captagon in all black market
locally manufactured tablets.
From this fact we can conclude that, the manufacture procedures
of Captagon are not aim to manufacturing the original nature
compound {Fenethylline} but all exciting procedures are
simulating and attempting to only produce stimulant tablets
effects but in random manufacture pathways.
In the current study, the main active principle of the investigated
tablets was amphetamine. Amphetamine was present in a
considerable concentration of 38.8% of the investigated tablet. On the
other aspect, about the half of the investigated tablets (49%) were not
containing amphetamines at all, and 12.2% of investigated tablets were
contained a trace amount of the active amphetamines constitute.
From all of the previous results we can conclude that, all investigated
tablets were black market manufactured tablets that,
simulating Captagon tablet but never contain the same active principle of Captagon “Fenethylline” in all of the them by
100% assurance rate.
The second surprising note in the results of the current study is absence of
amphetamine in 12.8% of investigated tablets. This fact is a very recent
dramatic observing note. All of the previous studies discovered the
process of adulteration by variable percentages ranged from 40 – 47 %
“as a mixture of amphetamines with other adulterants substances and
the remaining constitutes were amphetamines only”, but no previous researches were stated a fact of complete absence of amphetamine before the
current work.
In the current work, the researchers discovered two heavy
metals with toxic contaminated level in the investigated tablets.
The first one is Zinc, although Zinc is one of essential metal in the human
body, but its high toxic level inside human being induced many
serious toxic health problems as, stomach ache,
dermatitis, nausea and vomiting, anaemia,
pancreatic functions impairments, disturbance in
protein metabolism and atherosclerosis.
The second contaminated metal is Nickel; it is a highly
carcinogenic inducing metal with high a incidence rates of lung,
nose, mouth, larynx and prostatic cancer.
In the present research, we reported a multiple adulterants
material that were added to investigated tablets like, Caffeine,
Alluprinol, Theophylline and Paracetamol.
Regarding adulteration by Caffeine, Caffeine was detected in 96% of the
investigated tablets. Caffeine is characterized by several criteria as its
cheapness, stimulating effects, available and
augmented effect on the action of amphetamines.
Theophylline was detected in 93.9% of the investigated tablets,
the researchers suspect the reasons for adulteration by this
drug may be attributed to its availability, its usage to dilute the
concentration of manufactured amphetamines, its enhancement
excitatory effects and finally its usage to increase the amount of manufactured tablet.
Alluprinol was detected in 59.2% of the investigated tablets, the aim of its addition was same as the aim of addition of Theophylline , as to
dilute the concentration of amphetamine, to enhance its excitatory
effects and to increase its amount.
Acetaminophen was detected in 57.1% of the investigated tablet, its usage in adulteration process same to the previous reasons of
Theophylline, Alluprinol and Caffeine.
On Similarity with our results; most of reported studies stated the
presence of caffeine as a most common adulterating substance in
amphetamine black market manufacturing tablets.
Conclusion
In conclusion, from the previous mentioned results of the present
research; we can conclude the presence of multiple
adulterants substances in the investigated tablets may be
attributed to multiple purposes; 1- to accelerate the evaporating
process during amphetamine manufacture “as Caffaine”, 2- to enhance
the analgesic effects “as Paracetamol and Alluprinol”, or
finally 3- to exaggerate the stimulant effect of amphetamines “as
Theophylline”.
Conclusion
2- The presence of more than one adulterant substance
in the investigated group “2-7” indicate that black market amphetamine
tablet manufacturing in Saudi Society is very dangerous
manufacturing process with multiple hazardous health impacts.
Conclusion
3- All investigated tablets were black market manufactured
tablets that, simulating Captagon tablet but never
contain the same active principle of Captagon “Fenethylline”.
Conclusion
4- Absence of amphetamine in 12.8% of investigated tablets is
a very recent observing note regarding adulteration process of
amphetamines tablets with no previous researches were stated this fact.
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