nalysis of Captagon Tablets in Saudi Arabia A Maha Al-Mazroua

Head of Dammam Regional Poison Control Center

Eastern Region – Ministry of Health -KSA

ntroduction

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.

im of the work

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?

esults

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

Types & Frequency of Contaminated Heavy Metals in Investigated Tablets

1%

14%

Nickel Zinc

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

Types and Percentages of Investigated Plant Samples

Cannabis Sativa

46%

Catha Edulis

54%

Results

Active Ingredient Percentage in Investigated Plant Samples

CathioneCathine

87.5%

100.0%

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

isccusion

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.

onclusion

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.