Analysis of adulterants from cocaine preparations in lung tissue and blood

Aims: The purity of street cocaine preparations, which are incorporated by a drug consumer, may differ considerably. Cocaine may be adulterated with a various number of pharmacologically active compounds, such as lidocaine or levamisole. Adverse side effects or lethal complications may occur if cocaine is found to contain these substances (adulterants). We examined lung tissue und blood for some typically adulterants founds in cocaine preparations and checked whether there are concentration differences in these specimens. Methods: The adulterants were quantified by high-performance-liquid-chromatography-time-of-flight-mass spectrometry (LC/TOF-MS) after isolation from the matrices using solid-phase (SPE) and liquid-liquid extraction (LLE). Results and Discussion: Phenacetin, lidocaine, diltiazem, levamisole and hydroxyzine could be found in blood and lung tissue. Levamisole could be detected in all samples. The concentrations of these substances were often higher in the lung tissue than in the correspondent body fluids. Post-mortem redistribution of the adulterants could be demonstrated. Conclusion: Phenacetin, lidocaine, diltiazem, levamisole and hydroxyzine accumulate in the lung and may be redistributed after death into the blood. For the interpretation of drug related deaths, adulterants of drug preparations should be taken into account in addition to the drug itself.