A yellow powder sample expected to contain oxycodone was instead found to contain caffeine, chloroquine, ketamine, 6-MAM, acetylcodeine and heroin. No oxycodone was detected.

Effects

This combination in a single sample could be particularly unpredictable, with an increased risk of overdose:

Heroin & ketamine are both sedating. Heroin’s a depressant that suppresses breathing and ketamine can increase sedation and dissociation. Together, they significantly increase the risk of airway compromise/respiratory depression.

Caffeine can temporarily mask sedation from heroin, leading to redosing – this can result in a delayrd overdose once stimulant effects wear off.

Chloroquine is a medication mainly used to prevent and treat malaria. Larger doses can effect how the body handles potassium and affect the heart’s electrical activity.

If someone was expecting oxycodone, they may take a larger amount or redose, increasing their risk of harm.

Reducing the Harm

Test your stuff! This sample shows you can’t always tell what’s in your drugs just by looking at them, and you can’t always rely on what you’ve been told being accurate. A global trend is that unregulated or counterfeit pharmaceuticals are becoming more common. In cases like this sample, there are several different unexpected substances in a single sample – drastically raising the risk for users.

Keep naloxone on hand. While it only reverses opioid overdoses (like from heroin), there’s no risk of harm using naloxone when other drugs like ketamine or chloroquine have been used.

Don’t mix it with alcohol or other depressants.

Start low, go slow. Try a test dose first and never use alone.

Be alert for signs of an overdose. Think someone has overdose? Call 000 for an ambulance immediately.