Public Alert from Fredric Rieders Family Foundation: Phenacetin

PUBLIC HEALTH ALERT

The Fredric Rieders Family Foundation (FRFF) in conjunction with the Colombo Plan would like to notify you about phenacetin, a toxic adulterant identified in illicit street drug products. Their new Public Alert details the dangers associated with phenacetin consumption which can have serious health implications, as well as recommendations for their collaborative communities. The Colombo Plan has created the International Toxic Adulterant Database (ITAD) which is managed by the FRFF. ITAD allows monitoring of the spread and prevalence of toxic adulterating substances in the drug supply internationally. Phenacetin was commonly identified in samples containing cocaine, but also in cases with heroin and/or fentanyl. Data collected from 10 states over four years show that phenacetin was used as an adulterant. Detection increased in frequency over time.

Substance abuse treatment providers, clinicians, outreach workers, and public health clinics should be aware of the following information. Phenacetin is commonly used as an adulterant in illicit drug products, most often in cocaine exhibits, but has also been identified in samples containing heroin and/or fentanyl or multicomponent seized material products. The addition of phenacetin to illicit drugs may be due to it’s minor euphoric effects, influence on some side-effects of cocaine due to its analgesic action, or to disguise the bitter taste of cocaine without compromising the physical properties of the product – both have similar melting points. Phenacetin is a known carcinogen and has associated adverse effects on cardiovascular, renal and urologic systems. Exposure to phenacetin is associated with nephrotoxicity, nephropathy, hemolytic anemia, methemoglobinemia, and kidney and bladder cancer. Read more HERE.

According to New England HIDTA, Phenacetin is a pain-relieving and fever-reducing drug with hazardous side effects, including carcinogenic and kidney-damaging properties. This led the FDA to order its withdrawal from the drug market. Phenacetin has most commonly been found as an active cut in cocaine, but cases have also been identified with heroin and/or fentanyl. There has been identified cases in both New Hampshire (120 phenacetin positives) and Vermont (116 phenacetin positives). Here in Massachusetts, the Massachusetts Drug Supply Data Stream (MADDS) program has confirmed 29 samples being sold as cocaine contained phenacetin from June 2020- February 2021. Healthcare providers working with people who use cocaine might consider increased monitoring of kidney and liver function. Learn more HERE.

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