Phenacetin: A Toxic Adulterant Found in Illicit Street Drugs

Phenacetin, a pain-relieving and fever-reducing drug, was discovered as an analgesic in 1887. It was one of the first synthetic fever reducers on the market and one of the first non-opioid analgesics without anti-inflammatory properties. Due to its hazardous side effects, including carcinogenic and kidney-damaging properties, the Food and Drug Administration (FDA) ordered its withdrawal from drug markets in 1983. Since being withdrawn phenacetin has become a common adulterant of illicit substances. In a 9-year longitudinal study of cocaine powders in the Netherlands, the percentage of samples containing phenacetin increased from 1.6 to 40.6 with a peak of 48% in 2006. Additionally, phenacetin was the most frequently identified adulterant in the samples.
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