What Is Heroin Cut With?

2 min read · 3 sections
Evidence-Based Care
Expert Staff

Heroin is known as a powerful and illegal street drug and opiate, derived from morphine.

As a Schedule I substance, it has no medical use, and it is only available through illicit black markets. Because of this, nobody even really knows what they will get in a substance marketed as heroin.

This drug can easily be “cut” with a variety of difference substances. This means that drug dealers will add other drugs or non-intoxicating substances to the drug so they can sell more of it at a lesser expense to themselves.

Because heroin typically comes in a white powder, clear solution, or black tar-like substance, it’s easy to hide substances of a similar appearance to the drug and pass it off as pure. This practice is so widespread that it’s expected that no heroin found on the streets is actually pure. Heroin can be anywhere between 3 and 99 percent pure, making the effects of any batch highly unpredictable.1

Common Cutting Agents

Common substances that heroin may be cut with include:

  • Baking soda
  • Sucrose (sugar)
  • Starch
  • Crushed over-the-counter painkillers
  • Talcum powder
  • Powdered milk
  • Laundry detergent
  • Caffeine
  • Rat poison

Depending on what adulterants are used, the practice of cutting opioids (adding other substances to increase the volume of the product) may increase the danger of opioid use by any route of administration.3 

For example, heroin and counterfeit opioid pills are often cut with fentanyl because fentanyl is cheap to produce.3 And because fentanyl is so potent, it makes these drugs even more addictive and dangerous. Synthetic opioids like fentanyl are the primary driver of fatal overdose in the U.S.4

Opioid overdose involves severe depression of the respiratory system and other essential bodily functions as this class of drug depresses the entire central nervous system. This can cause a user to begin to breath very slowly or take very shallow breaths to the point that not enough oxygen can reach the brain. This leads to rapid cell death, coma, and brain damage.

Heroin overdose symptoms can include:

  • Disorientation
  • Slow or shallow breathing
  • No breathing
  • Snoring or gurgling sounds
  • No response to stimuli
  • Unconsciousness
  • Floppy arms and legs
  • Blue lips or fingernails

An opioid overdose is very dangerous, but with quick medical intervention, most people can be saved.


Call 9-1-1 if you see an individual showing signs of heroin overdose and administer naloxone if it is available.

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