Comment on Iranian crystal a misunderstanding of the crystal-meth

Abstract

• Dear Editor

I read with interest the study conducted by Karrari and colleagues regarding “Iranian crystal a misunderstanding of the crystal-meth” published in your journal.^[1] In this study, the authors have explained that the pattern of substances of abuse is varied in different parts of the world, also in Iran, and the main ingredient of street named drugs is different according to city or country, for example Crack is kind of cocaine, but in Iran is heroin that may also contain amphetamine, ecstasy, and/or corticosteroids with different amounts that make it even more harmful than pure heroin or any other drugs.

Two major points should be mentioned about this study; first, the appearance and physical characteristics of crystal and heroin or crack are completely different so it can be easily differentiated each other, but it must be remember in mind that these substances may be delivered as a mixture of different substances. Second, In order to find out the ingredients of a substance, especially an illicit drug, it seems relying on urine qualitative screening toxicological test, as the authors have mentioned, is not reasonable because of false positive or negative results, and it is recommended to sampling some kind of heroin that used or distributed in theirs society and then analyze for clarify or diagnose its ingredients. Again according to my own experience during years in point of management of poisoned patient and treatment of addicted man and in the present study, as the authors have themselves declared, heroin is a mixture of impurities and adulterants. Thanks for this interesting study.