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Penn Lupovich, MD; Robert Pilewski, MD; Joseph D. Sapira, MD; Roger Juselius, PhD
University of Pittsburgh

JAMA. 1970;212(7):1216.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Quinine is an alkaloid which depresses myocardial excitability. Originally popularized for treatment of certain cardiac arrhythmias by Wenkebach, it was later replaced by its D-isomer, quinidine. However, at the present time quinine is often used for adulterating heroin. In this regard, it is superior to the other common adulterant, lactose, for two reasons: (1) Quinine's bitter taste, by mimicking the bitter taste of heroin itself, makes it impossible for an addict to assay the degree of adulteration. (2) When injected intravenously, quinine causes a vasodilation which mimics certain vascular effects of heroin sufficiently to help confound the naive purchaser. Thus, many addicts are currently intravenously injecting themselves with relatively large amounts of quinine. We have seen two patients in which this practice appears to have caused a clinically apparent depression of myocardial excitability.

Report of Cases.—CASE 1.—

A 22-year-old Negro man was brought to Presbyterian-University . . . [Full Text PDF of this Article]

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