Drug Policy

Don't Say 'Cheese'

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Dallas, where I live, is in the midst of a "cheese epidemic," which I guess I would have known sooner if I watched the local news or read the local paper. I looked into it after friends and neighbors mentioned that local kids were overdosing on a newly fashionable mixture of "heroin and Tylenol," which did not make sense to me. Why would you want to mix heroin with acetaminophen, and why would the combination be any deadlier than plain old heroin? It turns out that cheese, which first caught the attention of the national press and the DEA a year ago, is a combination of heroin and Tylenol PM, which includes diphenhydramine (Benadryl) as well as acetaminophen. Since Benadryl is a sedative, I gather, it has a less obvious diluting effect when added to heroin than a nonpsychoactive powder would. The result is a snortable mixture that sells for as little as $2 a dose (according to local news reports) and contains up to 8 percent heroin (according to the DEA). Based  on toxicology results indicating both heroin and diphenhydramine (sometimes confirmed by reports from friends, relatives, or police), 18 Dallas County teenagers are believed to have died from cheese overdoses since 2005.

Some of these teenagers had been drinking as well, so it might be more accurate to say they died as a result of the synergistic combination of an opiate and another depressant (which is often the case with deaths attributed to heroin). Adding diphenhydramine, yet another depressant that can be fatal on its own in large doses, presumably did not help. "I think people are ignoring that diphenhdyramine is a significant contributor," a pharmacologist told The Dallas Morning News. I'm not sure whether she means that heroin plus diphenhydramine is more dangerous than purer heroin would have been, or just that heroin plus diphenhydramine is more dangerous than heroin plus an inert ingredient. The Tylenol also seems to be a problem: One story refers to liver damage suffered by regular cheese snorters. (It's not clear what function the acetaminophen serves, aside from adding bulk. Why not use diphenhydramine alone?) As none of the alarming stories about cheese have bothered to note, the problem of potentially dangerous cutting agents is peculiar to the black market created by prohibition. Likewise the problem of unpredictable strength, which reportedly contributed to several of the deaths linked to cheese: Users did not know how much heroin they were snorting. 

A string of heroin overdose deaths in the Dallas suburb of Plano—some of which involved heroin mixed with diphenhydramine, supposedly today's "new deadly drug of choice"—led to a nationwide panic about dope-using teenagers in the late 1990s. This was a period when, according to the federal government's survey data, heroin use among teenagers was steady or falling. Before we follow the same script, it's worth noting that heroin use is even less common now than it was then.

NEXT: There Oughta Be a Law

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  1. It turns out that cheese…is a combination of heroin and Tylenol PM, which includes diphenhydramine (Benadryl) as well as acetaminophen.

    18 Dallas County teenagers are believed to have died from cheese overdoses since 2005.

    One story refers to liver damage suffered by regular cheese snorters.

    This is the most surreal goddamn thing I’ve ever seen.

  2. hier is where you purchase said cheese…

  3. Remember when people used to die from alcohol additives? Hey, how did we stop that?

    Oh, wait, I remember now. Something about “legalization.”

    Exit question: If it required a constitutional amendment to outlaw alcohol, how does it not require one to outlaw other drugs? And if the 4th Amendment allows one to terminate a viable human being if it’s inside you, how does it not allow one to ingest a drug?

  4. I snorted Parmesean once. A decent high, but the hangover’s a bitch. Good thing was, for weeks afterward I could garnish my salad with a good strong sneeze.

  5. How long before some do-gooder proposes requiring ID to purchase Tylenol PM, Benadryl, and everything else with diphenhydramine? ‘Cause, you know, that worked so well with meth…

    > And if the 4th Amendment allows one to terminate a viable human being if it’s inside you, how does it not allow one to ingest a drug?

    Great point. I’ve often wondered why “liberals” (Democrats) don’t get called out for this blatant hypocrisy. Even if the thing inside a woman is “just a fetus,” surely THAT is more valuable than a couple brain cells or whatever the comparatively minor effects of drug use are.

  6. For the love of god, this “epidemic” has killed less teenagers than the flu. Would someone allow natural selection to please take its course.

  7. This isn’t new. Ten years ago it was called Chiva. Plano, an affluent suburb north of Dallas, had a rash of Chiva ODs in the late 90s. The only difference is that now the Heroin cut with Tylenol PM instead of cold pills. Dealers have been stretching their supply like this for years.

  8. This is nothing new. Dealers have been selling heroin cut with acetomimphen, with an 8% heroin content, for thirty years.

    All that’s changed is the name. Whereas it’s now called “cheese,” back then it was called “heroin.”

    Remember the spike in overdoses in the early 90s?

  9. When I was a psychotic teen living in Germany, I would regularly smoke opiate-laced hash and then have a beer.
    It took me a while to put it together that these tended to be the times that I suddenly found myself waking up face down in the grass.

  10. “gather, it has a less obvious diluting effect when added to heroin than a nonpsychoactive powder would. The result is a snortable mixture that sells for as little as $2 a dose (according to local news reports)”

    I love the local news. It is like a guide to being a reprobate. You want to know where to find a street walker? Just watch the 11 o’clock news and they will no doubt tell you just what part of town has them and what nights the cops are running a vice sting. Need to know the latest and greatest street drug is and where it is sold? The local news has you covered.

  11. I’ve gained about twenty pounds since I started snorting cheese.

  12. Some of these teenagers had been drinking as well,

    That explains the liver damage, alcohol and acetaminophen.

  13. Anyone remember Bongwater Taffy. It was a brilliant marketing bit by a lousy band. They managed to trick some local news outlets into reporting that Bongwater Taffy was the new drug menace amongst our youth. Several national outlets picked up the story before they figured out it was a hoax.

    We should come up with a fake drug menace. I vote for – Shoelace.

  14. Why in the name of Urkobold is called “cheese?” I’ve heard some stupid drug name before but this takes the cake. (Cheesecake of course, which is actually a form of custard pie.)

  15. I have no idea about what synergistic toxicity heroin and Benadryl have together, but acetaminophen and heavy alcohol consumption have been contraindicated for a long time. Google for more info, although this Straight Dope article covers the basics.

    High doses of benadryl by itself have some psychoactive effect. (increased ARCI scores for sedation and dysphoria, with noted side effects restlessness, agitation, irritability, and vomiting) (Preston KL, Wolf B, Guarino JJ, Griffiths RR: Subjective and behavioral effects of diphenhydramine, lorazepam and methocarbamol: Evaluation of abuse liability. J Pharmacol Exp Ther 1992; 262:707-20).

    A review paper claims few cases of diphenhydramine abuse in the literature, probably due to the side effects. (Anesthesiology:Volume 90(1)January 1999pp 269-288 Psychotropic Drugs Used in Anesthesia Practice: Abuse Liability and Epidemiology of Abuse, Zacny, J.P; Galinkin, J. L.)

    Erowid claims FWIW that large doses are often accompanied by hallucinations and dissociation.

    It all seems rather ghetto and ultimately Darwinian to me, like pounding cough syrup, nutmeg, or huffing inhalents. I can understand it, vaguely, if you’re stuck in prison and can’t get anything else but these are kids on the outside. Crap like this is supposed to be a better high than just smoking a bowl?

  16. This really grates on my nerves. Are we going to keep standing for this curdling of our rights? I’m sure they’ll milk this one for all it’s worth.

  17. Gray Ghost,

    Diphenhydramine is considered, at least colloquially in medicine, to potentiate the pain relieving/euphoric effects of opiates. I’ve seen no real research in the area, but histamine does play a role in pain perception, and perhaps blocking its function in the brain could be linked to opiate effects in some manner. Drug seekers are aware of this, and frequently request Benadryl for “allergies” to go along with their narcotics. In the ED, these requests are a good mark of a professional user. Probably a similar situation is emerging on the street where Benadryl can be used to make more effect out of less drug.

  18. “Why in the name of Urkobold is called “cheese?” I’ve heard some stupid drug name before but this takes the cake. (Cheesecake of course, which is actually a form of custard pie.)”

    Cheese is black slang for anything that has value. And blacks make up all the street drug slang.

  19. All this cheese is gonna make me cry
    Gorgonzola, Provolone
    Don’t even get me started on this microphone

  20. During the late nineties, when Plano was in heroin crisis mode, the problem was “chiva”, or black tar heroin. I’ve heard the name “cheese” comes from “chiva”.

  21. TallDave:

    If it required a constitutional amendment to outlaw alcohol, how does it not require one to outlaw other drugs?

    The answer is in the ruling the SCOTUS made regarding the post-alcohol prohibition case of Wickard V. Filburn. In short, the SCOTUS determined that even if an item is not moved over state lines, it’s very existence affects the price of said item in other states and therefore falls within the jurisdiction of the Commerce Clause and under the purview of Congress. It’s totally bullshit and basically gave Congress the ability to regulate any damn thing it wants.

  22. James Capp,

    I thought the answer would be funnier than that. Oh, well. Shine on, suburban wiggers, shine on.

  23. Once again, the panic mongering fallout from the WOsD can be answered with the single word; Alcohol.

  24. When my get up and go has got up and went
    I hanker for a hunk of cheese

  25. There has to be some way of bringing Cheez Whiz into this.

    I got nothin’.

    I did snort sondium nitrate by accident once (it was in science class in jr. high…heh heh… he said high). Burned like a bitch.

    So, we’ll be buying our Tylenol PM at the pharmacy counter now, once we show ID? It’s just a matter of time before the cheese craze supplants the meth craze in poilice chiefs’ budgets.

  26. “James Capp,

    I thought the answer would be funnier than that. Oh, well. Shine on, suburban wiggers, shine on.”

    The pupose was to educate, not make you laugh.

    PS Yes I’m white, but have lived in the inner-city working with at-risk youth for decades. But I guess to you, the white part is all that really matters.

  27. Hey man, anybody got some cheddar?

    Got to be sharp, man. Extra sharp.

  28. I got yer cheddar right here muthafucker! If you really want something that’ll rock you, I got Gouda.

    Ah, don’t be like that!! Come on man, havarti.

  29. Chiva is black tar cut with OTC cold medicine. Same stuff as cheese.

    The problem is, there are only so many drugs. You can only get so many grants to fight coke, pot, amphetamines and heroin. So you make up new names. Ice, Cheese, Meth, Boat, Chiva – each new name is a new revenue stream.

    Drug war math:

    Old Panic + New Name = Shiny New Armored Assault Vehicle

  30. Stevo, Kwix. sigh.

    There is no cheddar. Not much call for it around here.

    James Capp’s mind reading show is obviously a hobby then.

  31. The pupose was to educate, not make you laugh.

    PS Yes I’m white, but have lived in the inner-city working with at-risk youth for decades. But I guess to you, the white part is all that really matters.

    HUMORLESS COMMENT OF THE DAY

  32. The pupose was to educate, not make you laugh.

    PS Yes I’m white, but have lived in the inner-city working with at-risk youth for decades. But I guess to you, the white part is all that really matters.

    HUMORLESS COMMENT OF THE DAY

    and the Maalox moment of the month.

    mein Gott.

  33. “James Capp’s mind reading show is obviously a hobby then.”

    What does that mean? Please enlighten me. Thanks in advance of your efforts.

  34. Addendum:

    “HUMORLESS COMMENT OF THE DAY”

    Oh I get it. This is a board for comedians. My mistake.

  35. Well, duh – what else would you expect from a magazine called reason?

  36. OO====D

  37. Man, you people are so funny, NOT!
    James Capp is a saint. He’s white (which is verrryy important to us) and he’s worked with inner-city at-risk youths.

    Wait a minute! What do you do to the inner-city at-risk adults, James? Are you too good for them? What about the ones that are no longer at-risk, but are full blown risks?

    James,
    Lighten up. You’ll live longer.
    Or don’t. It’s your life.

  38. Because it’s an illicit market, some kids are probably also getting ripped off and being sold cheese food.


  39. PS Yes I’m white, but have lived in the inner-city working with at-risk youth for decades. But I guess to you, the white part is all that really matters.

    Jeez, I didn’t mean to make you cry.

    (And the comment was directed at the white kids in Dallas using an appropriated term from black culture. Everything’s not about you, you know.)

  40. James Capp,

    Get over yourself. You are being an asshole.

  41. This isn’t new. Ten years ago it was called Chiva. Plano, an affluent suburb north of Dallas, had a rash of Chiva ODs in the late 90s.

    Ya don’t say Matt J… I suppose that just might be why Jacob Sullum mentioned exactly that in his post.

    A string of heroin overdose deaths in the Dallas suburb of Plano-some of which involved heroin mixed with diphenhydramine, supposedly today’s “new deadly drug of choice”-led to a nationwide panic about dope-using teenagers in the late 1990s.

    Funny how many comments have come to appear as the standard boilerplate of H&R, as if saved on some “canned comment” list like frequently used text messages that you just don’t want to waste time retyping. The “this is nothing new” one must be awfully near the top of that list, given its ubiquitous appearance. Even funnier, though, when the post actually bothers to detail the “not newness” of itself and it still sends people scurrying to punch up their favorite “Mad Lib” comment and start filling in the blanks.

    Let me save someone from the trouble of digging through their list of favorite clich?d comment by doing it for them: “What? A few teenagers experimenting with drugs occasionally overdose and die? I’m shocked, SHOCKED!”

  42. If you really want something that’ll rock you, I got Gouda.

    “Are you sure it’s Gouda?”

    “Of course it’s good-a. I just bought-a it this morning.”

    From the old TV show Barney Miller. The episode where Harris makes a porno movie as part of an undercover scheme.

  43. From the old TV show Barney Miller. The episode where Harris makes a porno movie as part of an undercover scheme.

    My favorite part in the scene is the blind guy watching it with them. “What’s happening? What are they doing now?”

    Damn, I miss that show.

  44. I’m the Pusher! The Pusher!
    I push raisins on kids, and kids think it’s cool,
    ’cause they’re told not to do it by their parents and school.
    I’m the Pusher! I’m the Pusher!
    I become alluring with bans and boycotts.
    First they’ll smoke raisins, then they’ll shoot up apricots.
    I know you can’t resist me!
    Do you want to smoke some fruit?
    Check out my sweet-ass matching pantsuit.
    I’m bad-ass, low-class the Pusher!
    I’m the booty-lickin’, taco-stickin’ Pusher!
    Kids think that drugs are cool,
    that is why I rule.
    I provoke simple folk so they’ll smoke.
    Have a toke, get your foot off my cloak.
    Joan: Oop, sorry.
    I’m the sky-high, have-a-try Pusher!
    I’m the smoke-screen, have-a-dream Pusher!
    I’m the booty-pokin, raisin smokin’ Pusher!
    And in summary…. I’m the Pusher.

  45. Barney Miller? Hell, yeah!

    My favorite was, of course, the episode where Wojo’s girlfriend bakes them brownies.

    Isn’t it still syndicated?

  46. Isn’t it still syndicated?

    Yeah, but I can never find it. All TV Land shows is Andy Griffith and Gunsmoke.

    What I always thought was unusual about Barney Miller is that it started out not-so-funny and grew to be heelarious. It took a while for Abe Vigoda to get his Fish on. Half of the comedy was from the recurring characters that were the criminals.

    Usually, it’s the other way around **cough cough*** M*A*S*H, Happy Days **chough cough**

    Could it be said that Barney never jumped the shark? I know they had a couple “special” eps, but I can’t think of a particular moment that would qualify as jumping. Almost the reverse; when Gregory Sierra was replaced, that’s when it really started to click.

    Heck, Ron Glass playing Sheperd Book is only one more reason to retroactively love Barney Miller.

  47. Speaking of great (or at least enjoyable) TV shows, has it been mentioned here that WKRP was just released (or the announcement regarding pending release was made) on DVD, albeit with generic “rock” music replacing the songs originally used?

  48. Scary stuff. I’ve been following this story and the growing death toll. I’ve heard both that it’s a mixture of heroin and meth and heroin and Tylenol PM, but it’s usually reported as being Tylenol.

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