Biesa and shado drugsPowders sold as cheap heroin: what do we know about them, and why does their unknown composition make them more dangerous?

13What is biesa?

“This is biesa, cheaper than heroin and does the same thing.” This is how the powder is often presented to someone trying it for the first time. But no one knows exactly what is in these bags, neither the person selling them nor the person buying them, and that alone is reason enough to consider them among the most dangerous things sold on the street.

Biesa is a widespread street name in Egypt for a powder sold as cheap heroin or “second grade.” The name does not refer to a specific chemical you could look up in a medical reference, but to a commercial product in the illicit market whose contents change from one seller to another and from one time to another. So it should be treated as an unknown substance that may contain an opioid in an unknown proportion along with other unknown substances.

14What is shado?

Shado is a street name that does not point to a single substance, and the available sources do not agree on what it means. Some treatment centers describe it as a powder sold as a cheap type of heroin or “powder” and use it interchangeably with biesa, while others describe it as a mix based on Strox or hashish, and some link it to powder drug. In an incident reported by Telegraph Misr, Maadi-area (Al-Maasara) detectives in Cairo seized a factory making “shado” and “Strox” together; the information indicated that its owner sold both to heroin dealers, and heroin was also found in his possession. The bottom line is that the composition of shado is unknown and there are no published analyses of it in Egypt; it may contain an opioid, synthetic cannabis or both, along with other substances, and there is no evidence that it is any “cleaner” than the others.

15Why are biesa and shado sold at a lower price?

Cheapness in the drug market usually has one explanation: a lower proportion of the active substance and a higher proportion of additives. The UK’s FRANK service notes that heroin is often cut with sugar, starch, powdered milk, quinine and paracetamol because they add weight and profit. The problem is that these “cheap additives” are not the whole story; something that strengthens the effect or masks its weakness may be added to the mix, and that is where the real danger begins.

16What is street heroin cut with?

There are no published studies on the composition of biesa or shado in Egypt, but studies from other countries give a picture of street heroin in general:

• In a Danish study that analyzed 676 samples of street heroin between 2006 and 2024, the median heroin purity was only about 22%, and caffeine was found in 87.8% of samples and paracetamol in 71.4%.
• FRANK warns that some drugs are mixed with very potent synthetic opioids such as fentanyls and nitazenes, and that heroin may be cut with sedatives from the benzodiazepine and barbiturate groups.
• In a 2021 case report from India, analysis of an unknown substance that a patient had mixed with heroin revealed high concentrations of benzodiazepines and barbiturates alongside caffeine and paracetamol, and he developed sudden sedation, weakness, unsteadiness and slurred speech.

17How do biesa and shado affect the brain and body?

As long as the powder contains heroin, it acts like heroin. The US National Institute on Drug Abuse (NIDA) explains that in the brain heroin is converted to morphine, which binds quickly to opioid receptors, causing a “rush” of pleasure with warm skin, dry mouth and heavy limbs, and possibly nausea, vomiting and severe itching. Then comes drowsiness lasting for hours, clouded thinking, a slow heart rate, and slowed breathing that can be life-threatening and lead to coma and permanent brain damage.

The unknown substances add symptoms you would not expect: sedatives increase drowsiness, slurred speech and unsteadiness, stronger opioids raise the risk of breathing stopping, and repeated paracetamol in unknown amounts is an added burden on the liver.

18Biesa and shado compared with heroin and pharmaceutical opioids

Pharmaceutical opioids such as tramadol are not safe outside a prescription either, but the difference is that a person who uses biesa does not even know what they are taking.

19Why do young people fall into the biesa and shado trap?

• The belief that they are “milder” than heroin and will not cause addiction, when there is no evidence of that.
• The low price, which makes trying and repeating easier.
• The assumption that smoking or sniffing instead of injecting makes them safe, even though addiction and overdose happen with every route.
• Using them to ease withdrawal from another opioid such as tramadol, which starts a new cycle.

20The legal status of biesa and shado in Egypt

Biesa and shado are not legal names, but what is sold under them is generally assumed to be heroin, and in the case of shado it may be synthetic cannabis; both are prohibited. Heroin is completely prohibited in Egypt and is listed in Schedule 1 attached to Law No. 182 of 1960 on drug control, with no permitted medical use. The Fund for Drug Control and Treatment of Addiction offers free, confidential treatment through hotline 16023, and seeking treatment is a healthy step that fear should not prevent.

This is general educational information and not legal advice.

21Street heroin in numbers

Source: Hesse et al., study of street heroin purity and additives in Denmark 2006–2024, Forensic Science International. No comparable published figures are available for Egypt.

22Biesa and heroin: where to find the details?

Because biesa is sold as heroin, and shado often is too, their harms, symptoms and treatment are close to what the heroin guide explains, with an added risk from unknown substances (and if what the person used was a mix based on synthetic cannabis, the Strox guide is the closer match):

• Harms: from the heart, lungs and liver to infections from injecting, in harms of heroin.
• Signs: what a family may notice, such as drowsiness, small pupils and behavior changes, in symptoms of heroin addiction and signs of use.
• Withdrawal: when it starts and how long it lasts, day by day, in heroin withdrawal symptoms.
• Treatment: detox, approved medications and rehabilitation, in heroin addiction treatment.
• Testing: how long it stays in urine, blood and hair, in how long heroin stays in the body.
• Causes: why addiction happens so quickly, in causes of heroin addiction.

Among the medicines a doctor may decide on is buprenorphine, with hepatitis virus testing for anyone who injected, and closer monitoring of withdrawal if the mix may have contained sedatives.

23Biesa and Shado Guide: Everything You Need to Know

We have gathered everything about biesa and shado into 6 pages, each answering one question in detail. Choose what you are looking for:

24Found out your son uses biesa or shado? Start here

1. Stay calm, and do not start the conversation while he is under the influence or very drowsy.
2. Learn the signs of overdose and save the ambulance number, 123; they matter more than any discussion.
3. Do not assume it is “milder” than heroin; treat it with the same seriousness.
4. Avoid threats and punishment alone, and use the guide to convincing a person with addiction to accept treatment.
5. Seek a specialist assessment; detox may need a residential program if the mix is unknown or relapses have recurred, with the family program to support you.