Cheese is a recreational drug that surfaced in the United States in 2006. It is formed by combining heroin and crushed over-the-counter common cold medication (such as Tylenol PM). The cold medication includes acetaminophen (Tylenol) and diphenhydramine (Benadryl), an antihistamine. http://www.mysanantonio.com/news/metro/stories/MYSA050406.heroin.KENS.90a1956.html Since it is snorted instead of injecting it, it is more tempting for an inexperienced drug user such as a teenager to start usage of the drug because most people are afraid of using needles. One tenth of a gram, which is one "hit", costs two United States dollars http://www.khou.com/news/local/stories/khou060505_jj_cheese.113605e0.html on the black market. One quarter gram costs $5 . The heroin in cheese is a highly addictive substance. Once a person is physically addicted, withdrawal symptoms may appear 12 hours after the last dose of the drug.

The drug made many local news headlines when it appeared in several public middle and high schools in Dallas, Texas. One 18-year old Dallas woman died from inhaling cheese and drinking alcohol. Some police agencies and the Dallas Independent School District dubbed the mixture "starter heroin." http://www.wthr.com/Global/story.asp?S=4863444&nav=9Tai

The acetaminophen from the tylenol tablets can be highly poisonous once a "cheese" (or other forms of heroin) user has reached a certain level of tolerance, so if an addicted user tries to satisfy his heroin need with big enough amounts of "cheese" he will eventually suffer liver failure. Similarly, there are hydrocodone tablets that have a certain maximum amount of hydrocodone in combination with a certain minimum amount of acetaminophen that are designed this way to prevent abuse. If an addict is in withdrawal and has only those hydrocodone/acetaminophen tablets available, he will use as many as he may deem appropriate, but the massive amount of acetaminophen is, either acutely in large amounts, but, too, in much lower (therapeutic) doses (if taken over a long time), overburdening the liver and thus may lead to its failure which triggers a life-threatening condition.

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