Cocaine: Levamisole Adulteration

What is levamisole? 

Levamisole is an anti-parasitic drug currently approved for use in the U.S. by veterinarians. Its use with humans in the U.S. was discontinued in 2000 because of serious side-effects in some people. In September, 2009, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a public health alert about the risk that substantial levels of cocaine may be adulterated with levamisole.

How often is it found in cocaine?

Data from the Drug Enforcement Administration (DEA) and state testing labs indicate that the percentage of cocaine seizures containing levamisole has increased steadily since 2002. Levamisole was found in 30% of illicit cocaine samples analyzed by the DEA in October 2008 and 70% of the illicit cocaine analyzed in July 2009.

Urinalysis monitoring has also been used to identify the use of this drug as an adulterant. A recent analysis by the D.C. Pretrial Services Agency found that 45% of 75 randomly selected cocaine-positive specimens taken from the D.C. defendant/offender population were also positive for levamisole.

What are the health effects of levamisole ingestion?

Ingestion of levamisole can lead to agranulocytosis, a serious condition in which white blood cells are dramatically reduced and the body’s immune system is dangerously suppressed. The person is then vulnerable to rapidly developing life-threatening infections. There have been approximately 20 confirmed or probable cases of agranulocytosis, including two deaths, associated with cocaine adulterated with levamisole.  

What are the warning signs of agranulocytosis?

The warning signs are high fever, chills, weakness, swollen glands, painful anal or oral sores, thrush, skin infections and abscesses, and any infection that won’t go away or worsens quickly, including sore throat and pneumonia.

What should I do if I am experiencing these warning signs?

If you have used cocaine and are experiencing any of the above symptoms, seek medical help immediately. Brown students should call Health Services at 401.863-1330.

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Source: Center for Substance Abuse Research


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