Because of an adulterant now commonly found in Cocaine called levamisole, a veterinary chemical no longer approved for human consumption, users run the risk of levamisole toxicity, which can cause plaque on the skin and even kill epidermis.

Citation:   Erowid Crew. “Cocaine Adulterated with Levamisole on the Rise: Status as of September 2009” Oct 1, 2009. has long been a practice, particularly among street-level dealers, to “cut” cocaine with diluents in order to increase profits. In the past, cuts have commonly been fairly innocuous materials, such as lactose, mannitol, or niacinamide, chosen because they match the appearance of cocaine, or chemicals such as benzocaine, lidocaine, or procaine, chosen because they cause a localized numbing effect similar to that produced by cocaine. However, in recent years there has been an upsurge in the use of more pharmacologically active chemicals as cocaine adulterants, including compounds such as acetaminophen, atropine, caffeine, hydroxyzine, methylephedrine, diltiazem, methylphenidate (Ritalin), and phenacetin.[DEA microgram 2004] [Vroegop 2009] [Elias 2007] One of the more concerning adulterants that has become increasingly prevalent over the last few years is levamisole, a pharmaceutical veterinary dewormer and a research immunomodulator.

Levamisole is Not New

Although levamisole has been a known adulterant in cocaine since at least 2002,[SAMHSA 2009] on September 21, 2009, the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) made the surprising announcement that levamisole had been found in “over 70 percent of the illicit cocaine analyzed [by the DEA] in July. In addition, a recent analysis in Seattle, Washington found that almost 80 percent of the individuals who test positive for cocaine also test positive for levamisole.”[SAMHSA 2009]

Following the SAMHSA alert, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) also sent out an email alert, which claimed that levamisole was found in over 50% of cocaine samples tested in the United Kingdom and the Netherlands during a period in 2009.[Ventura 2009] Previous reports by the DEA and testing conducted by a number of other organizations had shown levamisole present in cocaine, but in a much smaller percentage of tested samples than reported by the DEA in August/September 2009. For example, in October 2008, the DEA reported detecting levamisole in 30% of the bricks of cocaine that they analyzed,[DEA Microgram Oct 2008] and Health Canada reported 11% of cocaine samples from April to December 2008 were contaminated with levamisole.[Zhu 2009]

Levamisole Media Blitz

Beginning in late August 2009, a surge of media stories warned about negative health effects and deaths associated with levamisole as a cocaine adulterant, with Google News showing 606 stories in September alone. The death of a popular DJ and Los Angeles club owner, Adam Goldstein “DJ AM”, in late August kept the issue in the news because autopsy-related forensic toxicology results included levamisole among a long list of other drugs detected.

Levamisole Health Risks

As a cocaine adulterant, levamisole is dangerous primarily because it suppresses the immune system of those who are exposed to it. It is also possible that levamisole interacts with cocaine’s stimulant effects and increases acute cardiovascular toxicity, though this is still speculation based on levamisole metabolites (such as aminorex) that have been found to occur in horses. Such metabolites have not been confirmed in humans.

Though it has been used therapeutically in humans for decades, levamisole can cause agranulocytosis (acute neutropenia), a blood disorder characterized by the disappearance of certain types of white blood cells necessary for the proper functioning of the immune system. Agranulocytosis/neutropenia can result in a wide range of problems associated with a weakened immune system including infections throughout the body, high fever, chills, swollen glands, painful sores, and wounds that don’t heal. Left untreated, the condition can result in death. Agranulocytosis can be treated if detected and diagnosed properly.

Because the symptoms of agranulocytosis can be so wide-ranging, because it is an unusual condition, and because levamisole contamination of cocaine is a relatively new problem, it is essential that those seeking medical care for a condition like high fever be honest with their health care providers about the illicit substances they have taken, in order to improve their chances of being diagnosed properly and recovering quickly.

It is likely that people whose immune systems are already compromised by disease or genetic background are more susceptible to the risk of agranulocytosis from levamisole exposure.

As well summarized by Erowid, levamisole, in addition to damaging human skin, also leaves humans succeptible to Agranulocytosis or acute neutropenia, a blood disorder which reduces white blood cell count and harms the human immune system.  Please read the above information closely, especially if you are a cocaine user.

Though this problem has been known to the scientific community for a little while, the story was widely publicized in today’s New York Daily News.

On the disease Agranulocytosis resulting from levamisole, Medscape said the following in September of last year:

September 24, 2009 — Levamisole used as an adulterant in cocaine has resulted in 20 confirmed or probable cases of agranulocytosis, including 2 deaths, according to an alert from the Substance Abuse and Mental Health Services Administration (SAMHSA).

According to the SAMHSA alert, US Drug Enforcement Administration and state testing laboratories report that more than 70% of the illicit cocaine analyzed in July 2009 was positive for levamisole, an antiparasitic drug used by veterinarians to treat worm infestations. This represents an increase over previous reports indicating that levamisole contaminated only 30% of cocaine seized by the Drug Enforcement Agency from July to September 2008. Furthermore, a recent analysis found that almost 80% of the individuals who test positive for cocaine also test positive for levamisole.

Here’s our take on this disturbing news: cocaine users need to seriously worry about this development, especially if they don’t have access to “chip off the block” charlie, which is obviously not adulterated.  Anyone buying cocaine that is completely broken down to powder, and people in rural areas, or those far from points of entry such as port cities, are almost sure to be ingesting cocaine cut with levamisole or similar adulterants. does offer cocaine testing kits, and since levamisole passes through the body very quickly on intake, blood or urine tests will be less effective in detecting levamisole than if they tested their cocaine prior to ingestion.

Cokeheads are warned.

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