SMOKINCHOICES (and other musings)

September 2, 2009

Fatal Spiked Cocaine in use

Spiked cocaine has killed 3;

(. . . . . most doctors unaware of it)

By Jon Gambrell

LITTLE ROCK, Ark. — Nearly a third of all cocaine seized in the United States is laced with a dangerous veterinary medicine: a livestock deworming drug that might enhance cocaine’s effects but has been blamed in at least three deaths and scores of serious illnesses.   The medication is called levamisole has killed at least three people in the U.S. and Canada and sickened more than 100 others. It can be used in humans to treat colorectal cancer, but it severely weakens the body’s immune system, leaving patients vulnerable to fatal infections.

Scientific studies suggest that levamisole might give cocaine a more-intense high, possibly by increasing levels of dopamine, the brain’s “feel-good” neurotransmitters.

Drug Enforcement Administration documents indicate that 30 percent of all U.S. cocaine seizures are tainted with the drug. And health officials said that most physicians know virtually nothing about its risks. “I would think it would be fair to say the vast majority of doctors in the United States have no idea this is going on,” said Eric Lavonas, assistant director of the Rocky Mountain Poison and Drug Center in Denver, where as much as half of the cocaine is thought to contain levami
sole. “You can’t diagnose a disease you’ve never heard of.”

Authorities think cocaine manufacturers are adding the levamisole in Colombia, before the cocaine is smug
gled into the U.S. and Canada to be sold as white powder or crack.   Economic pressures might play a role. Decreased supply in the U.S. has raised cocaine prices and lowered streetlevel purity. Cocaine traffickers might think levamisole adds an extra boost to an otherwise weakened product.

The medication started showing up frequently in cocaine from Colombia in January 2008. By late last year, the DEA concluded that the spiked cocaine was in wide circulation.   Hospitals across the country began noticing cocaine users coming in with agranulocytosis, an illness that suppresses white blood cells, which fight off infections.

In Spokane, Wash., a woman in her mid-40s who tested positive for cocaine turned up at a hospital suffering from rashes and other maladies. She eventually died, and the doctor who investigated suspected she had used cocaine laced with levamisole. Doctors also suspect levamisole in at least three other illnesses in the Spokane area.   “It’s hard to know where this contamination (is), in what part of the country it’s located, because there’s really no systematic testing for it,” said Dr. Joel McCullough, health officer for the Spokane area.

Other deaths suspected of links to levamisole occurred in New Mexico and in Alberta, Canada.

Many other people have become gravely ill, including about a dozen patients in Denver and 10 more in Seattle. At least one patient in each city required intensive care or extensive surgery.

In a study published in the Annals of Internal Medicine, researchers suggested that the medication might increase dopamine in the brain, as it has in previous animal experiments.   Levamisole “elevates opiate levels in various brain regions, like codeine and morphine,” said Don LeGatt, a clinical toxicologist at the University of Alberta who has studied levamisole in cocaine. “Once you get those elevated, people tend to feel fairly comfortable and not
too bad.”   LeGatt said doctors should consider levamisole exposure in cases where otherwisehealthy adults or newborns get infections because of low white-blood-cell counts. But levamisole appears in urine for only a few days after exposure, meaning that tests should be performed as soon as possible.


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