The Mystery of the Tainted Cocaine
What's a drug used to deworm livestock—a drug that can obliterate your immune system—doing in your cocaine? Nobody knows.
by Brendan Kiley
A granulocytosis can kill you, but its symptoms are frustratingly broad. Some people's throats close up. Some people get diarrhea. Some people get skin infections, sores in their mouth or anus, or just a fever. Some people have it, don't know it, and get better without seeing a doctor. Some people don't see a doctor until it's too late.
Basically, agranulocytosis is a catastrophic crash in a person's immune system, which can turn a zit, a scratch, or even the bacteria that normally live in and around your body into a life-threatening infection. In one vividly described case from the 1920s, an otherwise healthy 40-year-old woman came down with a mysterious fever. Over the next nine days, under the care of baffled physicians, she sprouted "brownish papular eruptions" all over her face and body, necrotic abscesses on her neck and buttocks, and "a greyish-green dirty membrane" covering her mouth and throat with "scattered small greyish ulcers." In one cubic millimeter of blood, her doctors found 4,000,000 red blood cells but only 1,000 white blood cells. Then, after a blood transfusion, she died.
Agranulocytosis is rare and typically caused by medications: Antibiotics, gold salts (to treat arthritis), and some antipsychotic drugs can trigger the crash. But lately, doctors have been seeing more and more cocaine users with mysterious cases of agranulocytosis linked to a mysterious cutting agent called levamisole. Levamisole was discovered in 1966 and studied for its ability to rev up the effects of chemotherapy drugs and people's immune systems. It also turned out to work wonders with intestinal worms. Levamisole is an immunomodulator, meaning it can either strengthen or weaken your immune system, depending on your genes and what other drugs you might be taking. But too many patients came down with agranulocytosis, the studies were discontinued, and the FDA withdrew its approval of the drug.
One of the last studies on levamisole use in humans was in 2001, when Iranian researchers gave the drug to a group of girls who lived in crowded, unhygienic conditions with uncontrollable lice infestations. According to the International Journal of Dermatology, a 10-day course of levamisole tablets was "completely effective": The girls took the drugs, and the drugs poisoned the lice. (The study didn't mention whether the drugs poisoned the girls.)
These days, levamisole is mostly used by farmers to deworm cows and pigs—and, for some reason, it's also used by people in the cocaine trade. The DEA first reported seeing significant amounts of levamisole-tainted cocaine in 2005, with 331 samples testing positive. Then the numbers spiked: The DEA found 6,061 tainted samples in 2008 and 7,427 in 2009. One DEA brief from 2010 reports that between October 2007 and October 2009, the percentage of seized cocaine bricks containing levamisole jumped from 2 percent to 71 percent.
Which is not only sudden, but odd. Levamisole is not like other common cutting agents—sugar, baking powder, laxatives, etc.—in three important ways:
...
source
What's a drug used to deworm livestock—a drug that can obliterate your immune system—doing in your cocaine? Nobody knows.
by Brendan Kiley
A granulocytosis can kill you, but its symptoms are frustratingly broad. Some people's throats close up. Some people get diarrhea. Some people get skin infections, sores in their mouth or anus, or just a fever. Some people have it, don't know it, and get better without seeing a doctor. Some people don't see a doctor until it's too late.
Basically, agranulocytosis is a catastrophic crash in a person's immune system, which can turn a zit, a scratch, or even the bacteria that normally live in and around your body into a life-threatening infection. In one vividly described case from the 1920s, an otherwise healthy 40-year-old woman came down with a mysterious fever. Over the next nine days, under the care of baffled physicians, she sprouted "brownish papular eruptions" all over her face and body, necrotic abscesses on her neck and buttocks, and "a greyish-green dirty membrane" covering her mouth and throat with "scattered small greyish ulcers." In one cubic millimeter of blood, her doctors found 4,000,000 red blood cells but only 1,000 white blood cells. Then, after a blood transfusion, she died.
Agranulocytosis is rare and typically caused by medications: Antibiotics, gold salts (to treat arthritis), and some antipsychotic drugs can trigger the crash. But lately, doctors have been seeing more and more cocaine users with mysterious cases of agranulocytosis linked to a mysterious cutting agent called levamisole. Levamisole was discovered in 1966 and studied for its ability to rev up the effects of chemotherapy drugs and people's immune systems. It also turned out to work wonders with intestinal worms. Levamisole is an immunomodulator, meaning it can either strengthen or weaken your immune system, depending on your genes and what other drugs you might be taking. But too many patients came down with agranulocytosis, the studies were discontinued, and the FDA withdrew its approval of the drug.
One of the last studies on levamisole use in humans was in 2001, when Iranian researchers gave the drug to a group of girls who lived in crowded, unhygienic conditions with uncontrollable lice infestations. According to the International Journal of Dermatology, a 10-day course of levamisole tablets was "completely effective": The girls took the drugs, and the drugs poisoned the lice. (The study didn't mention whether the drugs poisoned the girls.)
These days, levamisole is mostly used by farmers to deworm cows and pigs—and, for some reason, it's also used by people in the cocaine trade. The DEA first reported seeing significant amounts of levamisole-tainted cocaine in 2005, with 331 samples testing positive. Then the numbers spiked: The DEA found 6,061 tainted samples in 2008 and 7,427 in 2009. One DEA brief from 2010 reports that between October 2007 and October 2009, the percentage of seized cocaine bricks containing levamisole jumped from 2 percent to 71 percent.
Which is not only sudden, but odd. Levamisole is not like other common cutting agents—sugar, baking powder, laxatives, etc.—in three important ways:
...
source
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