Sunday, May 7, 2017

Levamisole (That’s not cocaine)

Levamisole is one of those drugs that was discovered quite awhile ago, when we had even less idea what target things were hitting. It’s not used often in people these days. What’s interesting about it is that it is occasionally found as an adulterant in cocaine (PDF) – and it popped up again recently.
It is truly bizzare what people use to cut drugs. I once heard of a chemistry professor who told his class about how he walked into a head shop and saw a big sack of mannitol behind the counter (which is used as a cutting or bulking agent for street drugs as well). He marvelled that he had just bought mannitol from Aldrich for his lab (presumably for more mundane, licit purposes) and that the shop was charging much too high a price. So, if you were thinking of saving on lab supplies at the bong store, that’s right out.
Levamisole, sold under the trade name Ergamisol among others, is a medication used to treat parasitic worm infections.[1]Specifically it is used for ascariasis and hookworm infections. It is taken by mouth.[2]...
Levamisole has increasingly been used as a cutting agent in cocaine sold around the globe with the highest incidence being in the USA. In 2008–2009, levamisole was found in 69% of cocaine samples seized by the Drug Enforcement Administration (DEA).[15] By April 2011, the DEA reported the adulterant was found in 82% of seizures.[26] 
Levamisole adds bulk and weight to powdered cocaine (whereas other adulterants produce smaller "rocks" of cocaine) and makes the drug appear purer.[27] In a series of investigative articles for The Stranger, Brendan Kiley details other rationales for levamisole's rise as an adulterant: possible stimulant effects, a similar appearance to cocaine, and an ability to pass street purity tests.[28] 
Levamisole suppresses the production of white blood cells, resulting in neutropenia and agranulocytosis. With the increasing use of levamisole as an adulterant, a number of these complications have been reported among cocaine users.[15][29][30] Levamisole has also been linked to a risk of vasculitis,[31] and two cases of vasculitic skin necrosis have been reported in users of cocaine adulterated with levamisole.[32] 
Levamisole-tainted cocaine was linked to several high-profile deaths. Toxicology reports showed levamisole, along with cocaine, was present in DJ AM's body at the time of his death.[33] Andrew Koppel, son of newsman Ted Koppel, was also found with levamisole in his body after his death was ruled a drug overdose.[34] More recently it has also been suspected in the death of a Sydney teenager.[35] 
In response to the dangers, The Stranger, People's Harm-Reduction Alliance and DanceSafe began producing tests to identify levamisole's presence in cocaine. The kits include a survey postcard, and one revealed its presence in a 1/4-kg block of cocaine, indicating both users and dealers were using the kits.[36]


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