Levamisole was also detected using gas chromatography/mass spectrometry (GC/MS) in a postmortem blood specimen from a cocaine user who died of Serratia marcescens sepsis secondary to agranulocytosis. Epidemiological studies of initial cases reported by the New Mexico Department of Health found evidence of levamisole, an antihelminthic agent, in drug paraphernalia of cocaine users. Since 2006, several cases of severe agranulocytosis associated with cocaine use have been reported. Recent recognition of levamisole-induced agranulocytosis, vasculitis, and other complications, from contaminated cocaine, dictate that physicians be aware of these potential problems. Cocaine's effects on the health care system cross multiple medical disciplines, but clinicians may be less cognizant of the problems caused by some of the adulterants added to cocaine. More than 5 million Americans use cocaine regularly via insufflation (snorting/sniffing), inhalation (smoking), and injection. Cocaine use and its related complications are well-known public health issues. The incidence of hospitalizations related to use of levamisole-contaminated cocaine continues to increase and clinicians should be aware of the more common clinical manifestations. The drug, used to deworm cattle, pigs and sheep, can rot the.
Treatment is primarily supportive, and skin lesions typically resolve with cessation of cocaine use.Ĭocaine cut with the veterinary drug levamisole could be the culprit in a flurry of flesh-eating disease in New York and Los Angeles. Potential complications associated with use of levamisole-laced cocaine include neutropenia, agranulocytosis, arthralgias, retiform purpura, and skin necrosis. Levamisole is currently approved as an antihelminthic agent in veterinary medicine, but is also being used illicitly as a cocaine adulterant. Levamisole is an immunomodulatory agent that was used to treat various cancers before being withdrawn from the United States market in 2000 because of adverse effects. Making Crack With Levamisole Hydrochloride.