WhiteCoat

The Scarlet Ear

Another page to the “that’s why they call it dope” chronicles.

ScienceDaily reports that several people are suffering from skin necrosis related to adultered cocaine. Updated ScienceDaily story here. Good Morning America report about topic here. January 2010 article in Time magazine about the same phenomenon here.

It seems that the dealers are cutting cocaine with a medication called levamisole, which is an antihelminthic and cancer treatment that was taken off the market in 2003 due to serious side effects.  Supposedly, levamisole increases the high experienced by cocaine users by increasing dopamine in the user’s body. Andrew Koppel, the son of news anchor Ted Koppel, died from a multi-drug overdose and was found to have levamisole in his body.

Levamisole was found in 70% of cocaine confiscated by the DEA in 2009 and in 82% of seized cocaine according to an April 2011 DEA report.

Although levamisole is not available for human use, it is reportedly still popular as a deworming agent by veterinarians.

I guess we can now cross “helminth infections” off of the differential diagnosis in cocaine users.

9 Responses to “The Scarlet Ear”

  1. ERP says:

    Yeah, I read in CA, a user has come in with facial necrosis not once, but twice.

  2. DrNorm says:

    In detroit we have had a couple cases of Levamisole induced vasculitis and subsequent skin necrosis with some pretty nasty end results. Think parts of the face falling off…

  3. Ross says:

    Folks should also check out coverage in The Strager (a Seattle weekly newspaper). They have been covering the story for a while including recent availability of a levamisole test kit for users. I know my ex has had several of her patients hospitalized due to Neutropenia from levamisole exposure via tainted coke but I don’t think that they have been seeing much skin necrosis in their Seattle area patient population.

  4. Gene says:

    I’ve seen in in Massachusetts as well. VERY VERY VERY nasty looking. One person lost the tip of the nose to the necrosis.

  5. Anonymous says:

    “Supposedly, levamisole increases the high experienced by cocaine users by increasing dopamine in the user’s body.”

    If only the baddies applied their talents to a pharmacy degree.

  6. SeaSpray says:

    EWWW!

    Don’t they realize what is in it?!

    I know ..addicts don’t care ..just want the high …but still. What a price to pay!

  7. eriko says:

    I think you are in the Puget Sound area right? The Stranger did a multi part article covering this. The source seems to all the way back in south america as cocaine coming across the border already has it cut with it as it does not show up on the normal cutting tests. One item of interesting is that is pretty cheap and easy to make a test kit for levamisole but it might be considered make drug paraphernalia so no one will make them.

  8. rlbates says:

    Hope you don’t see many of these.

  9. I saw a case of this my intern year and we’ve had about 5 at my hospital in Upstate NY…did a CPC case on it at SAEM.

Leave a Reply


− seven = 0

Popular Authors

  • Greg Henry
  • Rick Bukata
  • Mark Plaster
  • Kevin Klauer
  • Jesse Pines
  • David Newman
  • Rich Levitan
  • Ghazala Sharieff
  • Nicholas Genes
  • Jeannette Wolfe
  • William Sullivan
  • Michael Silverman

Subscribe to EPM