Levamisole is an antihelminthic (dewormer, anti-parasitic) used in large livestock and aquarium fish. Levamisole is also an antineoplastic (a drug that inhibits abnormal cell growth that can produce potentially malignant tumors) used in the treatment of colo-rectal cancer in humans. Levamisole is a known immunomodulating agent frequently used as a cutting agent in cocaine consumed in the United States today. Numerous cases of anti-neutrophil cytoplasmic antibody (ANCA) vasculitis connected with the use of levamisole-adulterated cocaine have previously been reported in the literature, classically characterized by a retiform purpuric rash. It is recommended that Levasole Injectable Solution, 13.65% be injected only in cattle in stocker or feeder condition. Cattle nearing slaughter weight and condition may show objectionable reactions at the site of injection. An occasional animal in stocker or feeder flesh may show swelling at the injection site.
Nearly two-thirds of cocaine is cut with a substance that can rot human flesh and 80 per cent contains a chemical linked to bladder cancer, a new study has found.
Levamisole is supposed to be used by farmers to purge their livestock of parasitic worms. But a study by the addiction treatment website DrugAbuse.com found that it was present in 65 per cent of street cocaine.
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This is despite the fact that if ingested in sufficient quantities, levamisole can cause ulcerating skin lesions and rot the skin.
Although other testing has suggested levamisole is in street cocaine at levels too low to affect most users, among some unlucky addicts it can rot the skin and also cause a serious drop in their “disease fighting” white blood cell count, leaving them open to infections – a condition described by one US dermatologist as “a little bit like having HIV.”
“They may be walking around like a time bomb,” said Dr Noah Craft, of the Los Angeles Biomedical Research Institute. “About 10 per cent of these patients will die from severe infections.”
Levamisole, though, was only the second most common cocaine cutting agent. The study found that the most common – occurring in four in five samples – was phenacetin, a painkiller banned in the US since 1983 because of its links to cancer and kidney damage.
One scientific study of people abusing phenacetin found they were four times more likely to develop bladder cancer than non-users.
The DrugAbuse.com study – Russian Roulette: the hidden dangers of cutting agents in cocaine and heroin – referred to samples of street drugs found in the US, but the incidence of cutting agents in the UK is thought to be roughly similar, or even higher.
In 2014 the Liberal Democrat Crime Prevention Minister Norman Baker said around 80 per cent of UK cocaine contained levamisole and warned that people taking illegal drugs without knowing what they had been cut with were “playing Russian Roulette with their lives”.
The DrugAbuse.com study also comes after drug testing at UK festivals this summer found that dealers were duping users into consuming ground up cement or crushed anti-malarial pills with their Class A drugs – which led some to suggest that legalising and properly regulating drugs instead of leaving the market to organised crime might reduce the harm they caused.
After analysing what cutting agents were used in heroin and cocaine, the DrugAbuse.com study concluded: “There is no ‘safe’ street drug and cutting agents are only adding to the danger.”
The researchers found an increasing use of cutting agents, which are used to dilute drugs doses so dealers can sell more hits and make more money, and in some cases to give an added “kick” to the already potent Class A drug.
In 1987, the study found, cocaine was 80 per cent pure, whereas average purity is now around 52 per cent.
Heroin purity has fallen from 58 per cent in 1993 to about 35 per cent now.
This is about the same purity level as during the heroin epidemic of the 1980s, but the study suggests that cutting agents found in heroin today are far more dangerous than those used 30 years ago.
One increasingly common cutting agent, fentanyl, has been described by the US Centres for Disease Control and Prevention as “80 times as potent as morphine and hundreds of times more potent than heroin” – an impression also borne out by street names such as “Drop Dead” and “Serial Killer”.
It has been linked to a wave of fatalities among American heroin users and also to the death in April of the pop star Prince. There have been reports that the singer took fentanyl pills from a bottle that had been incorrectly labelled as containing much weaker painkillers.
Levamisole For Horses
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In recent years fentanyl has been illegally manufactured in backstreet labs in Mexico and China. Some users deliberately take heroin laced with fentanyl to get a more powerful high, but increasingly it is being used to cut the Class A drug and sold to addicts without them knowing what they are really taking.
Most deaths so far have occurred in America, but in the UK, Thaker Hafid, 37, a father of three from Cardiff, was last year found to have died from taking a variant of the drug known as acetyl fentanyl after ordering it online from China as a so-called “legal high”.
And there is evidence that the cutting agents used by dealers may be getting even more dangerous. In the last few weeks, US officials have revealed that overdoses are now being caused by heroin laced with carfentanil, which is supposed to be used by vets as a sedative for elephants and other very large animals.
It is 100 times stronger than fentanyl and is the most potent commercially available opioid in the world.
Tallarida, Christopher S; Egan, Erin; Alejo, Gissel D; Raffa, Robert; Tallarida, Ronald J; Rawls, Scott M
2014-04-01
Levamisole is estimated by the Drug Enforcement Agency (DEA) to be present in about 80% of cocaine seized in the United States and linked to debilitating, and sometimes fatal, immunologic effects in cocaine abusers. One explanation for the addition of levamisole to cocaine is that it increases the amount of product and enhances profits. An alternative possibility, and one investigated here, is that levamisole alters cocaine's action in vivo. We specifically investigated effects of levamisole on cocaine's stereotypical and place-conditioning effects in an established invertebrate (planarian) assay. Acute exposure to levamisole or cocaine produced concentration-dependent increases in stereotyped movements. For combined administration of the two agents, isobolographic analysis revealed that the observed stereotypical response was enhanced relative to the predicted effect, indicating synergism for the interaction. In conditioned place preference (CPP) experiments, cocaine produced a significant preference shift; in contrast, levamisole was ineffective at all concentrations tested. For combination experiments, a submaximal concentration of cocaine produced CPP that was enhanced by inactive concentrations of levamisole, indicating synergism. The present results provide the first experimental evidence that levamisole enhances cocaine's action in vivo. Most important is the identification of synergism for the levamisole/cocaine interaction, which now requires further study in mammals. Copyright © 2014 Elsevier Ltd. All rights reserved.