Los Angeles Joint Regional Intelligence Center

• 4 pages
• For Official Use Only
• July 2011

In April 2011, the US Drug Enforcement Administration (DEA) reported up to 82 percent of all cocaine seized in the United States contained levamisole, a veterinary drug used to de-worm livestock. Law enforcement and public health officials in the United States are warning of serious public health consequences for drug users related to contaminated cocaine use.

Background

• Levamisole is an inexpensive anti-parasitic (de-worming) agent used in veterinary medicine currently approved for cattle, sheep, and swine
• It has been increasingly used as a cutting agent in cocaine instead of traditional fillers such as baking soda; DEA agents have detected it in cocaine seized in the United States since 2003
• Recently, serious skin infection cases related to cocaine use have been seen in Los Angeles, New York, Denver, and San Francisco
• Studies report that levamisole is known to increase dopamine, a neurotransmitter that helps control the brain’s reward and pleasure centers, leading experts to believe that it is added to cocaine to further enhance or prolong the user’s “high”
• It can be added at anytime during the production, transport, or shipment of cocaine

Health Effects:

• It appears that some people, especially women, are more susceptible to the effects of levamisole. Users of cocaine contaminated with levamisole may experience the following health effects:
• Decrease of white blood cells (“agranulocytosis”), which causes a greater risk of infection
• Crusty, purplish areas of dead skin—particularly around the ears—that are extremely painful (“purpura”)
• Worsening or persistent sore throat and fever
• Swollen glands (“lymphadenopathy”)
• Painful sores (especially in the areas of the mouth and anus)
• White fungal coating of the mouth, tongue, or throat (“thrush”)
• Constriction of the blood vessels (“vasoconstriction”)
• Pneumonia

Implications:

• The increasing presence of levamisole in cocaine is a development that is important to both law enforcement and public health professionals:
• Detection of levamisole in a patient is challenging because specific testing is necessary, but not routinely available
• Levamisole’s half-life—the amount of time it takes for drug concentration to reach half of its original concentration—is only 5.6 hours
• Large amounts of levamisole being diverted away from standard veterinary medicine could potentially lead to the identification of major cocaine trafficking organizations

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