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Cocaine Laced With Levamisole Increasing....... *LINK*

Cocaine Laced With Levamisole Increasing, Poses Risk for Agranulocytosis
Emma Hitt, PhD

Posted: 09/24/2009

September 24, 2009 — Levamisole used as an adulterant in cocaine has resulted in 20 confirmed or probable cases of agranulocytosis, including 2 deaths, according to an alert from the Substance Abuse and Mental Health Services Administration (SAMHSA).

According to the SAMHSA alert, US Drug Enforcement Administration and state testing laboratories report that more than 70% of the illicit cocaine analyzed in July 2009 was positive for levamisole, an antiparasitic drug used by veterinarians to treat worm infestations. This represents an increase over previous reports indicating that levamisole contaminated only 30% of cocaine seized by the Drug Enforcement Agency from July to September 2008. Furthermore, a recent analysis found that almost 80% of the individuals who test positive for cocaine also test positive for levamisole.

"SAMHSA and other public health authorities are working together to inform everyone of this serious potential public health risk and what measures are being taken to address it," noted SAMHSA Acting Administrator Eric Broderick, DDS, MPH, in a press release.

SAMHSA is advising healthcare providers to be aware of symptoms indicating that patients may have ingested levamisole. Symptoms include high fever, swollen glands, painful sores on the mouth or anus, and lingering infections, including sore throat, mouth sores, skin infections, abscesses, thrush, or pneumonia.

SAMHSA is working with the US Centers for Disease Control and Prevention (CDC) and other federal and international agencies to monitor the levamisole contamination of cocaine. A case report analysis will be published in the CDC's Morbidity and Mortality Weekly Report.

A letter in the February 17, 2009, issue of the Annals of Internal Medicine also describes 5 cases of agranulocytosis occurring after consumption of cocaine adulterated with levamisole. All patients fully recovered with use of filgrastim, intravenous antibiotics, and close monitoring.

Suspected and confirmed cases of agranulocytosis associated with cocaine abuse should be reported to state health departments. Confirmed cases can also be reported to local Poison Control Centers at 1-800-222-1222.

More information is available on the SAMHSA Web site.

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Cocaine Laced With Levamisole Increasing....... *LINK*
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