Drug Policy

Cocaine, Now With More Levamisole! Thanks, Uncle Sam!

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In September I noted government warnings about cocaine cut with levamisole hydrochloride, a veterinary drug that can impair people's immune systems, leaving them vulnerable to disfiguring, disabling, and potentially deadly diseases. As of July, according to the Drug Enforcement Administration, about 70 percent of the cocaine entering the country was tainted by levamisole, which may be favored as a cutting agent because it boosts the stimulant's perceived effect. The San Francisco Chronicle reports that levamisole-related medical problems are starting to turn up in that city:

So far, eight cases of illness caused by the drug levamisole have been identified in San Francisco, one of a handful of cities in the country where pockets of sickness caused by the drug have been found….

Levamisole can significantly reduce the number of white blood cells in the body, a condition called agranulocytosis. Symptoms include fever, swollen glands, painful sores in the mouth and anus, and an infection that won't go away. In San Francisco, patients with levamisole poisoning also are getting serious skin conditions that make their skin look black.

In a group of 200 patients at San Francisco General Hospital who tested positive for cocaine, 90 percent also tested positive for levamisole. That figure may exaggerate the prevalence of levamisole in cocaine, since patients who test positive for cocaine are not necessarily representative of cocaine users in general. In any case, most of the patients who had been exposed to levamisole did not get sick as a result. "The big question we have right now," the associate chief of the hospital's toxicology lab tells the Chronicle,"is, if 90 percent of cocaine users in San Francisco are positive for levamisole and are being exposed to this compound, then why aren't 90 percent of them in the emergency room with these side effects?" It may be that the drug has a dramatic effect only on people who are predisposed to immune system problems. It is also possible that milder reactions are being misidentified as flu, or that repeated exposure is necessary, in which case a larger percentage of cocaine users can be expected to get sick over time.

As I emphasized in September, whatever the magnitude of the levamisole hazard, we have prohibition to thank for it:

You won't find levamisole in legal, pharmaceutical cocaine, just as you won't find methanol in the whiskey you get at your local liquor store. The main reason for that is not government regulation (although there's none of that in a black market) but the need to compete for customers in a legal, open market where fraud and negligence are punished not only by law but by the loss of business. By making such competition impossible, prohibition creates uncertainty about the quality and purity of drugs, and more aggressive enforcement only makes the problem worse. To the extent that the government succeeds at its avowed goal of reducing cocaine purity, for example, it encourages more use of levamisole, resulting in more disease and death. Anyone who supports this policy has to accept the resulting casualties as a necessary cost of deterrence.

[Thanks to Paul Rako for the tip.]

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  1. Wait… San Francisco hospitals haven’t always been filled with people on cocaine complaining about painful sores in the mouth and anus?

  2. In San Francisco, patients with levamisole poisoning also are getting serious skin conditions that make their skin look black.

    RACIST

    1. Sounds like Michael Jackson could have used some of that.

      1. That was the only veterinary drug he decided not to take.

  3. Anyone who supports this policy has to accept the resulting casualties as a necessary cost of deterrence.

    They do. Drug warriors who are against needle exchanges think that the death of drug users from disease is a bonus deterrent.

    1. Just like homophobic Christians believe AIDS is a message from God.

      1. Or just like Jewish people using God to justify their wars on the Palestinians.

        1. Uh no, it’s not like that at all.

  4. No, X. You don’t understand. When we all have levamisole-blackened skin and failing immune systems, true equality will finally be reached.

  5. may be favored as a cutting agent because it boosts the stimulant’s perceived effect

    Also because veterinarians (who have all the really good coke) and coke suppliers whose cover is veterinary (second best to being a cop) have it around.

    1. Re: c,

      Also because veterinarians (who have all the really good coke) and coke suppliers whose cover is veterinary (second best to being a cop) have it around.

      Oh, no. I know what you’re thinking – restricting the sale of Levamisole. That would just generate yet another black market – how many do you need before you accept that the War on Drugs is unwinnable?

      1. It’s better to plunge ahead and rally the troops toward a changing defintion of victory, than to admit victory is not obtainable. So they think.

        1. It’s winnable if all the drug-users die from poisoned drugs, apparently.

        2. It’s better to plunge ahead and rally the troops toward a changing defintion of victory, than to admit victory is not obtainable.

          Did you make that up? It is lovely. I might need to steal it.

  6. During Prohibition, a lot of the hooch that circulated in the black market could make you sick or even kill you, because of the suspect methods used to distill it.

    Once Prohibition was repealed, products started to appear in the market that were many times less dangerous than the previous offerings, since competing, honest producers did not find killing their customers as being in their best interest.

    1. BUT BUT BUT, Chony assured me it was liquor safety regulations. Because evil companies don’t care if they kill their customers!

    2. So, is the message here that black market merchants can make a profit by killing their customers, or that there is insufficient competition among cocaine manufacturers and dealers?

      Don’t get me wrong, if you make it hard to run a large scale operation without being noticed and shut down, the supply side of the market will consist of amateurs with poor equipment who like to sample their own goods and have highly risk-tolerant personalities. This places something of a ceiling on quality and safety in the black market.

      That principle might well apply in the case of trailer park meth labs, but I always got the impression foreign cocaine production was a little more… professional.

  7. “Anyone who supports this policy has to accept the resulting casualties as a necessary cost of deterrence.”

    I’ll probably lose my libertarian cred by asking, but don’t the drug users, those folks freely purchasing and consuming an illegal product they know is potentially dangerous, don’t they bear any responsibility for their situation?
    I will vote for legalization in a heartbeat, but until then, the folks taking drugs pays their money and they takes their chances.

    1. I don’t think anyone is saying that someone else is responsible – just that if cocaine was legal this wouldn’t be an issue. Prohibition is what allows these tainted products; pharmaceutical companies wouldn’t be as likely to sell cocaine with hazardous agents that cause additional side effects.

    2. Re: In Time of War,

      [… D]on’t they [the drug addicts] bear any responsibility for their situation?

      The government says “no”. Otherwise there would be no prohibition.

      Imagine, people having responsibility for their actions! Shocking! Poppycock! Why would we need governments for, then?

    3. Hmm, alright, maybe I misread the intent. It just seems that blaming the prohibitionists for the quality of drugs is…sort of a stretch. It might be a predictable result of the law but I’m not convinced it’s the government’s “fault”.

      1. How do you not blame someone for a predictable result of their actions, should it turn out to be negative?

        1. Because this is America buddy!

          (Or something along those lines. works everytime)

        2. Hmm, let’s say I have an alcoholic employee with weak job skills. I get tired of his crap and fire him.
          I could predict he’ll go on a bender, lose his wife and house, and wind up living under a bridge.
          Is that my fault?

          No one’s making the manufacturers cut their drug with levamisole. They’re just trying to maximize their profits, which I thought was a “good” thing.

      2. Re: ITOW,

        The point of the article is to establish that while honest brokers do not try to kill their customers, black-market purveryors working under the shadow of government interventionism will show no scruples when it comes to THEIR customers.

        Interventionism (Statism, to be succinct) kills.

      3. It isn’t like the gov is adding hog wormer to coke like Jimmy Carter put paraquat on the Colombian weed.

  8. Please only snort UNCUT Cocaine.

    1. That’s the objective, dude.

    2. That would probably kill you.

  9. Symptoms include fever, swollen glands, painful sores in the mouth and anus, and an infection that won’t go away.

    Sounds like the effects of a date with Warty.

    (Sorry, that was just too good a setup)

    1. I seem to be becoming a meme here.

      1. Ironic that a meme is communicable too.

  10. either the amount of cocaine tainted with levamisole in the US cocaine supply is being exaggerated or they are exaggerating the toxicity of levamisole. clearly 8 people doesn’t seem to suggest its a problem for most coke users.

    1. This seems to be primarily a problem for people with certain variant of the HLA molecule (HLA B27) which is used in the immune response:

      http://content.karger.com/ProdukteDB/produkte.asp?Doi=232788

      If you have this variant, you’re predisposed to get neutropenia from the drug; if not, then it’s less likely to happen, if at all.

      I’m a pathologist, and remember being on the diagnostic vangard of these cases in the spring of 2008 when we started seeing bone marrow biopsies of otherwise healthy people with unexplained neutropenia. Working with the hematologists, we found the correlation to illicit drug use but it was another institution that identified the adulterant.

  11. If cocaine ever became legal again in a regulatory state I suggest that the warning label of the product, regardless of what else is in it, state “This drug is only fun once for most people. And YOU are probably one of them.”

    1. I like that or how about

      “This drug intensifies your personality. This is a good thing unless you are an asshole which you probably are”

    2. Sounds good. Also add “However much fun it is, it’s not worth what you go through coming down.”

      1. Never had any issues coming down from coke. Certainly much less than coming down from being drunk off my ass. Not sure what you’re talking about. Of course I only use it very infrequently at a party now and then so maybe it takes chronic use to have that problem?

        1. Same here; coming off of coke has never been a problem, even when I did a fair amount.

          1. I won’t argue with your own direct observations, but I think you are rare. That’s in my own direct observations. Most people get kicked in the ass by coke.

          2. Epi — you might want to go with a different screen name and leave off the email link when mentioning prior felony acts.

            I wouldn’t put it past law enforcement agencies to troll threads like this.

      2. Ambien: Causes deep restful sleep, relieving the user’s memory of the evening’s reckless screwing.

  12. I’ve said this before, but Ritalin (methylphenidate) has basically identical effects to cocaine when crushed and snorted, and if you got the pill uncrushed (or better yet, have a prescription!) you know it’s 100% uncut. Plus you can take your prescription through airline security with you. That’s hard to beat.

    1. So you are telling me at the same time that we are sending people to jail for decades on the pretense of saving our children from drugs, we are feeding that very same drug to millions of those very same children in the form of Ritalin? We live in truly fucked up times.

      1. The difference between a prescription drug and an illegal drug is a piece of paper.

        1. And some pharmaceutical company lobbying!

          1. I never buy into the big corporate conspiracies, but some of the ones about the pharmaceutical industry make me wonder. They have foisted any number of crap drugs on the public while suppressing research into drugs like THC and LSD that at one time showed promise to actually help people.

            1. LSD was actually a pharmaceutical product (Sandoz pharmaceuticals) initially; I doubt it was the victim of a corporate conspiracy.

        2. And some levamisole!

    2. Hey now, I’ve been saying that here for a long time! 🙂

      However, as an alternative, you can always try crushing and snorting some methylphenidate (Ritalin). It produces a high strikingly similar to coke with a couple advantages: You know it will be consistently high quality and never laced or excessively cut with anything. If you have a prescription and insurance it is dirt-cheap. And, it isn’t illegal (assuming you have the script) to carry the pills making it safe and convenient to take with you. Oh, and as it’s not a topical anesthetic like cocaine, it won’t give you that numbness in the back of your throat that some people find unpleasant.

    3. 100% uncut

      Aside from all the binders and other shit they use to make it stay in pill form, right?

      Shouldn’t put that shit up your nose either.

      1. Is there a shred of evidence that any of that is really a concern? I would be willing to bet it’s orders of magnitude less dangerous than stuff like levamisole.

        1. Yeah, as if anyone will be permitted to study the safety of snorting pharmaceutical binders.

          1. Well, we seem to have figured out it is bad to snort levamisole hydrochloride without anyone likely directly studying it. If hundreds of thousands of people are doing it, and it was even minimally risky, we’d know about it. Besides, even if there are some very minor risks, life is full of minor risks we take all the time for trivial benefits. So what?

  13. To the extent that the government succeeds at its avowed goal of reducing cocaine purity, for example, it encourages more use of levamisole, resulting in more disease and death.

    And the scorpion answers the toad, while both began to drown: “That’s what I do.”

    The State KILLS. That’s what it does.

  14. Once word of this gets around people will start demanding levamisole free coke. Dealers will probably even advertise their stuff is clean. something like this only works for a short time.

  15. Ambien: Causes deep restful sleep, relieving the user’s memory of the evening’s reckless screwing.

    Sleep screwing.
    Sleep walking.
    Sleep baking.
    Sleep driving. (*)
    Sleep deep, meaningful (if utterly unrecalled) conversations.
    Sleep financial planning.

    It’s all the same to Ambien.

    (*) This one I’ve only read about. All the other have happened to people I know.

  16. It’s all the same to Ambien

    I am a hard-core insomniac (jebus, I’m posting a comment at close to midnite!) and take Ambien 5-6 nights per week. I have never once had any of the mentioned side effects.

    YMMV, I guess.

    … Hobbit

    1. How would you know?

      Aside from the baking of course: the cookies are a dead give away.

  17. at lawyer is taking the class action lawsuit against the drug dealers

  18. So why does the nit-wit author think this somehow is “Uncle Sam’s” fault? This contamination is actually a good thing. When you are walking thru your neighborhood, you can now be more aware of cocaine users.

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