Alerts and Advisories

Health Alerts > 9/28/09 Nationwide Public Health Alert Issued Concerning Life-Threatening Risk Posed by Cocaine Laced with Veterinary Anti-Parasite Drug

Topic:  Nationwide Public Health Alert Issued Concerning Life-Threatening Risk Posed by Cocaine Laced with Veterinary Anti-Parasite Drug (

The Substance Abuse and Mental Health Services Administration (SAMHSA) is alerting medical professionals, substance abuse treatment centers and other public health authorities about the risk that substantial levels of cocaine may be adulterated with levamisole – a veterinary anti-parasitic drug. There have been approximately 20 confirmed or probable cases of agranulocytosis (a serious, sometimes fatal blood disorder), including two deaths, associated with cocaine adulterated with levamisole. The number of reported cases is expected to increase as information about cocaine adulterated with levamisole is disseminated.

According to the Drug Enforcement Administration and State testing laboratories, the percentage of cocaine specimens containing levamisole has increased steadily since 2002, with levamisole now found in over 70 percent of the illicit cocaine analyzed in July. In addition, a recent analysis in Seattle, Washington found that almost 80 percent of the individuals who test positive for cocaine also test positive for levamisole.

Levamisole is used in veterinary medicine and is currently approved for use in cattle, sheep and swine as an anti-parasitic agent. Although it was once used in human medicine in the past for treating autoimmune diseases and cancer, it is no longer an approved drug for human use.

Ingesting cocaine mixed with levamisole can seriously reduce a person's white blood cells, suppressing immune function and the body's ability to fight off even minor infections. People who snort, smoke, or inject crack or powder cocaine contaminated by levamisole can experience overwhelming, rapidly-developing, life threatening infections. Other serious side effects can also occur. …


Levamisole can severely reduce the number of white blood cells, a problem called agranulocytosis. THIS IS A VERY SERIOUS ILLNESS THAT NEEDS TO BE TREATED AT A HOSPITAL. If you use cocaine, watch out for:

* high fever, chills, or weakness

* swollen glands

* painful sores (mouth, anal)

* any infection that won’t go away or gets worse very fast, including sore throat or mouth sores -skin infections, abscesses -thrush (white coating of the mouth, tongue, or throat) -pneumonia (fever, cough, shortness of breath).”

Individuals are encouraged to report suspected and confirmed cases of agranulocytosis that are associated with cocaine abuse to their respective state health departments. Cases can also be reported to local Poison Control Centers (1-800-222-1222), these centers may also Provide assistance in clinical management and additional reporting.

 Deb McMahan, MD


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