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Cocaine laced with levamisole may cause skin rot

Dominika Osmolska Psy.D.'s picture

That cocaine has been laced, or “cut,” with fillers has been a well-known fact for decades. Dealers of the illegal drug use fillers routinely to bulk up their product in order to stretch the profit margin. Baking soda is one well-known filler, for example. Most individuals using cocaine are not overly concerned about some such residue, but a case study publicized today ought to make future users pause.

Over eighty two percent of the nation’s cocaine supply is laced with a veterinary drug called levamisole, used to deworm cattle, pigs and sheep. It can rot the skin off of noses, cheeks, and ears. In a worst-case scenario, an individual can die a slow and agonizing death from external and internal rot.

The case study, published in the Journal of the American Academy of Dermatology, describes six cocaine users recently plagued by the dark purple patches of dying flesh. Although the cases occurred on the East and West coasts, the problem is pervasive throughout the country.

(Presumably the clustering of cases on the coasts is attributable to a higher population concentration in urban centers).

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Dealers may be stretching their cocaine with levamisole because it may act on the same brain receptors as cocaine, so it might be added to enhance or extend the cocaine's euphoric effects on the cheap.

Dr. Noah Craft, a dermatologist with the Los Angeles Biomedical Research Institute, is one of several doctors across the country who have linked the rotting skin to tainted coke. The gruesome wounds surface days after a hit because of an immune reaction that attacks the blood vessels supplying the skin. Without blood, the skin starves and suffocates.

The condition is not the same as a case of flesh-eating bacteria and is managed by facilitating the drug’s clearance from the body. Once it is cleared from the body, the wounds do heal, leaving behind a shiny scar. However, each individual’s reaction is different and may be acute. Dr. Lindy Fox of the University of California, San Francisco, said she once saw a photo of a man whose entire body, face included, was black with dying flesh. Although some people might be more vulnerable to the effects of levamisole, the drug doesn't discriminate based on race or socioeconomic status. All appear to be equally vulnerable.

Levamisole also prevents the bone marrow from producing infection-fighting white blood cells, which leaves a user in a vulnerable condition similar to HIV. The individual is doubly vulnerable: he or she may contract an unusual infectious condition because of a compromised immune system, and the open lesions in the flesh leave the body vulnerable to acquiring an infection through the wounds, such as MRSA (a drug resistant form of staph infection).

Ingesting levamisole is a gamble. Some people appear not to be affected by the skin rotting condition after taking cocaine, while others, vulnerable in some as-yet not identifiable way, develop a reaction over days after use. Long-term exposure to levamisole may lead to other complications, of which we are currently unaware because of the novelty of the phenomenon.