What's a drug used to deworm livestock—a drug that can obliterate your immune system—doing in cocaine? Nobody knows.
Note from Frank: A few days ago I made a
post in which I may have over speculated the levels at
which the coke is cut with fent, it does appear to be done in smaller quantities among street gangs, mostly limited to western Canada.
which the coke is cut with fent, it does appear to be done in smaller quantities among street gangs, mostly limited to western Canada.
Levamisole however, is
another story. Levamisole bases up with coke during the process of reverting
cocaine hydrochloride (other cuts and impurities dissolve during the cook) to a
base so that it burns at a far lower temperature (rendering it smokeable freebase).
As an addictions counsellor, I witnessed first hand the flesh eating
disease-like side effects, mainly presenting in clients who used crack or IV
coke multiple times a day.
I’m talking massive patches of skin missing revealing horrible open wounds, which some of the clients would eagerly remove bandages covering their wound to show me the foul effects that they suffered, despite my insistence that they not remove the bandage. The madness of addiction is such that the drug had such a grip on these individuals that they continued to use the low low grade coke despite these horrible disfigurations and knowing that
they would get worse, unless they stopped using. No
longer on the frontlines of running a harm reduction facility, but I do know
that Levamisole or ’lebam’ to the dealers is still very much ubiquitous in
cocaine that is tested.
I recently brought a sample of cocaine untampered with since its
arrival, to a Physician friend in a fairly rural area, Interested to see if it
had in fact been cut before getting here, when the results were in the Dr. told
me it was the first sample In 10 years that he had seen that did not contain
any levamisole. I hope this is a growing trend as opposed to an anomaly. Here
is some is some non-anecdotal info/evidence on that subject. I know to many
B.B. followers it’s old news, but here it is:
Vasculitis due to levamisole-adulterated cocaine |
The Mystery of the Tainted Cocaine
What's a drug used to
deworm livestock—a drug that can obliterate your immune system—doing in your
cocaine? Nobody knows.
by Brendan Kiley
A granulocytosis can
kill you, but its symptoms are frustratingly broad. Some people's throats close
up. Some people get diarrhea. Some people get skin infections, sores in their
mouth or anus, or just a fever. Some people have it, don't know it, and get better
without seeing a doctor. Some people don't see a doctor until it's too late.
Basically,
agranulocytosis is a catastrophic crash in a person's immune system, which can
turn a zit, a scratch, or even the bacteria that normally live in and around
your body into a life-threatening infection. In one vividly described case from
the 1920s, an otherwise healthy 40-year-old woman came down with a mysterious
fever. Over the next nine days, under the care of baffled physicians, she
sprouted "brownish papular eruptions" all over her face and body,
necrotic abscesses on her neck and buttocks, and "a greyish-green dirty
membrane" covering her mouth and throat with "scattered small greyish
ulcers." In one cubic millimeter of blood, her doctors found 4,000,000 red
blood cells but only 1,000 white blood cells. Then, after a blood transfusion,
she died.
Agranulocytosis is rare
and typically caused by medications: Antibiotics, gold salts (to treat
arthritis), and some antipsychotic drugs can trigger the crash. But lately,
doctors have been seeing more and more cocaine users with mysterious cases of
agranulocytosis linked to a mysterious cutting agent called levamisole.
Levamisole was discovered in 1966 and studied for its ability to rev up the
effects of chemotherapy drugs and people's immune systems. It also turned out
to work wonders with intestinal worms. Levamisole is an immunomodulator,
meaning it can either strengthen or weaken your immune system, depending on
your genes and what other drugs you might be taking. But too many patients came
down with agranulocytosis, the studies were discontinued, and the FDA withdrew
its approval of the drug.
One of the last studies
on levamisole use in humans was in 2001, when Iranian researchers gave the drug
to a group of girls who lived in crowded, unhygienic conditions with
uncontrollable lice infestations. According to the International Journal of
Dermatology, a 10-day course of levamisole tablets was "completely
effective": The girls took the drugs, and the drugs poisoned the lice.
(The study didn't mention whether the drugs poisoned the girls.)
These days, levamisole
is mostly used by farmers to deworm cows and pigs—and, for some reason, it's
also used by people in the cocaine trade. The DEA first reported seeing
significant amounts of levamisole-tainted cocaine in 2005, with 331 samples
testing positive. Then the numbers spiked: The DEA found 6,061 tainted samples
in 2008 and 7,427 in 2009. One DEA brief from 2010 reports that between October
2007 and October 2009, the percentage of seized cocaine bricks containing
levamisole jumped from 2 percent to 71 percent.
Which is not only
sudden, but odd. Levamisole is not like other common cutting agents—sugar,
baking powder, laxatives, etc.—in three important ways:
1. It's more expensive
than other cuts.
2. It makes some
customers sick.
3. It's being cut into
the cocaine before it hits the United States.
This last mystery is
the most puzzling. Typically, smugglers like to move the purest possible
product—less volume means less chance of detection—and cut their drugs once
they cross into the United States.
So what's the incentive
to use a relatively expensive cut of something that makes your customers sick
and increases your smuggling risk? Even stranger: The cocaine trade, in both smuggling
and production, has fragmented in recent years (more on that in a minute). If
there's no central production, how did hundreds and hundreds of independent
shops come to use the same unusual cutting agent?
Nobody seems to know,
including experts I spoke with on both coasts of the United States: doctors,
scholars, chemists, think-tank fellows, research scientists, federal and state
public-health analysts, law enforcement agencies from the Seattle Police Department
to the DEA, and even people who work in and around the drug trade. Everyone has
theories, but nobody has answers.
It's a mystery.
What We Do Know
Some people are getting
sick from levamisole and a few have died, but it's impossible to pin down exact
numbers. In April 2008, a lab in New Mexico reported an unexplained cluster of
11 agranulocytosis cases in cocaine users. In November 2009, public health
officials in Seattle announced another 10 cases. The CDC began a surveillance
program in eight states.
During levamisole's
early clinical trials for cancer and autoimmune disorders, around 10 percent of
the patients developed agranulocytosis. If the nation's cocaine supply is so
thoroughly tainted, why aren't 10 percent of cocaine users going to hospitals
with unexplained infections?
"Maybe 10 percent
are experiencing pressure on their neutrophils," says Dr. Phillip Coffin
of the University of Washington, who has studied drug use in New York City and
Seattle. (Neutrophils are the type of white blood cell wiped out by
agranulocytosis.) "But only a proportion of them are getting sick enough
and using enough that they come to our attention. And an even smaller
proportion of those people are coming to the attention of physicians who are
aware of the cocaine-levamisole problem. There are many steps in the pathway
that have left such a small number of cases being reported."
The problem might
be—and probably is—larger than we know. And, because of budget crunches, last
month the CDC abandoned its surveillance program in Washington State. This is
worrisome not only for people who've already gotten sick and are likely to get
sick again (doctors at Harborview have reported seeing the same patients
multiple times for agranulocytosis), but because levamisole has a cumulative
effect: The more you're exposed to it, the more likely you are to get sick, and
even if you've had levamisole-tainted cocaine and not gotten sick doesn't mean
you won't get sick from levamisole-tainted cocaine in the future. With the DEA
reporting such a radical increase in the percentage of tainted cocaine (which
more than doubled between 2008 and 2009), the number of people at risk is also
increasing radically.
The Cocaine Trade
So who's lacing the
world's cocaine with levamisole and why? "I honestly can't tell you,"
says Sanho Tree of the Institute for Policy Studies, a think tank based in
Washington, D.C. An internationally recognized scholar, Tree has spent his
career studying the drug trade—if anyone (outside of a drug cartel) should know
where and why levamisole is being cut into the world's cocaine supply, it's
him.
The ubiquity of tainted
cocaine could, he says, be an unintended consequence of the drug war.
Centralized drug-producing operations, like the old Medellín and Cali cartels,
depended more on consistency of product and long-term business relationships.
But after those cartels were infiltrated and disrupted, hundreds of small
shops—many of them family-operated—jumped into the void. "We can't even
count those operations, much less infiltrate and break them up," Tree
says.
Recent developments in
Colombia's guerilla wars have also destabilized business as usual. Right-wing
paramilitary death squads—which are on U.S. lists of international terrorist
organizations—have been fighting against Colombia's Marxist-Leninist guerillas
for years on the government's behalf. Both the guerillas and the paramilitaries
have been involved in the country's black market, but, Tree says,
"guerillas deal more with peso economy"—the trade within
Colombia—"and the paramilitary death squads made a play for the coastal
regions. They were cutting the guerillas off from weapons and from smuggling
zones. Those dynamics have been shifting over the past few years. The death
squads were officially disbanded by government but have reemerged: same people,
different names." (In 2007, the produce distributor Chiquita pled guilty
to paying almost $2 million to these paramilitary death squads. U.S.
congressman William Delahunt said Chiquita was only "the tip of the
iceberg" of U.S. businesses getting tied up in paramilitary groups, which
means those businesses are implicitly tied up with the cocaine trade.)
"As a result,
there's much less accountability within Colombia now," Tree says.
"The drug market is much more fragmented. Who are you going to complain
to? Plus, you've got the meat grinder in Mexico"—where gangs ship South
American product into North America. "Will any of these people even see
each other again? Who knows? It's shorter-term careers these days."
Meanwhile, Peruvian
shops are also stepping up production to compete with the small Colombian
producers—the dynamics across the South American cocaine market are shifting
rapidly and violently.
Even the old Mexican
shipping networks are breaking up as turf wars make the smuggling routes less
reliable and more expensive. Some gangs are making an end run around Mexico by
sea—the U.S. government has begun intercepting homemade submarines, loaded with
cocaine, that sail by night just beneath the surface of the water. One of the
first narco-subs was found in 2000 in Bogotá. "It had Russian blueprints
and the engineers fled just before the police arrived," Tree says.
"In Bogotá—8,000 feet in the Andes and nowhere near any ocean. How corrupt
can you get?"
The U.S. has only
intercepted around two dozen narco-subs so far. "They've got no wake, no
conning towers—just a snorkel sticking up for air. By day they stay idle and
throw a blue tarp over themselves so they blend in with the ocean," Tree
says. "As one intelligence officer put it to me, rather frankly: 'You try
finding a log floating in the Pacific Ocean.'"
With such a fragmented
drug market, accountability and quality control decline. As Tree says, who are
you going to complain to?
Which leaves the
question of why producers and/or smugglers are cutting their cocaine with
levamisole. Why that, instead of a cheaper and more benign cut?
"That," Tree
says, "I don't know. This is the most interdisciplinary field in the
world. The people who focus on violence and the cartels don't understand the
pharmacology, and the people who understand the pharmacology don't understand
the economics and shifting forces of the cartels. Nobody has a bird's-eye view
of the whole thing."
Working Theories
In 2004, a controversy
erupted in the horse-racing world. A string of trainers with long and
distinguished reputations were accused of doping their horses after aminorex,
an amphetamine-like stimulant, was detected in their animals' urine. The
penalty for doping horses with aminorex is a one- to five-year suspension and a
career-ending stigma. Accusations flew, the trainers protested their innocence,
and scientists stepped in to investigate.
It turned out the whole
thing was an accident: The horses had been injected with levamisole for
deworming, which their bodies metabolized into speed. Studies in the 1970s had
discovered that dogs experienced "mood elevation" after receiving
doses of levamisole. And a 1998 study at Vanderbilt University showed that
levamisole eased withdrawal symptoms in rats addicted to morphine.
That study caught the
attention of Dr. Mike Clark, an assistant professor of psychiatry at Harborview
Medical Center, who also studies cocaine addiction in lab rats. "According
to the study, levamisole acts on all three monoamine neurotransmitters,"
he says. "That's exactly what you'd expect from something that potentiates
cocaine." In other words, levamisole may heighten cocaine's effects—or
might be a stimulant all by itself. In the next few weeks, Dr. Clark will begin
an experiment of his own to find out (among other things) whether levamisole,
without any cocaine, can produce cocainelike effects in lab rats.
If he can demonstrate
that levamisole makes cocaine more potent, we'll be a step closer to
understanding what it's doing in the supply chain. Other people have other
theories, including:
• Something about the
chemical structure of levamisole retains the iridescent fish-scale sheen of
pure cocaine, according to a chemist with ties to the cocaine trade, giving
cocaine cut with levamisole the same appearance as pure cocaine.
• Levamisole is a
bulking agent for crack. The process of making crack involves
"washing" cocaine and filtering out impurities and cutting agents.
Levamisole slips through this process, meaning you can produce more volume of
crack with less pure cocaine.
• Levamisole passes the
"bleach test," a simple street test used to detect impurities in
cocaine. When dropped in Clorox, pure cocaine dissolves clearly. Procaine (a
common cutting agent) turns reddish brown, lidocaine turns yellowish, and other
impurities float to the bottom. In a lab test conducted by Dr. Clark,
levamisole stayed clean and clear.
If levamisole can do
all of these things—pass the visual test, pass the bleach test, pass the
crack-purifying process, and provide a stimulant effect either on its own or in
conjunction with cocaine—it explains not only why producers use it, but why so
many small South American producers have independently decided to start cutting
their "pure" product. "Think of it as evolution in action,"
Dr. Clark says. Like a mutated gene that is beneficial to a species and is
passed on through the pressures of natural selection, levamisole has a variety
of benefits that become, in essence, selective pressures.
Instead of the
traditional smuggling model, where centralized producers ship pure product and
cut it once it crosses the U.S. border, levamisole (theoretically) behaves
enough like cocaine that producers can pass off cut kilos as 100 percent
pure—even to the smugglers who may believe they're shipping pure product to
sell to American wholesalers. This theory is supported by a couple of findings,
including reports of seizures in the DEA's Microgram Bulletin. One flight from
Guyana into New York's JFK airport contained 192 churros stuffed with
levamisole-tainted cocaine. And DEA agents in Bogotá came across a magazine
page coated in a "protective" plastic laminate that was 21.5 percent
cocaine, cut with levamisole. The research and development labs that developed
this relatively sophisticated smuggling technique were at the source of
production. And the source of production was cutting its "pure"
product with levamisole.
A source with close
ties to the DEA confirmed this, saying a recent, still-classified report has
revealed that Colombian cocaine producers are putting a great deal of effort
into making sure they maintain access to levamisole. "More than
that," the source says, "I cannot tell you right now."
The Do It Yourself Test Kit
Because the official
research on levamisole's effects on human beings was stopped years ago—and,
apart from Dr. Clark's pending experiments with rats, there's been no official
research on its effects when combined with cocaine—there's still a lot we don't
know. It's possible that agranulocytosis is only one of its health hazards.
According to a 2009
article in the Journal of Analytic Toxicology, levamisole-laced cocaine might
also increase the risk of cardiac problems: "Cocaine increases sympathetic
activity by blocking the reuptake of norepinephrine at the postganglionic synapse.
Additive, if not synergistic effects could be expected when the drugs are
combined. Concerns of increased toxicity with exaggerated pressure response or
development of arrhythmia could then arise when cocaine is combined with
levamisole."
Heart attack and
cardiac arrest are two of the common causes of death associated with cocaine
overdoses—levamisole might exacerbate those risks. It's hard to say: Cocaine,
according to the latest Seattle/King County drug trends report, released this
June, is the most common illegal drug detected in deaths, but its manner of
killing is less clear-cut than opiates. "Opiate overdose is pretty simple
and straightforward," explains Dr. Coffin. "It's breathing. Keep
them breathing and they live. Cocaine is more difficult: Is it a massive heart
attack? Is it a stroke? It's not very well defined."
Currently, people who
suffer cardiac problems associated with cocaine are not tested for the presence
of levamisole, so we really have no idea what kind of damage this new cutting
agent is inflicting on the nation's cocaine users, nor the strain on already
strapped public funds—every time someone without health insurance lands in the
emergency room, it costs taxpayers thousands of dollars.
The fuzziness
surrounding cocaine's destructive qualities makes harm-reduction strategies
more difficult for cocaine than for opiates. Nobody doubts that cocaine is
destructive. "It's toxic to heart-muscle cells," Dr. Coffin says.
"Even in its purest form, it's among the worst recreational drugs for the
cardiovascular system." But its spectrum of harmful qualities, some of
which are exacerbated by levamisole, makes it tricky to pinpoint good
maintenance programs for chronic addicts. Opiate addicts, Dr. Coffin says, can
live on methadone or other controlled dosing mechanisms their entire lives with
no medical harm besides constipation and loss of libido. But cocaine- and
amphetamine-maintenance programs haven't shown any conclusive results, despite
attempts in Colombia to prescribe coca tablets and tea to addicts.
One thing that can be
done: develop an inexpensive field-test kit to try to detect levamisole. Dr.
Clark has invented such a kit and—in association with The Stranger, a few folks
in the local harm-reduction community, and the People's Harm Reduction Alliance
(PHRA), which runs the U-District needle exchange—hopes to begin distributing
kits in a few weeks. Unfortunately, kits are technically drug paraphernalia
under Washington State law, not only because the kits will contain cocaine
residue, but because it is illegal for any person to possess something used to
"process, prepare, test, analyze, pack, repack, store, contain, conceal,
inject, ingest, inhale, or otherwise introduce into the human body a controlled
substance." It's a perfect example of how drug prohibition laws make drugs
more dangerous—an unregulated market for cocaine, with no quality control, has
encouraged the use of levamisole as a cutting agent. And U.S. drug laws make it
illegal for users to test their cocaine for poison—if users could, they might
stop buying from dealers who sell tainted cocaine, putting economic pressure on
the market to be less dangerous. It's a classically self-defeating chain of
policies, but some antidrug warriors defend it on the grounds that since drugs are
illegal, users get what they deserve. And if cocaine is perceived as more
dangerous, perhaps fewer people will use it.
This, of course, is a
cruel, stupid, and expensive way to deal with the problem. As Dr. Clark put it:
"The idea of letting addicts die to make drugs scarier is
reprehensible."
It's not quite the same
in the heroin world: Because of the public outcry about the health risks of
sharing needles, hypodermic syringes have a special exemption. Crack users need
similar exemptions.
"If you read the
paraphernalia laws, cocaine is both the forgotten drug and in some ways the
most hated drug," says Shiloh Murphy, director of PHRA, an independent
nonprofit that isn't affiliated with public-health-funded needle exchanges. He
gestures behind him to a tower of cardboard boxes full of hypodermic needles.
"A young person just starting to inject knows he shouldn't share his
syringes," he says. "But a 20-year crack veteran doesn't realize that
every time he smokes and burns his lips and passes on his stem, he could be
transferring the same diseases—it's open sores to open sores."
To combat this problem,
Murphy has begun a controversial program to distribute crack stems, rubber
crack "condoms," and fresh steel wool to users. (Steel wool, which is
used as a filter in crack pipes, weakens and flakes off after repeated use,
sending red-hot chunks of metal into users' throats and lungs, which leads to
infections and abscesses.) Murphy got the idea for his crack program one
afternoon two years ago, when he was approached by an angry crack user.
"I was sitting at
the table, handing out flyers and things," Murphy says, "and a man
said to me: 'You're a real motherfucker, you know that? You're sitting here
with all these syringes and talking about health. I use crack and my friends
are dying of HIV and hepatitis C and there's nothing on this table for us. I
guess crack users are always just left to die.' I said, 'You're right. I'm
sorry. Tell me what you need.' It was an enlightening moment for me."
"All we have to do,"
he says, "is save one person from getting HIV, and we've become
economically worth it." PHRA's annual budget is around $385,000. Its
budget for the crack program is currently $6,000. The lifetime cost for the
state to take care of an uninsured person with HIV, he says, is half a million
dollars. "We've saved the state thousands and thousands of dollars."
Now Murphy will be at
the forefront of our combined attempt to distribute Dr. Clark's levamisole kits
to cocaine users. The kits will contain instructions for use, a fact sheet
about levamisole and agranulocytosis, and a survey on a prestamped postcard
about where and when the cocaine was purchased, whether it's powder or rock
cocaine, whether it tested positive for levamisole, and a few other research questions.
Hopefully, that data will help us—me, Dr. Clark, PHRA, and a local
harm-reduction organization called DanceSafe—develop a better understanding of
how levamisole-tainted cocaine is distributed through the city and whether some
neighborhoods face greater health risks than others. (Is the cocaine you can
buy on the street in Georgetown, for example, more or less tainted than the
cocaine at some millionaire's house party in Bellevue?)
the bottom line is stop smoking freebase don't keep doing it
ReplyDeleteThis has been going on for a long time.
ReplyDeleteReally nothing new
But people should heed the warning
Devastating effects for those who consume.
ReplyDeleteLike all drugs this one is ferocious.
In the end; it's like buying a lottery ticket. Chances of contradicting are slim to none. Now that is. Not halting the urgency to consume for those addicts.
E42
Not all drugs are ferocious!
DeletePlenty of really good drugs around. Of course, moderation is key.
They use dewormer in ecstasy pills too and that's not even it! Pressed pills are the epitome of nastiness.
503 you sound like a junkie that’s trying to justify their drug use. Drugs aren’t good you sound ignorant to say the least they’re all detrimental to your health including prescription.
Delete5:15 far from a junkie! I just think most are closed minded when it comes to other not so popular drugs. I've never seen a DMT junkie, a psilocybin junkie. Go look up the increased brain activity during a hit of LSD. There are drugs that are illegal cause they are horrible then there are drugs that are illegal cause the government doesn't want you to expand your mind. There are people like you who are clueless and close minded. No one is out there killing people over LSD, DMT or mushrooms. I've used those drugs and have never had an addiction to them. Drugs like that expand your mind 95% of the time. You just can't be weak minded.
DeleteNice find, Frank! Thank you for your contributions.
ReplyDeleteThanks MX, I’ve been reading for years, figured it was time to share what I know/find and also learn from those who post in the forum. Nice job on the Japanese bust post
DeleteCheers!
Coke have been cut with Levamisole for ages now, it's not new, infact it's not used anymore. Superbuff is, which is phenacetin.
ReplyDeleteTheyve always used horse or cow stuff as cutting agents,meth uses rat poison,people are barely surprised? As if drugs arent dangerous alone
ReplyDeleteHow bout that entitled crack head? Give me give me give me...
ReplyDeleteCoke also is made with gasoline..
ReplyDeleteMexican drug cartels creating more american dummies every year with that fake tainted coke.
DeleteInteresting report. It's always been my understanding the levamisole is used as a cutting agent because it exacerbates the high. Which never really made much sense to me. I doubt it has anything to do with maintaining the fish scale sheen much more effective alternatives. What is interesting is how wide spread it is. And so little information.
ReplyDeleteI wonder if worms we’re eating the dope?either while being shipped inside the animal or during the pre or post distribution phase.
DeleteExcellent read
ReplyDeleteHowever the words Russian and Irainian makes me think its a plan to kill or hurt Westerners ..
Thanks for the Education
Oh hell
ReplyDeleteNo!! I ain’t ever doing another BUMP in my life..
North americans are getting scammed wih that fake shxt.
DeleteGotta have a good connection lol.. most of shit that comes all cut up is frm chumps that buy 3 keys and try to make triple smh.. cocaine is a hell of a drug 🤣
ReplyDelete