Nearly 70 percent of the cocaine entering the U.S. Virgin Islands and the rest of the country right now is contaminated with a cattle de-worming chemical, causing poisonings and immune system disorders in some users.
The Poison Information Center for Florida and U.S. Virgin Islands has issued an alert to all emergency departments in its geographic area to be on the alert for deadly immune system problems in cocaine and heroin users.
The two conditions, severe neutropenia and agranulocytosis, are immune problems related to the death of white blood cells. Neutropenia is an abnormally low level of white blood cells, used by the body to fight off infections. Agranulocytosis is even more severe, with a dangerously low level of these protective white blood cells. These effects are purportedly due to the contaminant, levamisole, being mixed in with these street drugs. Levamisole is used as a de-worming agent in veterinary medicine and is currently approved for use in cattle, sheep and swine. It has also been used for treating autoimmune diseases and cancer, but is no longer approved for human use in the United States.
There have been two confirmed deaths and more than 20 cases of illness directly tied to levamisole-contaminated cocaine or heroin, Dr. Jay Schauben, the center’s director, said Wednesday.
The problem has been growing for the past six months to a year, Schauben said. The adulterant is being added at the source before being shipped out.
"A lot of the South American labs seem to be adding this chemical, and we don’t know why," he said.
As part of surveillance efforts mounted by the Florida Department of Health and the Centers for Disease Control, the poison center has requested emergency departments to report any such cases occurring in the cocaine- or heroin-abusing population.
Symptoms can include fever, infections, swelling, sores that won’t heal and other signs of a compromised immune system, he said. The untreated infections can overwhelm the patient, leading to death, he said.
“We are not trying to get anyone in trouble but to find out what kind of public health impact this is going to have," Schauben said. The information will be used to help target drug prevention messages, according to the Poison Information Center.
Heavy use is not necessary to cause the reaction. Three to 10 percent of people exposed to the contaminant have an "idiosyncratic" reaction, developing immune problems even at low levels of exposure, Schauben said.
According to the Drug Enforcement Administration, as of July 2009, 69 percent of cocaine and three percent of heroin seized before arriving in the United States was contaminated with levamisole.
If you suspect a poisoning has occurred, or if you have questions concerning poisonings, immediately call the Poison Center at 1-800-222-1222. The line is open 24 hours a day.
