An analysis of cocaine powder in the Netherlands: content and health hazards due to adulterants

Brunt, Tibor M.; Rigter, Sander; Hoek, J.; Vogels, Neeltje; Dijk, Peter Van; Niesink, Raymond

doi:10.1111/j.1360-0443.2009.02532.x

Cited by 84 publications

(61 citation statements)

References 31 publications

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“…Nowadays levamisole is almost only used in veterinary medicine as an anthelminthic, but recently, it has been found to be an adulterant of seized cocaine in several countries (USA [1], Canada [2], the Netherlands [3], Italy [4] and Spain [5] among others). It is supposed to be added to cocaine in order to enhance its euphoric effects, as it is believed to inhibit dopamine reuptake in presynaptic terminals of neurons [6].…”

Section: Discussionmentioning

confidence: 99%

Necrosis of Ears after Use of Cocaine Probably Adulterated with Levamisole

et al. 2011

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Background/Aims: Levamisole is an anthelminthic drug with immunomodulatory properties that has been found to be an adulterant of cocaine in the last 2 years. It was present at least in 70% of tainted cocaine in the USA in 2009. Methods: We present the case of a 40-year-old patient with a history of weekend cocaine use who consulted for bilateral necrotic lesions in the ears that had appeared 3 days after the last use. Results: Levamisole causes a typical clinical picture characterized by bilateral necrosis of the ears, positive perinuclear antineutrophil cytoplasmic antibodies and laboratory findings of antiphospholipid syndrome, such as anticardiolipin antibodies and/or lupus anticoagulant. Conclusion: Dermatologists should be aware of this new entity, which is likely to be more and more frequent due to the increasing use of cocaine. Here we describe a clinical case that is likely to be secondary to levamisole-tainted cocaine and review the literature.

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Section: Discussionmentioning

confidence: 99%

Necrosis of Ears after Use of Cocaine Probably Adulterated with Levamisole

et al. 2011

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“…Similar results have been observed elsewhere in Italy [18], and the rest of Europe [19], though the true percentage is not known. Levamisole now permeates the U.S. cocaine supply [3,7,9,11,12,[20][21][22][23][24][25], and there may well be a medical price to pay. …”

Section: Levamisole-adulterated Cocainementioning

confidence: 99%

“…However, the authors of the Dutch report also observed that cardiac and hallucinatory effects in that region's cocaine abusers were, for no apparent reason, being reported more frequently. They suggested that the adverse effects might have been due to some unrecognized adulterant [3]. These speculations were followed five years later by controlled studies demonstrating the equine conversion of levamisole to aminorex [4].…”

Section: Introductionmentioning

confidence: 96%

Aminorex poisoning in cocaine abusers

Karch¹,

Mari

Bartolini

et al. 2012

International Journal of Cardiology

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“…The term “crack” is derived from the audible crackling noise produced when this form is heated as it is smoked. Street forms of cocaine may contain adulterants such as sugar, and anesthetics like lidocaine and benzocaine (Fucci & De Giovanni, 1998) (McKinney et al, 1992) and other adulterants (Evrard et al, 2010) (Brunt et al, 2009). Of particular concern is the recent finding that nearly 70% of seized cocaine entering the USA contains detectable amounts of the agranulocytosis-inducing, anti-helminthic drug, levamisole.…”

Section: Introductionmentioning

confidence: 99%

Pharmacotherapeutics directed at deficiencies associated with cocaine dependence: Focus on dopamine, norepinephrine and glutamate

Haile

Mahoney

Newton

et al. 2012

Pharmacology & Therapeutics

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Much effort has been devoted to research focused on pharmacotherapies for cocaine dependence yet there are no FDA-approved medications for this brain disease. Preclinical models have been essential to defining the central and peripheral effects produced by cocaine. Recent evidence suggests that cocaine exerts its reinforcing effects by acting on multiple neurotransmitter systems within mesocorticolimibic circuitry. Imaging studies in cocaine-dependent individuals have identified deficiencies in dopaminergic signaling primarily localized to corticolimbic areas. In addition to dysregulated striatal dopamine, norepinephrine and glutamate are also altered in cocaine dependence. In this review, we present these brain abnormalities as therapeutic targets for the treatment of cocaine dependence. We then survey promising medications that exert their therapeutic effects by presumably ameliorating these brain deficiencies. Correcting neurochemical deficits in cocaine-dependent individuals improves memory and impulse control, and reduces drug craving that may decrease cocaine use. We hypothesize that using medications aimed at reversing known neurochemical imbalances is likely to be more productive than current approaches. This view is also consistent with treatment paradigms used in neuropsychiatry and general medicine.

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An analysis of cocaine powder in the Netherlands: content and health hazards due to adulterants

Cited by 84 publications

References 31 publications

Necrosis of Ears after Use of Cocaine Probably Adulterated with Levamisole

Necrosis of Ears after Use of Cocaine Probably Adulterated with Levamisole

Aminorex poisoning in cocaine abusers

Pharmacotherapeutics directed at deficiencies associated with cocaine dependence: Focus on dopamine, norepinephrine and glutamate

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