Adultération de la cocaïne par le lévamisole: quels risques?
(2015) Toxicologie Analytique et Clinique — Vol. 27, n° 6, p. 216-225 (2015)
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- (en) [Cocaine adulterated with levamisole: Which are the risks?] The presence of adulterants in cocaine preparations has been reported for many years. Until recently, it was assumed that the main objective of cocaine adulteration was the reduction of the purity of the cocaine, with a financial benefit for the dealers. However, it appeared rapidly that cocaine was also adulterated by pharmacologically active substances. Therefore, some serious adverse effects can be expected in relationship with the properties of these substances. Since 2003, levamisole was regularly introduced as a cocaine adulterant in the United States, with a rapid spread in the other countries. Today, it seems actually that about 70% of all the cocaine seized worldwide is containing levamisole. Historically, levamisole is an antihelminthic agent that was also used in humans as an immunomodulator to treat some specific inflammatory diseases. Currently, its human use is banned in most countries due to the high incidence of serious hematological and dermatological side effects. It is therefore not surprising to observe similar complications after the introduction of levamisole as a cocaine adulterant, while other manifestations may still appear after some delay. Recent data also show that levamisole can be transformed in humans into aminorex, an amphetamine-like substance that was used in the past as an anorexic agent and that was associated with some specific complications (idiopathic pulmonary hypertension) after chronic use. Finally, the possible interaction of levamisole and aminorex with cerebral neurotransmission, including serotoninergic and dopaminergic pathways, suggests that both substances could interfere with the central nervous system effects of cocaine.
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Hantson, P. (2015). Adultération de la cocaïne par le lévamisole: quels risques? Toxicologie Analytique et Clinique, 27(6), 216-225. https://doi.org/10.1016/j.toxac.2015.08.002 (Original work published 2015)