To the list of cocaine’s many dangers, health officials have added at least one more: purpura, a rash caused by internal bleeding from small blood vessels. Two recent papers in major medical journals have documented cases of cocaine users showing up in emergency rooms with patches of blackened, dying skin on the ears, face, trunk or extremities. The condition causes scarring and sometimes requires reconstructive surgery. Noah Craft, a dermatologist at the Harbor-UCLA Medical Center who co-authored a paper on the condition published online by the Journal of the American Academy of Dermatology in June, says he now sees about one case per month: “It’s become almost routine.”

The cause of the outbreak is a veterinary deworming medication that has become the most common ingredient used to dilute, or cut, cocaine coming into the U.S. from South America. The drug, called levamisole, was once approved for cancer treatment but was later pulled because of its side effects. Three quarters of the cocaine bricks seized by the U.S. Drug Enforcement Administration now contain levamisole.

Equally worrying is another of its side effects: a sometimes fatal lowered count of white blood cells that are called neutrophils. Doctors suspect that both conditions are allergic reactions to the drug. In one disease, the body’s immune system attacks the skin; in the other, it attacks the bone marrow.

Traffickers may add levamisole to cocaine because it is cheaper than pure cocaine and may contribute to the cocaine high. Papers between the 1970s and 1990s, when levamisole was being suggested and then approved for medical use in the U.S., found it improved mood and caused insomnia and hyperalertness, effects that are similar to cocaine’s.

For now, the dea will not change how it pursues traffickers, says Barbara Carreno, an agency spokesperson. But doctors are learning to spot the skin rash quicker. Craft has added photos of his patients to a computerized alert system used by 1,300 hospitals nationwide.

This article was originally published with the title Cocaine's Newest Risks.

6 Comments

1. 1. apapier 07:22 AM 8/23/11

   The computerized alert system the article refers to is VisualDx. VisualDx provides point of care diagnostic assistance in clinics, hospitals and doctors offices. Interested readers should refer to: http://www.skinsight.com/info/health_article/2011/06/21/cocaine-levamisole-toxicity . This is information posted from the professional VisualDx system to the public page at Skinsight. Physicians and other health professionals should refer to VisualDx at their healthcare institutions to see the visual differential diagnosis of eschar or purpura. The differential diagnosis is complex and broad, but purpura localizing to the ears, cheeks and nose should include cocaine levamisole toxicity.

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2. 2. Jonah Gruber 09:38 AM 8/23/11

   Fairly sure this is the same type of crime-fighting policy that brought us "buying guns from gangsters to find gangsters."
   
   The government is selling this stuff, just like they did in the 1970s. I don't think this is too conspiratorial. Drug cartels have a really nice thing going on, they have no reason to "cut cocaine" with "deworming agents."
   
   My bet is either on government meddling with drugs to manufacture "outbreaks," or an inter-cartel conflict. My instincts and understanding of DEA policies past and future make me think the former. "Three quarters of the cocaine bricks seized by the U.S. Drug Enforcement Administration now contain levamisole." Well, my eternal trust in the infallibility and goodness of the DEA will never be tested. 45 tons of cocaine suddenly have deworming powder in them for no reason whatsoever, a pill that happens to make you look ugly (great press!), something that might greatly hurt a drug dealer's ability to continue being a drug dealer, but does nothing more severe than that other than give the DEA talking points.
   
   Hmmmmmmmmm....

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3. 3. lamorpa in reply to Jonah Gruber 11:35 AM 8/23/11

   Jonah:
   It's only cocaine sold by the man on the grassy knoll that contains it...

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4. 4. myn0s 11:50 AM 8/23/11

   ...So it's not <b>actually</b> the Cocaine that's causing the problem. It's the unregulated criminals who cut it with all kinds of crap that are causing this...

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5. 5. AdamK83 in reply to myn0s 01:39 PM 8/24/11

   "The government is selling this stuff, just like they did in the 1970s. I don't think this is too conspiratorial. Drug cartels have a really nice thing going on, they have no reason to 'cut cocaine' with 'deworming agents.' My bet is either on government meddling with drugs to manufacture "outbreaks," or an inter-cartel conflict."
   
   "...So it's not <b>actually</b> the Cocaine that's causing the problem. It's the unregulated criminals who cut it with all kinds of crap that are causing this..."
   
   You are correct - Cocaine isn't cause this problem. Cocaine is actually 100% completely safe and does not cause any harm at all to a person. There are NO reported deaths from Cocaine nor is it abused in any way. Cocaine Induced Psychosis Disorder is something that Doctors make up with the government to help the conspiracy that is going on to prevent those honest drug dealers from making a living.

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6. 6. myn0s 01:59 PM 8/24/11

   Actually I was speaking specifically about this article. I'm sure that Cocaine is extremely dangerous, I'll never state otherwise. But it's not the cause of this particular problem.

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