A PSA-style book geared at children. The title is “Focus On Cocaine and Crack.”
Cocaine cut with livestock dewormer is causing users' skin to rot and fall off. (Photo Credit: CC BY-SA/Edward O'Connor/Flickr)

People who use drugs indiscriminately are taking real risks with their health. People who use tainted drugs fall prey to maladies that can make the flesh crawl, quite literally. Reports from the streets of New York and Los Angeles indicate that cocaine cut with a drug used by veterinarians to deworm livestock is causing users’ skin to rot and fall off.

Worming in on horror movie action

In a June report published in the Journal of the American Academy of Dermatology, a cadre of physicians recalled a number of cases in which users developed sizable areas of dead skin after using cocaine laced with levamisole. Levamisole, a hydrochloride salt marketed under the name Ergamisol, was discovered by Janssen Pharmaceutica in 1966. It was used to treat humans with parasitic worm infections, and was under consideration for use in the chemotherapy treatment of colon, head and neck cancer, as well as melanoma.

The drug was withdrawn from the U.S. and Canadian markets for human use in 2000 and 2003, respectively, because of the serious side effects. It remains in use by veterinarians to deworm livestock. According to drug officials, the use of levamisole as a cocaine cutting (diluting) agent has skyrocketed in recent years, to the point that in 2010, nearly 80 percent of the cocaine entering the U.S. was cut with the deworming agent. Time reports that health departments in Canada, New Mexico, Delaware and Washington state are currently on guard for tainted cocaine.

Cocaine causes necrosis

Dr. Mary Mercurio, a University of Rochester Medical Center dermatologist and co-author of the levamisole in cocaine study, has seen multiple cases in which cocaine users develop dead skin in the past year. This may because, in addition to being cheap, levamisole is believed to intensify the cocaine high and later cravings by stimulating the production of D1 dopamine receptors in the brain via the alteration of gene expression.

Mercurio believes health officials have only seen the tip of the iceberg.

“We’ve seen very profound areas of necrosis — dying skin — usually located on scalp, ears, face and elsewhere on the body,” she said. “It’s very alarming.”

Of livestock and crocodiles

In addition to the horror of levamisole, which kills blood vessels and causes skin to turn black and rot off, the blog Scallywag & Vagabond points to another drug terror from Russia known as krokodil (Крокодил, or “crocodile”). This opiate is cooked using a mixture of gasoline, paint thinner, hydrochloric acid, red phosphorous and codeine. It’s cheap and much more potent than heroin, according to sources. Reportedly, it is also disfiguring and can make it appear the user has developed gangrene.

What cocaine does to the brain


American Academy of Dermatology study: http://www.sciencedirect.com/science/article/pii/S0190962210009928

Levamisole Wiki: http://en.wikipedia.org/wiki/Levamisole

New York Daily News: http://nydn.us/mfqhpz

Scallywag & Vagabond: http://bit.ly/kXKiGj (NSFW images)

Time: http://www.time.com/time/health/article/0,8599,1955112,00.html

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