Levamisole is an antibiotic medication used to treat colon cancer and is a synthetic imidazothiazole derivative also employed as an antihelminthic to treat worm infestations in both humans and animals. Even if it is not yet well known why levamisole is added to cocaine, the presence of this adulterant is very dangerous, in fact this compound suppresses the production of white blood cells, resulting in neutropenia, agranulocytosis and idiopathic pulmonary hypertension. With the increasing use of levamisole as an adulterant, a number of these complications have been reported among cocaine users. The authors refer about the detection of levamisole in gastric content taken from a 48- year old woman who was found deceased at home with no evidence of trauma or asphyxia. The cause of death was related to an overdose of cocaine and morphine, and the presence of levamisole in gastric contents was correlated to oral ingestion of a considerable amount of cocaine, a hypothesis suggested by the presence of white powder found on the walls of the stomach of the cadaver.

Because levamisole is very common in samples of cocaine, as already observed elsewhere in Italy, in Europe and USA, and as the true percentage is not known, we believe this information could be useful. The presence of levamisole in cocaine suggested the increase of some symptoms as agranulocytosis, necrotizing vasculitis and idiopathic pulmonary hypertension;neither condition is very common and their diagnosis, particularly in a young person, should initiate a search for levamisole-contaminated cocaine. And such relevant topic falls under the scope of Journal of Forensic Toxicology & Pharmacology.

Katherine Gray
Editorial Coordinator
Journal of Forensic Toxicology and Pharmacology
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