FW: [EMS-L] Fw Cocaine adulteration advisory

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Lee

[EMS-L] Fw Cocaine adulteration advisory

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======================================================

The Commonwealth of Massachusetts

Executive Office of Health and Human Services Department of Public Health

250 Washington Street, Boston, MA 02108-4619

DEVAL L. PATRICK

GOVERNOR

LIEUTENANT GOVERNOR

TIMOTHY P. MURRAY

JUDYANN BIGBY, MD

SECRETARY

JOHN AUERBACH

COMMISSIONER

Health Advisory for Substance Abuse Providers

Cocaine Cutting Agent Causes Potentially Life-threatening Conditions

A cocaine user was admitted to a Boston area hospital recently with

agranulocytosis, a serious, acute blood disease characterized by low

white blood cell counts. Agranulocytosis may be associated with fever

and ulcerations of the mucous membranes, as well as immune compromise

and infections. The cause appeared to be associated with cocaine that

had been cut with levamisole. Levamisole has been used in veterinary

medicine in the de-worming of animals. It was used in human medicine

in the past for treating autoimmune diseases and cancer, was not very

effective, had severe adverse events associated with it, and is no

longer an approved drug for human use.

Levamisole is likely added to the cocaine product at the point of

production outside of the United States, though it is not understood

why. It can seriously reduce a person's white blood cells, suppressing

immune function and the body's ability to fight off even minor

infections. People who snort, smoke, or inject crack or powder cocaine

contaminated by levamisole can develop overwhelming, rapidly

developing, and life threatening infections. Other serious side

effects also occur.

Cocaine users with potentially life-threatening agranulocytosis have

presented in various cities in the U.S. and Canada. Some evidence

suggests that levamisole used to adulterate cocaine may be causing a

drug-induced effect on the bone marrow. Studies of cocaine from street

sources have revealed adulteration with levamisole in up to 30% of

samples; so many users might be at risk.

Investigational methods to test for the presence of levamisole in

urine or samples of cocaine are available, but the drug is quickly

eliminated and urine must be collected as close as possible after last

exposure to cocaine. The agranulocytosis is reversible with the

elimination of exposure to levamisole and these patients should

respond to usual treatment for agranulocytosis.

The Massachusetts Department of Public Health asks substance abuse

services providers and clinicians who might be seeing patients at

risk, to report any case of unexplained granulocytopenia in a cocaine

user to your Bureau of Substance Abuse Services Regional Manager.

--

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Elias Friedman A.S., EMT-P âš•

×Âלי×â€Ã—• מתתי×â€Ã—• בן צבי

elipongo@...

http://elipongo.blogspot.com/

--

EMS-L

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[Guest guest]

Well, the upside is that people who use that stuff won't have worms.

GG

In a message dated 8/31/09 10:42:03 AM, L@...

writes:

>

> From another list

>

> Lee

>

> [EMS-L] Fw Cocaine adulteration advisory

>

> Posted via the EMS-L mailing list and never sent unsolicited.

> Please see message footer for unsubscribe directions.

> ============ ======== ======== ======== ======== =====

>

> The Commonwealth of Massachusetts

> Executive Office of Health and Human Services Department of Public Health

> 250 Washington Street, Boston, MA 02108-4619

> DEVAL L. PATRICK

> GOVERNOR

> LIEUTENANT GOVERNOR

> TIMOTHY P. MURRAY

> JUDYANN BIGBY, MD

> SECRETARY

> JOHN AUERBACH

> COMMISSIONER

> Health Advisory for Substance Abuse Providers

> Cocaine Cutting Agent Causes Potentially Life-threatening Conditions

> A cocaine user was admitted to a Boston area hospital recently with

> agranulocytosis, a serious, acute blood disease characterized by low

> white blood cell counts. Agranulocytosis may be associated with fever

> and ulcerations of the mucous membranes, as well as immune compromise

> and infections. The cause appeared to be associated with cocaine that

> had been cut with levamisole. Levamisole has been used in veterinary

> medicine in the de-worming of animals. It was used in human medicine

> in the past for treating autoimmune diseases and cancer, was not very

> effective, had severe adverse events associated with it, and is no

> longer an approved drug for human use.

> Levamisole is likely added to the cocaine product at the point of

> production outside of the United States, though it is not understood

> why. It can seriously reduce a person's white blood cells, suppressing

> immune function and the body's ability to fight off even minor

> infections. People who snort, smoke, or inject crack or powder cocaine

> contaminated by levamisole can develop overwhelming, rapidly

> developing, and life threatening infections. Other serious side

> effects also occur.

> Cocaine users with potentially life-threatening agranulocytosis have

> presented in various cities in the U.S. and Canada. Some evidence

> suggests that levamisole used to adulterate cocaine may be causing a

> drug-induced effect on the bone marrow. Studies of cocaine from street

> sources have revealed adulteration with levamisole in up to 30% of

> samples; so many users might be at risk.

> Investigational methods to test for the presence of levamisole in

> urine or samples of cocaine are available, but the drug is quickly

> eliminated and urine must be collected as close as possible after last

> exposure to cocaine. The agranulocytosis is reversible with the

> elimination of exposure to levamisole and these patients should

> respond to usual treatment for agranulocytosis.

>

> The Massachusetts Department of Public Health asks substance abuse

> services providers and clinicians who might be seeing patients at

> risk, to report any case of unexplained granulocytopenia in a cocaine

> user to your Bureau of Substance Abuse Services Regional Manager.

>

> --

> Sent from my mobile device

>

> Elias Friedman A.S., EMT-P D+$¢®

> ¡ß¢®¡ßD)M¡ßD " o¡ß¡É¡ß

¡ß¢®¡ßD " l¡ßD " l¡ßD " o¡ß¡É¡ß ¡ß¡Æ¡ßD*s

¡ß¢®¡ß¡Æ¡ßD " o

> elipongo@...

> http://elipongo.http://elhttp

>

> --

>

> EMS-L

>

> Unsubscribe: Blank e-mail to: EMS-L-UNSUBSCRIBE@EMS-L-UNS

> Post to list: EMS-L@...

> List Manager: listadmin@EMS-lista

>

>

>

>

[Guest guest]

Well, the upside is that people who use that stuff won't have worms.

GG

In a message dated 8/31/09 10:42:03 AM, L@...

writes:

>

> From another list

>

> Lee

>

> [EMS-L] Fw Cocaine adulteration advisory

>

> Posted via the EMS-L mailing list and never sent unsolicited.

> Please see message footer for unsubscribe directions.

> ============ ======== ======== ======== ======== =====

>

> The Commonwealth of Massachusetts

> Executive Office of Health and Human Services Department of Public Health

> 250 Washington Street, Boston, MA 02108-4619

> DEVAL L. PATRICK

> GOVERNOR

> LIEUTENANT GOVERNOR

> TIMOTHY P. MURRAY

> JUDYANN BIGBY, MD

> SECRETARY

> JOHN AUERBACH

> COMMISSIONER

> Health Advisory for Substance Abuse Providers

> Cocaine Cutting Agent Causes Potentially Life-threatening Conditions

> A cocaine user was admitted to a Boston area hospital recently with

> agranulocytosis, a serious, acute blood disease characterized by low

> white blood cell counts. Agranulocytosis may be associated with fever

> and ulcerations of the mucous membranes, as well as immune compromise

> and infections. The cause appeared to be associated with cocaine that

> had been cut with levamisole. Levamisole has been used in veterinary

> medicine in the de-worming of animals. It was used in human medicine

> in the past for treating autoimmune diseases and cancer, was not very

> effective, had severe adverse events associated with it, and is no

> longer an approved drug for human use.

> Levamisole is likely added to the cocaine product at the point of

> production outside of the United States, though it is not understood

> why. It can seriously reduce a person's white blood cells, suppressing

> immune function and the body's ability to fight off even minor

> infections. People who snort, smoke, or inject crack or powder cocaine

> contaminated by levamisole can develop overwhelming, rapidly

> developing, and life threatening infections. Other serious side

> effects also occur.

> Cocaine users with potentially life-threatening agranulocytosis have

> presented in various cities in the U.S. and Canada. Some evidence

> suggests that levamisole used to adulterate cocaine may be causing a

> drug-induced effect on the bone marrow. Studies of cocaine from street

> sources have revealed adulteration with levamisole in up to 30% of

> samples; so many users might be at risk.

> Investigational methods to test for the presence of levamisole in

> urine or samples of cocaine are available, but the drug is quickly

> eliminated and urine must be collected as close as possible after last

> exposure to cocaine. The agranulocytosis is reversible with the

> elimination of exposure to levamisole and these patients should

> respond to usual treatment for agranulocytosis.

>

> The Massachusetts Department of Public Health asks substance abuse

> services providers and clinicians who might be seeing patients at

> risk, to report any case of unexplained granulocytopenia in a cocaine

> user to your Bureau of Substance Abuse Services Regional Manager.

>

> --

> Sent from my mobile device

>

> Elias Friedman A.S., EMT-P D+$¢®

> ¡ß¢®¡ßD)M¡ßD " o¡ß¡É¡ß

¡ß¢®¡ßD " l¡ßD " l¡ßD " o¡ß¡É¡ß ¡ß¡Æ¡ßD*s

¡ß¢®¡ß¡Æ¡ßD " o

> elipongo@...

> http://elipongo.http://elhttp

>

> --

>

> EMS-L

>

> Unsubscribe: Blank e-mail to: EMS-L-UNSUBSCRIBE@EMS-L-UNS

> Post to list: EMS-L@...

> List Manager: listadmin@EMS-lista

>

>

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