Some people still get very ill because of cocaine contaminated with levamisole. (It’s a toxic substance for de-worming animals, added by cocaine producers.) Most people doing cocaine do not react, however, people who do can have severe infections or sickness. Most crack/cocaine contains levamisole. You can’t tell if it’s there by looking at it, smelling. 99% Pure Levamisole HCl Powder is an anthelmintic (anti-worm) agent that works to rid of unwanted parasites in your aquarium, and boosts your pets' depressed immune systems. Relied upon by both aquatic hobbyists and experienced professionals, Subquaria Levamisole powder enables you to combat worms and parasites quickly and safely.
How to Make Your Very Own Levamisole Test Kit
Dr. Michael Clark, a psychiatrist and molecular biologist at Seattle’s Harborview Medical Center, invented a relatively cheap and easy-to-use street test kit to detect the presence of levamisole in—well, in anything. The kit requires no special, rare, toxic, or restricted ingredients and should be easy to assemble in most basic labs. Read through the recipe and make all solutions used before starting a test. They will stay good for several months—or even years—if stored in glass bottles.
Typically, we make a few hundred kits at a time and then distribute them for testing. You can find cartoon instructions on how to use the test (plus some visuals that might aid in assembling them) here.
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His recipe:
Step 1: Get 2 test vials. We use disposable spectrophotometer cuvettes—the only requirement is that they’re clear and can hold 3.5 mL or more. The first vial is for testing your sample; the second vial is a control for comparison.
Step 2: Make the reaction buffer. It consists of 1M diethanolamine and 0.5 mM magnesium chloride adjusted to pH 9.8 with hydrochloric acid. We typically make this by the liter. It can be stored at room temperature for several months in glass bottles.
Step 3: Get 0.25 mL of 150 mM fresh para-nitrophenyl phosphate solution, or a stabilized substrate like Pierce 1-Step pNPP for each vial. We use Pierce 1-Step pNPP because we tested it for stability (4 weeks at room temperature in the dark, no change from baseline) and because it claims to have no toxic components.
Step 4: Get 2.5 units of bovine kidney alkaline phosphatase for each vial. This enzyme is sold in “units” (typically by the kU, which is 1,000 units). One unit of enzyme is the amount needed to produce one micromole of p-NP from p-NPP each minute.
We rehydrate the enzyme at a concentration of 1.25 units per microliter in an enzyme buffer containing 50 mM Tris-Cl, 100 mM NaCl that has been adjusted to pH 8.0 with HCl. The enzyme buffer should be prepared in advance. We usually make 250–500 mL of buffer at a time. The buffer will stay good for years if stored in a glass bottle. Once rehydrated, the enzyme solution will stay good for “several months” at 4°C, per the original characterizing paper.
We pipette 2 uL (2.5 units) of the bovine kidney alkaline phosphatase onto disposable plastic cuvette caps that fit our test vials. The caps are then freeze-dried—using a vacuum pump with a cold trap—and packaged with silica gel desiccator packets in a tightly sealed container until ready for use. If using liquid enzyme solution stored in the fridge, freeze-drying is not necessary.
Now that you’ve assembled your components—vials, reaction buffer, substrate, alkaline phosphatase enzyme—you can move on to testing your sample.
Test step 1: Add a small (about 20 mg) sample of powder or crack cocaine to the bottom of the first vial (the vial for testing your substance), but not the second (the control vial). If the sample is crack, you need to dissolve it with a few drops of 50% (weight/volume) citric acid.
Test step 2: Add 2.25 mL of reaction buffer to each tube.
Test step 3: Add 0.25 mL of 150 mM fresh para-nitrophenyl phosphate solution, or a stabilized substrate like Pierce 1-Step pNPP, to each vial.
Test step 4: Place the caps (with the alkaline phosphatase enzyme) on the top of each tube and press down to seal.
Test step 5: Mix the contents of the tubes by turning upside down and back several times; wait 30 seconds while watching carefully.
Possible Results
If both vials turn yellow at approximately the same rate, levamisole is not present. (Since levamisole is a potent inhibitor of alkaline phosphatase, the test is looking for an inhibition. Therefore, if the chemical reaction—turning yellow—occurs, there’s no levamisole.)
If the first vial does not change in 30 seconds or develops a yellow color more slowly than the second tube, levamisole is present.
If the second vial (the control vial) does not turn yellow, something went wrong. Repeat the test.
This kit is sensitive to 0.25–0.5% levamisole (weight/weight).
If you have questions about this test kit or levamisole-tainted cocaine in general, please e-mail [email protected].
It was a medical mystery. In the summer of 2008, a man and woman, both in their 20s and both cocaine users, were separately admitted to a Canadian hospital with unremitting fevers, flulike symptoms and dangerously low white-blood-cell counts. Their symptoms were consistent with a life-threatening immune-system disorder called agranulocytosis, which kills 7% to 10% of patients and is rare except in chemotherapy patients and those taking certain antipsychotic medications.
Neither of the Canadian patients fit that bill, but they did have one thing in common: illegal drug use, says Dr. Nancy Zhu, who treated the patients during her hematology fellowship at the University of Alberta Hospital in Edmonton. 'We were theorizing that maybe it was something in the cocaine,' she says.
(See how cocaine scrambles genes in the brain.)The medical literature didn't contain any studies linking agranulocytosis with cocaine. However, in April of that same year, a New Mexico lab had identified a small number of unexplained cases of the disorder, also in people who had snorted, injected or smoked cocaine. Later, in 2009, a few cocaine addicts in San Francisco — crack smokers, mostly — began displaying even stranger symptoms, like dead, darkened skin. 'It looked like people were getting burns all over their body,' says Dr. Jonathan Graf, a rheumatologist at the University of California, San Francisco. '[Their skin was] black, as if you had taken a cigarette butt to it. In some people, it was all over, on their legs and bellies.'
By that time, back in Canada, a toxicologist at Alberta Hospital had noticed an unusual chemical in the urine of the two cocaine-using patients: levamisole. Zhu contacted him, and they put the puzzle together. Further research revealed that levamisole, a drug that was once used to treat colon cancer but is now reserved for veterinary use as a medication to get rid of worms, can cause agranulocytosis in humans. The 'burns' seen on Californian patients, who also were suffering from agranulocytosis, were the result of skin infections related to patients' compromised immunity. There have now been several dozen cases of cocaine-related agranulocytosis reported in North America — and one known death. 'For some reason, this drug called levamisole keeps popping up,' Zhu says.
(See the top 10 scientific discoveries of 2009.)Where is it coming from? According to the U.S. Drug Enforcement Agency, levamisole has become increasingly popular as a 'cut,' or diluting agent, in cocaine and possibly some heroin. It is now found in 70% of all cocaine seized in the U.S., up from 30% in 2008. Unlike most cuts — usually inert or relatively harmless substances like the B vitamin inositol, which are added by lower-level dealers looking to stretch supplies — levamisole appears to be added to cocaine from the outset, in the countries of origin. The substance has been found in various concentrations in cocaine analyzed in countries around the world, from Switzerland to Australia. And urine tests of cocaine users attending a drug clinic at San Francisco General Hospital in 2009 — one floor above Graf's office — found that 90% of samples were positive for levamisole; similar tests in Seattle revealed that 80% of cocaine users there had levamisole in their systems.
'If it's showing up in all those different places, that's a prima facie indicator that it's happening at the highest levels of production,' says Craig Reinarman, a sociologist at the University of California, Santa Cruz, who has long studied cocaine. But since cocaine is illegal, there's no easy way to remove levamisole from the supply chain. Law enforcement could instead target large purchasers, possibly putting pressure on dealers to switch to other cuts.
(See the top 10 news stories of 2009.)Levamisole is cheap, widely available and seems to have the right look, taste and melting point to go unnoticed by cocaine users, which may alone account for its popularity. 'Ease of availability seems likely to be important,' says Reinarman. 'Let's remember that producer countries are widely agrarian.' Levamisole is used on farms, and its cost per gram is minimal.
An understanding of how levamisole affects the body, however, may better explain its explosive popularity. A 1998 paper found that levamisole relieved symptoms of heroin withdrawal in rats and also raised levels of various brain chemicals related to drug highs. 'It may increase dopamine and by so doing may enhance cocaine effects,' speculates Dr. Nora Volkow, director of the National Institute on Drug Abuse.
(See 2009's best pictures.)Research conducted by Eldo Kuzhikandathil, assistant professor of pharmacology at the University of Medicine and Dentistry of New Jersey, suggests that levamisole may indirectly increase the number of D1 dopamine receptors in the brain by affecting gene expression there. 'Cocaine increases D1 expression,' he says, 'and this would probably accentuate that,' which could enhance both highs and craving.
Levamisole also affects acetylcholine receptors throughout the body, which can boost heart rate — and studies of cocaine users show that they associate jumps in heart rate with getting high, spurring good feelings even before the drug hits the brain. A cut that accelerates heart rate might make them think they're getting the real thing. In the brain, levamisole may affect the same acetylcholine receptors activated by nicotine, another addictive drug that raises dopamine levels — which may be another clue to levamisole's lure.
(See pictures of the antinarcotics police in Guinea-Bissau and Liberia.)But despite the wide use of levamisole, cases of agranulocytosis are relatively uncommon. According to government surveys, nearly 2 million Americans have used cocaine at least once in the past month. 'Why aren't 90% of cocaine users [in San Francisco] getting sick?' wonders Graf, who says he sees about one case every few weeks, mostly in women. He suspects that men are less likely to be affected because they are less vulnerable to autoimmune disorders than women, but says the truth is that no one really knows why certain users become ill. Zhu and Graf urge users who are suffering from fever or unexplained infections to seek medical help immediately — the sooner agranulocytosis is treated, the greater the odds of survival.
To both physicians, the biggest mystery may be the power of cocaine addiction itself. Some of Graf's patients waited months before seeking help, as patches of painful, blackened skin continued to grow — and some continued to use cocaine despite learning that it caused their immune problems and that they could require plastic surgery to avoid permanent disfigurement. Zhu has treated several patients with life-threatening infections, some needing breathing tubes and intensive care. 'It's quite sad — every time they use [cocaine], it happens. They wind up in the hospital for several weeks and almost die. But as soon as they go home and back into that environment, the cycle begins again.'
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