Levamisole in Gastric Content after Unusual Intake of Heroin and Cocaine

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 48year 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.