A granulocytosis can kill you, but its symptoms are frustratingly broad. Some people’s throats close up. Some people get diarrhea. Some people get skin infections, sores in their mouth or anus, or just a fever. Some people have it, don’t know it, and get better without seeing a doctor. Some people don’t see a doctor until it’s too late.

Basically, agranulocytosis is a catastrophic crash in a person’s immune system, which can turn a zit, a scratch, or even the bacteria that normally live in and around your body into a life-threatening infection. In one vividly described case from the 1920s, an otherwise healthy 40-year-old woman came down with a mysterious fever. Over the next nine days, under the care of baffled physicians, she sprouted “brownish papular eruptions” all over her face and body, necrotic abscesses on her neck and buttocks, and “a greyish-green dirty membrane” covering her mouth and throat with “scattered small greyish ulcers.” In one cubic millimeter of blood, her doctors found 4,000,000 red blood cells but only 1,000 white blood cells. Then, after a blood transfusion, she died.

Agranulocytosis is rare and typically caused by medications: Antibiotics, gold salts (to treat arthritis), and some anti­psychotic drugs can trigger the crash. But lately, doctors have been seeing more and more cocaine users with mysterious cases of agranulocytosis linked to a mysterious cutting agent called levamisole. Levamisole was discovered in 1966 and studied for its ability to rev up the effects of chemotherapy drugs and people’s immune systems. It also turned out to work wonders with intestinal worms. Levamisole is an immunomodulator, meaning it can either strengthen or weaken your immune system, depending on your genes and what other drugs you might be taking. But too many patients came down with agranulocytosis, the studies were discontinued, and the FDA withdrew its approval of the drug.

One of the last studies on levamisole use in humans was in 2001, when Iranian researchers gave the drug to a group of girls who lived in crowded, unhygienic conditions with uncontrollable lice infestations. According to the International Journal of Dermatology, a 10-day course of levamisole tablets was “completely effective”: The girls took the drugs, and the drugs poisoned the lice. (The study didn’t mention whether the drugs poisoned the girls.)

These days, levamisole is mostly used by farmers to deworm cows and pigs—and, for some reason, it’s also used by people in the cocaine trade. The DEA first reported seeing significant amounts of levamisole-tainted cocaine in 2005, with 331 samples testing positive. Then the numbers spiked: The DEA found 6,061 tainted samples in 2008 and 7,427 in 2009. One DEA brief from 2010 reports that between October 2007 and October 2009, the percentage of seized cocaine bricks containing levamisole jumped from 2 percent to 71 percent.

Which is not only sudden, but odd. Levamisole is not like other common cutting agents—sugar, baking powder, laxatives, etc.—in three important ways:

1. It’s more expensive than other cuts.

2. It makes some customers sick.

3. It’s being cut into the cocaine before it hits the United States.

This last mystery is the most puzzling. Typically, smugglers like to move the purest possible product—less volume means less chance of detection—and cut their drugs once they cross into the United States.

So what’s the incentive to use a relatively expensive cut of something that makes your customers sick and increases your smuggling risk? Even stranger: The cocaine trade, in both smuggling and production, has fragmented in recent years (more on that in a minute). If there’s no central production, how did hundreds and hundreds of independent shops come to use the same unusual cutting agent?

Nobody seems to know, including experts I spoke with on both coasts of the United States: doctors, scholars, chemists, think-tank fellows, research scientists, federal and state public-health analysts, law enforcement agencies from the Seattle Police Department to the DEA, and even people who work in and around the drug trade. Everyone has theories, but nobody has answers.

It’s a mystery.

What We Do Know

Some people are getting sick from levamisole and a few have died, but it’s impossible to pin down exact numbers. In April 2008, a lab in New Mexico reported an unexplained cluster of 11 agranulocytosis cases in cocaine users. In November 2009, public health officials in Seattle announced another 10 cases. The CDC began a surveillance program in eight states.

During levamisole’s early clinical trials for cancer and autoimmune disorders, around 10 percent of the patients developed agranulocytosis. If the nation’s cocaine supply is so thoroughly tainted, why aren’t 10 percent of cocaine users going to hospitals with unexplained infections?

“Maybe 10 percent are experiencing pressure on their neutrophils,” says Dr. Phillip Coffin of the University of Washington, who has studied drug use in New York City and Seattle. (Neutrophils are the type of white blood cell wiped out by agranulocytosis.) “But only a proportion of them are getting sick enough and using enough that they come to our attention. And an even smaller proportion of those people are coming to the attention of physicians who are aware of the cocaine-levamisole problem. There are many steps in the pathway that have left such a small number of cases being reported.”

The problem might be—and probably is—larger than we know. And, because of budget crunches, last month the CDC abandoned its surveillance program in Washington State. This is worrisome not only for people who’ve already gotten sick and are likely to get sick again (doctors at Harborview have reported seeing the same patients multiple times for agranulocytosis), but because levamisole has a cumulative effect: The more you’re exposed to it, the more likely you are to get sick, and even if you’ve had levamisole-tainted cocaine and not gotten sick doesn’t mean you won’t get sick from levamisole-tainted cocaine in the future. With the DEA reporting such a radical increase in the percentage of tainted cocaine (which more than doubled between 2008 and 2009), the number of people at risk is also increasing radically.

The Cocaine Trade

So who’s lacing the world’s cocaine with levamisole and why? “I honestly can’t tell you,” says Sanho Tree of the Institute for Policy Studies, a think tank based in Washington, D.C. An internationally recognized scholar, Tree has spent his career studying the drug trade—if anyone (outside of a drug cartel) should know where and why levamisole is being cut into the world’s cocaine supply, it’s him.

The ubiquity of tainted cocaine could, he says, be an unintended consequence of the drug war. Centralized drug-producing operations, like the old Medellín and Cali cartels, depended more on consistency of product and long-term business relationships. But after those cartels were infiltrated and disrupted, hundreds of small shops—many of them family-operated—jumped into the void. “We can’t even count those operations, much less infiltrate and break them up,” Tree says.

Recent developments in Colombia’s guerilla wars have also destabilized business as usual. Right-wing paramilitary death squads—which are on U.S. lists of international terrorist organizations—have been fighting against Colombia’s Marxist-Leninist guerillas for years on the government’s behalf. Both the guerillas and the paramilitaries have been involved in the country’s black market, but, Tree says, “guerillas deal more with peso economy”—the trade within Colombia—”and the paramilitary death squads made a play for the coastal regions. They were cutting the guerillas off from weapons and from smuggling zones. Those dynamics have been shifting over the past few years. The death squads were officially disbanded by government but have reemerged: same people, different names.” (In 2007, the produce distributor Chiquita pled guilty to paying almost $2 million to these paramilitary death squads. U.S. congressman William Delahunt said Chiquita was only “the tip of the iceberg” of U.S. businesses getting tied up in paramilitary groups, which means those businesses are implicitly tied up with the cocaine trade.)

“As a result, there’s much less accountability within Colombia now,” Tree says. “The drug market is much more fragmented. Who are you going to complain to? Plus, you’ve got the meat grinder in Mexico”—where gangs ship South American product into North America. “Will any of these people even see each other again? Who knows? It’s shorter-term careers these days.”

Meanwhile, Peruvian shops are also stepping up production to compete with the small Colombian producers—the dynamics across the South American cocaine market are shifting rapidly and violently.

Even the old Mexican shipping networks are breaking up as turf wars make the smuggling routes less reliable and more expensive. Some gangs are making an end run around Mexico by sea—the U.S. government has begun intercepting homemade submarines, loaded with cocaine, that sail by night just beneath the surface of the water. One of the first narco-­subs was found in 2000 in Bogotá. “It had Russian blueprints and the engineers fled just before the police arrived,” Tree says. “In Bogotá—8,000 feet in the Andes and nowhere near any ocean. How corrupt can you get?”

The U.S. has only intercepted around two dozen narco-subs so far. “They’ve got no wake, no conning towers—just a snorkel sticking up for air. By day they stay idle and throw a blue tarp over themselves so they blend in with the ocean,” Tree says. “As one intelligence officer put it to me, rather frankly: ‘You try finding a log floating in the Pacific Ocean.'”

With such a fragmented drug market, accountability and quality control decline. As Tree says, who are you going to complain to?

Which leaves the question of why producers and/or smugglers are cutting their cocaine with levamisole. Why that, instead of a cheaper and more benign cut?

“That,” Tree says, “I don’t know. This is the most interdisciplinary field in the world. The people who focus on violence and the cartels don’t understand the pharmacology, and the people who understand the pharmacology don’t understand the economics and shifting forces of the cartels. Nobody has a bird’s-eye view of the whole thing.”

Working Theories

In 2004, a controversy erupted in the horse-racing world. A string of trainers with long and distinguished reputations were accused of doping their horses after aminorex, an amphetamine-like stimulant, was detected in their animals’ urine. The penalty for doping horses with aminorex is a one- to five-year suspension and a career-ending stigma. Accusations flew, the trainers protested their innocence, and scientists stepped in to investigate.

It turned out the whole thing was an accident: The horses had been injected with levamisole for deworming, which their bodies metabolized into speed. Studies in the 1970s had discovered that dogs experienced “mood elevation” after receiving doses of levamisole. And a 1998 study at Vanderbilt University showed that levamisole eased withdrawal symptoms in rats addicted to morphine.

That study caught the attention of Dr. Mike Clark, an assistant professor of psychiatry at Harborview Medical Center, who also studies cocaine addiction in lab rats. “According to the study, levamisole acts on all three monoamine neurotransmitters,” he says. “That’s exactly what you’d expect from something that potentiates cocaine.” In other words, levamisole may heighten cocaine’s effects—or might be a stimulant all by itself. In the next few weeks, Dr. Clark will begin an experiment of his own to find out (among other things) whether levamisole, without any cocaine, can produce cocainelike effects in lab rats.

If he can demonstrate that levamisole makes cocaine more potent, we’ll be a step closer to understanding what it’s doing in the supply chain. Other people have other theories, including:

• Something about the chemical structure of levamisole retains the iridescent fish-scale sheen of pure cocaine, according to a chemist with ties to the cocaine trade, giving cocaine cut with levamisole the same appearance as pure cocaine.

• Levamisole is a bulking agent for crack. The process of making crack involves “washing” cocaine and filtering out impurities and cutting agents. Levamisole slips through this process, meaning you can produce more volume of crack with less pure cocaine.

• Levamisole passes the “bleach test,” a simple street test used to detect impurities in cocaine. When dropped in Clorox, pure cocaine dissolves clearly. Procaine (a common cutting agent) turns reddish brown, lidocaine turns yellowish, and other impurities float to the bottom. In a lab test conducted by ­Dr. Clark, levamisole stayed clean and clear.

If levamisole can do all of these things—pass the visual test, pass the bleach test, pass the crack-purifying process, and provide a stimulant effect either on its own or in conjunction with cocaine—it explains not only why producers use it, but why so many small South American producers have independently decided to start cutting their “pure” product. “Think of it as evolution in action,” Dr. Clark says. Like a mutated gene that is beneficial to a species and is passed on through the pressures of natural selection, levamisole has a variety of benefits that become, in essence, selective pressures.

Instead of the traditional smuggling model, where centralized producers ship pure product and cut it once it crosses the U.S. border, levamisole (theoretically) behaves enough like cocaine that producers can pass off cut kilos as 100 percent pure—even to the smugglers who may believe they’re shipping pure product to sell to American wholesalers. This theory is supported by a couple of findings, including reports of seizures in the DEA’s Microgram Bulletin. One flight from Guyana into New York’s JFK airport contained 192 churros stuffed with levamisole-tainted cocaine. And DEA agents in Bogotá came across a magazine page coated in a “protective” plastic laminate that was 21.5 percent cocaine, cut with levamisole. The research and development labs that developed this relatively sophisticated smuggling technique were at the source of production. And the source of production was cutting its “pure” product with levamisole.

A source with close ties to the DEA confirmed this, saying a recent, still-classified report has revealed that Colombian cocaine producers are putting a great deal of effort into making sure they maintain access to levamisole. “More than that,” the source says, “I cannot tell you right now.”

The Test-Your-Own Kit

Because the official research on levamisole’s effects on human beings was stopped years ago—and, apart from Dr. Clark’s pending experiments with rats, there’s been no official research on its effects when combined with cocaine—there’s still a lot we don’t know. It’s possible that agranulocytosis is only one of its health hazards.

According to a 2009 article in the Journal of Analytic Toxicology, levamisole-laced cocaine might also increase the risk of cardiac problems: “Cocaine increases sympathetic activity by blocking the reuptake of norepinephrine at the postganglionic synapse. Additive, if not synergistic effects could be expected when the drugs are combined. Concerns of increased toxicity with exaggerated pressure response or development of arrhythmia could then arise when cocaine is combined with levamisole.”

Heart attack and cardiac arrest are two of the common causes of death associated with cocaine overdoses—levamisole might exacerbate those risks. It’s hard to say: Cocaine, according to the latest Seattle/King County drug trends report, released this June, is the most common illegal drug detected in deaths, but its manner of killing is less clear-cut than opiates. “Opiate overdose is pretty simple and straightforward,” explains ­Dr. Coffin. “It’s breathing. Keep them breathing and they live. Cocaine is more difficult: Is it a massive heart attack? Is it a stroke? It’s not very well defined.”

Currently, people who suffer cardiac problems associated with cocaine are not tested for the presence of levamisole, so we really have no idea what kind of damage this new cutting agent is inflicting on the nation’s cocaine users, nor the strain on already strapped public funds—every time someone without health insurance lands in the emergency room, it costs taxpayers thousands of dollars.

The fuzziness surrounding cocaine’s destructive qualities makes harm-reduction strategies more difficult for cocaine than for opiates. Nobody doubts that cocaine is destructive. “It’s toxic to heart-muscle cells,” Dr. Coffin says. “Even in its purest form, it’s among the worst recreational drugs for the cardiovascular system.” But its spectrum of harmful qualities, some of which are exacerbated by levamisole, makes it tricky to pinpoint good maintenance programs for chronic addicts. Opiate addicts, Dr. Coffin says, can live on methadone or other controlled dosing mechanisms their entire lives with no medical harm besides constipation and loss of libido. But cocaine- and amphetamine-maintenance programs haven’t shown any conclusive results, despite attempts in Colombia to prescribe coca tablets and tea to addicts.

One thing that can be done: develop an inexpensive field-test kit to try to detect levamisole. Dr. Clark has invented such a kit and—in association with The Stranger, a few folks in the local harm-reduction community, and the People’s Harm Reduction Alliance (PHRA), which runs the U-District needle exchange—hopes to begin distributing kits in a few weeks. Unfortunately, kits are technically drug paraphernalia under Washington State law, not only because the kits will contain cocaine residue, but because it is illegal for any person to possess something used to “process, prepare, test, analyze, pack, repack, store, contain, conceal, inject, ingest, inhale, or otherwise introduce into the human body a controlled substance.” It’s a perfect example of how drug prohibition laws make drugs more dangerous—an unregulated market for cocaine, with no quality control, has encouraged the use of levamisole as a cutting agent. And U.S. drug laws make it illegal for users to test their cocaine for poison—if users could, they might stop buying from dealers who sell tainted cocaine, putting economic pressure on the market to be less dangerous. It’s a classically self-defeating chain of policies, but some antidrug warriors defend it on the grounds that since drugs are illegal, users get what they deserve. And if cocaine is perceived as more dangerous, perhaps fewer people will use it.

This, of course, is a cruel, stupid, and expensive way to deal with the problem. As Dr. Clark put it: “The idea of letting addicts die to make drugs scarier is reprehensible.”

It’s not quite the same in the heroin world: Because of the public outcry about the health risks of sharing needles, hypodermic syringes have a special exemption. Crack users need similar exemptions.

“If you read the paraphernalia laws, cocaine is both the forgotten drug and in some ways the most hated drug,” says Shiloh Murphy, director of PHRA, an independent nonprofit that isn’t affiliated with public-health-funded needle exchanges. He gestures behind him to a tower of cardboard boxes full of hypodermic needles. “A young person just starting to inject knows he shouldn’t share his syringes,” he says. “But a 20-year crack veteran doesn’t realize that every time he smokes and burns his lips and passes on his stem, he could be transferring the same diseases—it’s open sores to open sores.”

To combat this problem, Murphy has begun a controversial program to distribute crack stems, rubber crack “condoms,” and fresh steel wool to users. (Steel wool, which is used as a filter in crack pipes, weakens and flakes off after repeated use, sending red-hot chunks of metal into users’ throats and lungs, which leads to infections and abscesses.) Murphy got the idea for his crack program one afternoon two years ago, when he was approached by an angry crack user.

“I was sitting at the table, handing out flyers and things,” Murphy says, “and a man said to me: ‘You’re a real motherfucker, you know that? You’re sitting here with all these syringes and talking about health. I use crack and my friends are dying of HIV and hepatitis C and there’s nothing on this table for us. I guess crack users are always just left to die.’ I said, ‘You’re right. I’m sorry. Tell me what you need.’ It was an enlightening moment for me.”

“All we have to do,” he says, “is save one person from getting HIV, and we’ve become economically worth it.” PHRA’s annual budget is around $385,000. Its budget for the crack program is currently $6,000. The lifetime cost for the state to take care of an uninsured person with HIV, he says, is half a million dollars. “We’ve saved the state thousands and thousands of dollars.”

Now Murphy will be at the forefront of our combined attempt to distribute Dr. Clark’s levamisole kits to cocaine users. The kits will contain instructions for use, a fact sheet about levamisole and agranulocytosis, and a survey on a prestamped postcard about where and when the cocaine was purchased, whether it’s powder or rock cocaine, whether it tested positive for levamisole, and a few other research questions. Hopefully, that data will help us—me, Dr. Clark, PHRA, and a local harm-reduction organization called DanceSafe—develop a better understanding of how levamisole-tainted cocaine is distributed through the city and whether some neighborhoods face greater health risks than others. (Is the cocaine you can buy on the street in Georgetown, for example, more or less tainted than the cocaine at some millionaire’s house party in Bellevue?)

As for its illegality: After a meeting with ACLU lawyer Alison Holcomb, Stranger publisher Tim Keck, and me, Seattle city attorney Pete Holmes and King County prosecutor Dan Satterberg decided to allow us to distribute levamisole test kits—and collect data about whether people are finding levamisole—without prosecution. They notified new Seattle police chief John Diaz, who supports the program. recommended

The levamisole test kits will be available in a few weeks—watch for updates in The Stranger and on Slog. This piece is the first in an investigative series.

This story has been updated since its original publication.

Brend an Kiley has worked as a child actor in New Orleans, as a member of the junior press corps at the 1988 Republican National Convention, and, for one happy April, as a bootlegger’s assistant in Nicaragua....

102 replies on “The Mystery of the Tainted Cocaine”

  1. Brilliant, well-researched, relentless article. Your proactive test kit distribution program is unprecedented for a media organization in my memory. Micro-caveat: Medellín, not Medallín.

  9. Shouldn’t be too hard to track down. Levamisole isn’t exactly sitting on the beach like sea salt, waiting to be dried and refined – it has to be made in a factory, and I doubt there’s 50,000 little backyard operations making it. Follow the Levamisole from suppliers to growers, right?

  13. @4 – because the FDA doesn’t regulate illegal drugs. Er, that is, the government is regulating these drugs by making it absolutely illegal to use them. See how that works?

  14. This is some fine reporting, but the proactive step of distributing the levamisole detection kit goes way above and beyond. Advocacy journalism at its finest.

  16. Are you actually trying to make the case that cocaine users are worried about their health and have a legitimate right to a safe product? Let the law of natural selection take it’s course.

  17. well written article… thanks for the info. i’ve used levamisole in a research laboratory as an alkaline phosphatase inhibitor, but wasn’t aware of its role in the narcotics industry.

  18. Every now and then I think I am going to give up on the Stranger – then an article like this comes along. great work. Great work.

  21. Apparently “natural selection” means “childish fantasy where Those Bad Drug Users die in the street.” I’m sure that living in a society where such a policy is allowed wont eventually affect you at all. Grow up.

  22. If upwards of 70% of cocaine is tainted with an even more dangerous substance, maybe the rational response is not a test kit. Might it be time to consider switching from coke to something less likely to kill you?

  23. Excellent work–it’s so refreshing to read passionate investigative advocacy journalism.

    And didn’t the 1987 Whoopi Goldberg anti-drug action classic Fatal Beauty already answer these questions? Some production workers fooled around too much with the Columbian cuckoo powder and cut it with everything in sight. There’s a bitchin’ mall shoot-out in the end.

  24. Newsflash to any dumb cunt that does coke or meth. The people that sell this shit are human garbage. They’re not worried about where the shit came from and who stepped on it. Stick with weed. Mess with anything else and you deserve whatever you get.

  25. Not to be too much of a conspiracy nut (especially since I’ve seen no evidence to support this) but has it occurred to anyone that this could be the workings of an outside drug enforcement agency? It just seems incredible odd that thousands of small manufacturers all came up with the idea to use levamisole on their own… Is it possible that an outside influence could plant the idea to use levamisole (using the manufacturing advantages you’ve listed) in an effort to create fear in the end user and ultimately crush the demand for cocaine?

  27. Everyone touting “Those evil coke/crack/meth users get what they deserve!!!” don’t realize that YOU, THE TAXPAYER, will pay the price for their irresponsibility.

    When Joe the Crack addict (Joe the Plumber’s doppelgaenger) gets Agranulocytosis and heads to the ER to get his uninsured-ass treated, YOU, THE TAXPAYER will be responsible for footing the bill. Yes, Joe is an asshole/stupid/irresponsible/etc. for being a crack addict, but he’s not going to just “die off” or “get what he deserves”, he’s going to get sick and become an even more immense burden on society. Get him a test kit, offer him treatment while he is getting the test kit and you will, as the article said, save an immense amount of public funds.

    Amazing piece of investigative journalism.

  28. @24 – because the Mexican weed smuggling gangs who are decapitating journalists only do it for the love of the toker. RIIIIIGGGGHHHTTT.

  29. @29: Also, “you, the insurance premium payer.” The costs for people who don’t pay for their medical care are largely passed on to those who do in the form of higher premiums and higher charges for services.

  30. How complicated could this test kit be? Wouldn’t it be more efficient (and more legal) to publish how to make one’s own test kit?

  32. @30 How complicated could inventing this testing kit be? Wouldn’t it be more efficient to figure it out yourself?
    The networking, chemistry know how and effort that went into this kit’s origination are not negligible. Neither are the ongoing questions of sourcing the materials. DanceSafe sells kits to test the identities of several sorts of drugs. The instructions for these testing kits *are* available online. Still, people by and large find it much more practical to enjoy DanceSafe’s effort, and buy the kits from them.
    Thank you DanceSafe and Dr. Clark!
    and thank you to everybody else who’s gotten on board for the distribution part of the conversation.

  33. @32 Making specialized test reagents isn’t trivial stuff. In some cases, only a university lab would even have the equipment. Expecting crack-heads to be able to make anything more complicated than a toasted pop-tart is asking a lot. With any luck, they might be able to follow the instructions in the pre-made kit.

    Brendan, and The Stranger: once upon a time, the “Mainstream Media” would occasionally take public leadership on a life-saving issue. Well, the mainstream media has whored itself out of that arena. Thank god for an alternative weekly with a sense of public service! Outstanding.

  40. I’m sorry to hear people are getting cold sympotms by dirty coke, but do you understand that coke is also cut with slavery? genocide? happening right now??? Anyone who has been to Colombia knows that you cannot meet nicer, warmer people. They are being held in a state of poverty as a direct result of our hunger for blow, millions homeless and displaced. Something like 90% of all the cocaine in the world comes from Colombia. This is a country that has it’s head held under water because of our taste for cocaine. I wish you could see how fucked up this is. South America is witnessing a fucking BLOODBATH horrorshow that is the direct result of that ball you’re going to buy next month.

  41. I know that the people who are ridiculously anti-drug will tell me I need to cut him off and blah blah blah, but…my uncle is a crack addict. 20 years. 3 times in rehab. I love my uncle; his addiction has never really effected my sister and I like it effects the rest of the family. Also, he’s unusual in that he’s never stolen from his family (although, who he has stolen from is unknown). My uncle was the guy who would buy us ice cream or give us money to go rent a movie. He never involved us in his drug addiction. Not actively anyway. I remember reading about this a few years ago and worrying about him. I still worry about him, constantly. I still text him and ask him to get help, with no answers. I haven’t heard from him in a year and I worry that he’s dead from and overdose or something like this.

    It’s an excellent piece, Brendan. I’m glad someone is looking into it, because we can’t rely on the mainstream media to care while Lindsey’s in jail. Also, it’s nice to see someone who appeals to pragmatism and taxes on this issue, which (sadly) is more likely to make it relevant to more people. Maybe my uncle is a crack addict, but he’s still a human and he’s still my uncle.

  43. Thank God someone care! I’m going to donate money to the PHRA just based on this story! Thank you so much for sharing and I hope that these addicts can one day get clean, but until then, I want them to be as safe as possible because they are people and I want them to have the opportunity to live long, happy and productive lives!

  46. This article is alarmist. The average “weekend warrior” snorting a few bumps will have NO effect from the levamisole. the highest percentage of people who will be hurt by this are crack addicted women who have a genetic marker making them more suceptible to agranulocytosis. Specifically women of First Nations and Native American heritage according to the recent findings of medical professionals in King County and Canada. No one has died from agranulocytosis because as long as they stop smoking/injecting/snorting for a short while their white blood cell counts and symptoms go away. Not to say that this isnt concerning and that they shouldnt be testing. THEY SHOULD. but to act like we are all gonna die if we snort a bump at a party. Absolutely Not.

  47. @48 you have a great point; you are not all going to die if you do a bump at a party, but a lot of other people DID die for that bump to make it to the party. Does no one know about that or does no one care? I’m just curious.

  49. What a great read good job Brendan I would have to agree with the unpaid commenter (#25)it all smells a bit fishy.What a sad, sad world it has become.

  50. Thank God someone care! I’m going to donate money to the PHRA just based on this story! Thank you so much for sharing and I hope that these addicts can one day get clean, but until then, I want them to be as safe as possible because they are people and I want them to have the opportunity to live long, happy and productive lives!

  51. I’m trying to picture myself feeling sorry for hipster fuckwits who put this shit up their noses and then end up in the ER … Nope, not happening.

    This reminds me of the scare news articles pumped out in the late 1990s in Reno and Sacramento regarding meth bumps mixed with a lil’ heroin. Apparently the heroin was super clean and the little tweakers were ODing. Shit, too bad.

    Even 100% pure cocaine has a ridiculously high percentage of gasoline additives and lead. That’s because the producers in Columbia discovered years ago that nothing separates coke from coca leaves as well as leaded gasoline.

    The article is kinda like saying: THIS JUST IN, HARD DRUGS ARE BAD FOR YA, KIDS!

    Less obnoxious hipsters is just fine by me.

  52. I think it’s a very well written and well researched arcticle, but I think the least shocking thing about cocaine is the cutting agents. pssssssss guys, you’re not going to believe it, but there’s cocaine in your cocaine!!! but maybe you don’t know what that really means. it’s not made in nice clean sanitary laboratories, it’s made in the jungle. The way they recruit these workers is pretty cool too. Basically the FARC pass through the poorest area they can find and pass notes under all the doors of the houses saying that if you don’t send your sons to x place tomorrow to come work for us we will be back and kill your whole family. And they make good on their promises. Have a great weekend everyone!

  53. (still)Grrrl,
    You’re simplistically missing the point if you think this is about feeling sorry for cocaine users. Treating these upcoming problems from levamisole is going to cost EVERYONE money thru our health care system. It even says that in the article. Did you not read?

    Another great article STranger, this is turning into a real news-paper, well written and researched.

  54. Rather than distribute test kits, couldn’t you save money by just setting up a lab in the back of the Cha Cha and distribute the clean coke directly to the hipsters?

  56. The quality of reporting and activism in The Stranger continues to improve. Congratulations on this well researched and written article and thanks for your efforts.

  58. So savageslister, you did a bunch of blow, but it’s bad, so no one else should do it (mkay)? hypocrite much? You personally helped make this nation love cocaine, and enabled it’s producers. You are partially, but directly responsible for those scars on your husband’s legs, for those children murdered for not going to work on plantations. You can’t stop others from doing cocaine any more than anyone could’ve stopped you back then. To get on a soapbox about it now is pedantic, condescending, and offensive.

  59. “The idea of letting addicts die to make drugs scarier is reprehensible.”

    And yet this was US Gov’t policy during Prohibition:

    http://www.slate.com/id/2245188

    Commenter savageslister’s tone may be a bit much but the spirit of the comments are spot on – there are deep costs here…

  60. This is the piece I was always meant to read about this iceberg of a story–not much on the surface, but what lies beneath….

    My sincere thanks for your informative and engaging writing, Mr Kiley.

    /Steve Chapman

  61. #55 “going to cost EVERYONE money”

    Yeah, especially the cartels when sales plummet after all the hipster fuckwits switch back to meth.

    Remind me, which am I supposed to empathize with: drug dealers or coke addicts?

    I grew up in a time (the 80s) and an area (California) that was positively swimming in cocaine. I tried it once, didn’t like it. Nobody put a gun to my head and shoved a straw in my hand and said “Do this line now!”

    First rule of 12 Step Programs: personal accountability.

  62. #60 “To get on a soapbox about it now is pedantic, condescending, and offensive.”

    So if a person ever makes a mistake, they should — rather than learning from it and perhaps sharing what they learned with others — never think or speak of it again? Or have they become such completely worthless hypocrites that their only recourse is to kill themselves?

    The developed world’s consumption of cocaine isn’t just destroying Colombia — it’s a major factor behind the violence in Mexico, where tens of thousands of people have died as cartels struggle to control the drug trade. It affects West Africa (Guinea-Bissau in particular), most of Central America, parts of the Caribbean (Haiti’s corrupt military is deeply involved in cocaine trafficking), etc. We desperately need to stop doing coke — or (better yet) legalize it. Fat chance of either, though.

  63. Best Stranger article since that one about the underground Billboard defacers. Also, the presence of levamisole in so much cocaine smacks of institutional support/encouragement. Remember, their are powerful forces who want the war on drugs to continue, just as it is, indefinitely. And the “it gets you really high” theory seems like the winner.

  64. @60 I deeply apologize that I’ve offended you, it was definitely not my intention. Calling me out as a hypacrite is completely understandable; my hands aren’t clean. I’m not saying drugs are bad, I’m saying that now you know. How you continue is up to you, and your decisions affect people.

  65. See, remember things like this everytime you hear some dipshit Libertarian or Republican argue against government regulation of business.

    The drug trade is a perfect example of free market capitalism, except imagine if they didn’t have to worry about law enforcement at all…

  66. @63

    What sort of choices are you making? Smoking, drinking, eating too many potato chips? Driving your car too fast? Fuck your sanctimony.

  67. while this article is somewhat interesting, I’m more worried about what goes into my hamburger than what goes into illegal drugs that most people don’t partake of.

  68. I have to say that if this shit was legal and regulated we’d all be better off. Considering that refining coca is not the mechanically different from refining sugar means the drugs would get much cheaper, be quite a bit purer (i’ve never heard of any de-worming agents in table sugar, have you?), and would allow for fair trade production schemes much like what we see now with sweeteners and caffinated products. Cocaine and indeed all drugs, can and should be ethically produced. Which brings us to anther disgusting vector in this story. Much of the cocaine and poppies produced in the world are bought by pharmaceutical companies for commercial production of prescription medication. Those same companies also make de-worming agents. I can’t help but wonder if there’s a link there.

    Brendon, this is some of the finest journalism I’ve seen come out of your paper in a long time. Your support for both harm reduction and the thoroughness of your research speak volumes about both your professional integrity and the fullness of your character. Keep up the good work and if you guys need help raising money to produce these kits, let your community know. I would be happy to offer art work and/or performances to help. I worked in harm reduction services at the 1811 Eastlake project and agree that his is by far the best solution. Outstanding job.

  69. I am a former occasional user of coke. I have stopped using it all together due to affordability, the company it keeps and being completely over it. Towards the end of my use I started noticing that it began eating away the skin on the inside and outside of my nose, even if I hadn’t used in months. Leaving dry scabbing skin that took weeks to heal, and this would be only after using it one night. Over the years it was not only getting weaker in its effectiveness but also was taking on a particularly gross medicine smell and taste that was much more evident than before. I also began to have strange immediate reactions to it, like fatigue and a general unwell feeling, which as anyone who uses cocaine is the opposite of what it supposed to do, unless you are at the end of a 3 day bender. I had a particularly scary incident happen with a friend where they ended up in the ER after only snorting a small amount of coke and the doctors could not figure out why and had mentioned that they thought something had been added. After reading this article my suspicions that something else was being added or that the quality of coke had gone down over the years now makes sense to me. Also, learning all of the negative political and cultural and effects it has on the people of columbia and other countries. I found that I could not live with myself contributing my hard earned money to be put right back into the hands of drug lords who kill and destroy people and families every day. I guess I am on a bit of a soapbox so I will hop off and just thank Brenden for his informative article and his efforts to bring testing kits into the norm.

  71. Savageslister: you provide a very important, first-hand perspective. Taking a step back and looking at the broader picture, though, I’d argue that Colombia’s violence has roots even deeper than the drug trade. It has exploded into violence – profound, personal, sadistic kinds of violence – off an on since independence. The violence that exploded during the Bogotazo in 1948 (which is usually used to mark the beginning of the most recent epoch of civil war there) was in many ways a carry-over of the violence that tainted that country 20 years before. Colombia has never really been consolidated into a cohesive nation-state during its entire history. The hatred between different factions is profound and very difficult to even comprehend.

    The drug trade has most definitely exacerbated the situation – which might be the understatement of the century – but it certainly wasn’t a huge part of the picture when the FARC was formed in the mid-sixties.

    Finally – and I know it’s hard to believe this when you see stark and appalling poverty right in front of you – Colombia is one of the richer economies in Latin America, which is in turn considered a middle income region by global smarty-pants people who measure these things. It’s a damn sight more functional that some other parts of Latin America. Consider Venezuela, for example. But that’s hard to care about when you see undernourished children a few houses down on your block. This, I know about.

    Otra vez, gracias por tu perspectiva. Espero que vos y tu marido estén bien.

  72. to savagelister, # 40, you state that your husband told you,

    “To pass the time from the mindless work, he and his friends would count the dead bodies floating down the river next to the crops, usually bound and tied together. Lots of them kids. In a normal day he counted about 50.”

    so that would be about 18,000 plus bodies floating down the river per year, eh?? And that was only one little stretch of one river in Columbia, so that scene have been replicated over and over and for years, I guess…. You’re completely full of crap or your husband thinks you are a complete idiot who will believe anything.

  74. it’s nice to see that some people (73) get it. For others that so desperately need my story to be bullshit, all I can say is that your ignorance is a luxury that your environment has provided you. You are not burdoned by the weight of human suffering caused by cocaine as are the people who live where we live. A tremendously solvable part of the problem is lack of awareness, lack of human connection. I have to believe people would not feel so indifferent if they knew the truth. Sadly my husband told me, as you so eloquently put it, you’re an idiot and if you believe that, you’ll believe anything.

  76. @63 – um, no because there’s no rule of law and enforcement of contracts, which is very much the Libertarian ideal. Once we can run a class action lawsuit against the cartels for doing this, in a federal court, then we can start talking about free markets.

  78. It was reported DJ AM’s official cause of death a year ago in NY was “acute Oxycontin intoxication” but I recall seeing levamisole in list of toxicology report results (along with coke).

  79. Here goes- sorry for the long comment… Is this Seattle or fucking Redmond? Spokane? Bellevue? Seriously- these comments are so ignorant and judgmental that I’m having a hard time believing that this is The Stranger.
    Brendan- I heard about this article a while back from a friend who tried to hook us up to talk about it but we never ended up connecting; I am SO glad it wasn’t because you didn’t do the article. This NEEDS to be talked about.
    A very large proportion of Seattle residents do cocaine. Old people, young people, rich people (especially rich people), poor people, soccer moms, homeless people, educated people, your doctor, your mailman, your neighbor, our students (your child’s doctor!), your family… You’ve got to be kidding me with the comments here!
    Who the hell are we to dictate or judge what someone else does with their body and mind?
    Educate yourselves you fucking idiots! If you prevent illness and disease before it spreads, it costs YOU less money (education is accomplished through fact based teaching- not scary myths about growing hairy palms or refer madness). Everyone does things things that are dangerous… be it doing illegal drugs, living on the down low or riding your bike to work. Give people a fucking option to be as safe as they can be and you’re not putting yourself out at all compared to how you will be when the worst case scenario happens.
    Maybe you have children, because you never learned about safe sex or you believe that God hates birth control or that condoms are bad- OR maybe you were a young kid that was horny or had no self esteem so you had unprotected sex and got pregnant and NOW you use religion to defend your stupid actions cause you couldn’t say no. WE are paying for your children- or at least we will in the future…
    It’s unbelievable that you live in a supposedly progressive, educated city and so many of you are this selfish and stupid. Go away. Go to Cheney or Spirit Lake or some other red neck town. Let adults make adult choices and give them the tools they need.
    You don’t see 80 comments here about your magic undies, your ‘it doesn’t count if it was in the ass’ daughters, your drink and beat the wife on saturday but go to church on sunday or any other ‘sin’ that you judgmental assholes hold others to but excuse yourselves for.
    I can NOT believe the people in this city. Equal rights for all! Freedom of choice! Fucking bullshit. Equal rights as long as you can benefit from it. Freedom of choice as long as it fits nicely in your moral high ground. Jesus Fucking Christ. You want to pay less taxes? Want to see less homeless people? Less drug addicts and crazies? Legalize drugs, reduce (or eliminate) sentencing for non-violent crimes, take care of your own fucking families and mentally ill. Drugs are NOT your problem! People do drugs. People do too many drugs who have nobody and nowhere to turn to and nobody who cares enough to tell them to stop. Only when you’ve done all that you can do- do you have a voice worth listening to. Go fuck yourself. (again- sorry for the looooong comment.)

  80. Out of curiosity I researched who manufactures Levamisole and without exception, all the major manufacturer/exporters are in China– Yet another reason to question the safety of this cutting agent.

  81. @69… exactly. the irony is that we are worrying how an illegal narcotic is being cut with a potentially harmful agent. talk about having a sadistic death-wish, these engineers are ‘legally’ creating high-consumption GMO food / drink products that we all indulge in on a daily basis. you can find stuff like MSG, mercury, fluoride, lead, silicone, aspartame, etc. these elements are scientifically proven to be physiologically harmful. the cocaine article was excellent and insightful btw, but our own grocery stores can be scary in their own right. i definitely look forward to more solid articles and writing such as this. thanks.

  85. @savageslister: I wouldn’t touch the stuff for the reasons you mentioned, among others. But let’s get one thing straight: if you’re going to apply that ethos to this illegal substance, you should apply it across the board to all products you consume.

    That means: no domestic produce (explotation and ransoming of migrants… 72 found murdered today on one ranch), no home repairs to electric wiring (African copper mines maim or kill tens of thousands of people every year), and certainly no electronics (Chinese mining of rare earths are deadly). Really, you’re forbidden from buying from China… the work conditions are beyond appalling and the exploitation of children is disgusting, happening on a scale that would make your husband spit. Recycled steel from Bangladesh is out if you think Bangladeshis deserve four limbs, so no steel products to be safe.

    See how this goes? Enjoy your mountain shack and berry dinners!

  86. Getting de-wormed is the best new euphemism for doing a lot of coke in one night that I’ve heard in quite awhile – since last weekend.

  87. I’m not a huge follower of cocaine supplies in the US and I don’t know if anything has happened between 2005 and now, but by looking at the graph provided you can see two trends. The number of seized cocaine samples goes down and at the same time, correlating closely with that trend, is the fact that the number of samples testing positive for levamisol goes up. Add to that the fact that it is cut before it enters the US and I can make a deduce that levamisol may somehow inhibit the ability of drug dogs to smell the cocaine or something like that. It somehow reduces the risk of smuggling the cocaine into the country. That is my rough statistical analysis of the situation, anyway. Just a hypothesis on my part.

  88. to derptard post #69

    Perhaps you should be reading more health conscious blogs related to food safety and healthy diet. Your comment is wholly irrelevant to the subject at hand. Enjoy your feed-lot raised, hormone injected, corn-fed and shite up to the cattle’s knees, hamburger. Don’t forget that delicious slice of rBGH infused cheese for good measure.

  89. Excellent article and some great comments (savageslister, your comments were some of the best and most eye-opening! Thank you!) but it never ceases to amaze me how stupid and heartless and thoughtless Americans can be! For such an “educated” country, we sure do have a disproportionately large amount of bigots and haters! It saddens me to read some of these callous and hate-fuled comments! I have done speed/meth (never really liked coke, didn’t last very long and cost too much!) off and on since high school (thanks Dad, rest in peace), and lately I have had some of the symptoms 71 had mentioned, mainly the scabs just inside my nostrils. I am more than a little worried now, since I have been HIV+ since at LEAST ’96, and an AIDS diagnosis in 1998 (say what you will, HATERS, you can’t make me think any lower of you than I already do, and I’m sure I deserve AIDS because I’m a fucking faggot, and that’s how I got it, because an ex-boyfriend (now dead) of mine cared so much for me that he had unprotected sex with me knowing his status but not telling me! I’ve been chased, hunted down and beat up by assholes like you, so your hate-filled comments wont hurt me!). I really want to stop, and I am going to make more of an effort now, especially after reading savageslister’s insights! I had wondered what was causing the sores and scabs in my nose, and now I think I know. Why wasn’t there any mention of meth in this article? Where can I get a kit? More importantly, where can I get non-12 step help (listening to others drone on about their addictions does not help me use less, it makes me want to use more!)? I’ll shoot this comment off to your email, Brendan, so you know how to get ahold of me, and thanks again for such a well-executed and informative article! Had I not come across it accidentally (or maybe it wasn’t an accident!), I might become one of those statistics! I’m sure I am not the only life you may have saved! Kudos to you and this site for doing what mainstream media has failed in for decades now! Honesty and integrity are not totally dead (just in the conservative republican ass-wipes!).

  90. Reminds me of picking mushrooms in high school and the lawn’s home owner yelled, “those have been sprayed” and we laughed and took them anyway.

  91. You do stupid things like take drugs and bad things happen. Drug dealers are not nice people.

    I think it’s called evolution in action.

    People are dying from lack of food and yet there are addicts who want society to spend time and money and energy on saving them from the bad effects of the stuff thy voluntarily choose to shoot, smoke or snort.

    Sorry, my energies are used to help people who got into trouble through no fault of their own.

    To re-use an old old phrase “Why do you think they call it dope”?

  92. I am a drug and alcohol researcher and I have found this article well-argued, well-balanced and thorough and a fantastic contribution to my knowledge base. Thankyou for showing us the value of good journalism.

  93. @92 your sores and your scabs in your nose could be the result of just snorting shit that you’re not supposed to be snorting. Putting shit up your nose destroys blood vessels and causes nosebleeds. Dried blood causes scabs. Haven’t you ever seen the episode of the Simpsons where Ralph says “My dad says my nose would stop bleeding if I just stopped putting my finger up there.” Well it’s not just a joke, it’s the truth.

  94. You can always tell when a conservative has snuck into the discussion, e.g. (still) Grrrl or Niemand — the logic goes out the window:

    Poster: “Not taking care of these addicts will cost us money.”

    Idiot: “Um, it’s evolution and I don’t feel sorry for them.”

    Poster: “No seriously, everyone wants lower taxes, right? Let’s not let these people get sick and then have to pay for their medical care.”

    Idiot: “Yeah the cartels will lose money if we don’t help these addicts.”

    Poster: “Non sequitur?”

    Idiot: “You are a hipster.”

  96. This question easy to answer.

    Ask the producers why they add the substance. Its not hard to find them, I am in Colombia now, some tour guides in the Santa Marta area offers guided tours of “Cocaine Factories” in the jungle.

    Surely a determined researcher could make it out there, or to a Colombian jail to ask the question. Its ludicrous to attempt to solve this in the lab.

  99. One of the best articles I have read in a LONG time. I wish more people would put as much time and effort into their writing as the author.

    Great job and I am now a huge fan.

  100. This article was highly informative and well-researched; it also probably saved my life. So, thank you.

    What about test kits for those living in other states?

  101. This article was highly informative and well-researched; it also probably saved my life. So, thank you.

    What about test kits for those living in other states?

  102. At this point, we’re only distributing test kits in Seattle. But anyone with some basic lab know-how can make a kit. The recipe/protocol is here.

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