title: Levamisole-adulterated cocaine: Two fatal case reports and evaluation of possible cocaine toxicity potentiation.
abstract: Levamisole has been identified as a cocaine adulterant in the United States since 2002. Although there is a variation in the percentage of levamisole in cocaine samples between European countries, measurement of levamisole in human samples of cocaine users has become increasingly important. To our best knowledge, only five deaths are reported (one twice) as a result of complications secondary to levamisole-tainted cocaine and none of these cases reports the post-mortem levamisole concentration. In this article, we present the post-mortem levamisole concentrations in fluids and tissues in two young cocaine users, dead after levamisole-adulterated cocaine intake. With the dearth of levamisole reported concentrations in literature, this particular report is of interest to the forensic toxicological and pathological communities. This article aims to be a supplementary alert to aware the risk that may occur using levamisole-adulterated cocaine and an incentive to publication of toxicity reports and new researches involving the combination of levamisole and cocaine.
authors: Department "G.F. Ingrassia", Laboratory of Forensic Toxicology, University of Catania, Italy. Electronic address: fra.indorato@gmail.com.
authors: Francesca
authors: F
authors: Indorato
authors: Department "G.F. Ingrassia", Laboratory of Forensic Toxicology, University of Catania, Italy.
authors: Guido
authors: G
authors: Romano
authors: Department "G.F. Ingrassia", Laboratory of Forensic Toxicology, University of Catania, Italy.
authors: Nunziata
authors: N
authors: Barbera
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications*; D003937:Diagnosis, Differential; D004340:Drug Contamination; D017809:Fatal Outcome; D053593:Forensic Toxicology; D006801:Humans; D007978:Levamisole / Q000506:poisoning*; D008297:Male; D011041:Poisoning / Q000175:diagnosis
chemical_list: D007978:Levamisole
keywords: Adulterant; Cocaine; Drug-related death; Forensic toxicology; Levamisole; Toxicity