Two people died and three others became ill after using tainted cocaine now making its way into the Twin Cities, state health officials said Monday.
And, experts say, it may only be the beginning of a more widespread problem in Minnesota.
The deadly addition to the cocaine was Levamisole, an anti-worm veterinary medication added to stretch supplies, state health officials said, adding that they have identified three confirmed and two suspected cases associated with Levamisole. Users of the tainted cocaine fall victim to neutropenia, a decrease in the body's number of neutrophil blood cells, which are important for protecting from infection. Levamisole also damages red blood cells and platelets.
"This contaminant reduces your body's ability to fight infections," said Carol Falkowski, director of the alcohol and drug abuse division at the Minnesota Department of Human Services. "So even very minor infections can rapidly become fatal infections. ... This adds a level of danger and risk to what is already an iffy proposition, which is the unpredictability of using street drugs."
The two people who died had significant underlying health conditions that made them more vulnerable to the contaminant's effects, health officials said.
State epidemiologist Dr. Ruth Lynfield said she's "very concerned" more cases will surface. "We have some evidence that it's becoming more common," she said.
Through last July, Levamisole was detected by the U.S. Drug Enforcement Administration in 69 percent of cocaine lots seized upon entering the United States.
That's a sharp increase from a year earlier, when about 14 percent of seized cocaine contained Levamisole, said Wilfred Taylor, a DEA spokesman in Chicago.
"What we don't have is why this is showing up," he said. Drug manufacturers commonly mix other ingredients into narcotics to bulk up their supplies, said Taylor, but it's unclear who's adding Levamisole.
Reaching drug users difficult
Falkowski said a cocaine user probably wouldn't be able to tell if the drug was cut with Levamisole, which is tasteless, odorless and colorless. "You can't tell by looking at it," she said. "[You] can't tell by smoking it or tasting it, using it or sniffing it."
She urged cocaine users to seek immediate medical help if they have sores that don't heal, lung infections that worsen quickly or dead-looking splotches on their skin. But getting illegal drug users to heed the warnings may be difficult, she said.
"Saying drug users are a hard group to reach is an understatement," she said.
Falkowski said she will ask the state Bureau of Criminal Apprehension to test some of the recently seized cocaine to help determine how much of it is contaminated with Levamisole.
Cocaine made up 22 percent of all illegal drugs seized by Minnesota law enforcement agents in 2009, falling into third place behind marijuana (27.8 percent) and methamphetamine (24.4 percent), Falkowski said. This indicates that there's a "steady supply" of cocaine here, she said.
All five of the Minnesota cases were diagnosed by health care providers from March through May of this year, health officials said. The patients' ages ranged from 25 to 60. Three were women and two were men.
The cases came to the state's attention through a health network it runs that receives reports of unexplained illnesses.
Symptoms can include fever, darkened or "dead-looking" skin and other severe infections associated with low white blood cell counts.
The association between Levamisole and neutropenia was first identified in April 2008 from a cluster of 11 cases in New Mexico. Since then, more cases have been identified throughout the United States, as well as in Alberta, Canada.
Levamisole, no longer allowed for human use, was once used to treat rheumatoid arthritis and colorectal cancer.