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Updated: May 31, 2026
07:51
A Protocol for Measuring Cue Reactivity in a Rat Model of Cocaine Use Disorder
Published on: June 18, 2018
Aminorex poisoning in cocaine abusers.
Steven B Karch1, Francesco Mari, Viola Bartolini
1Consultant Pathologist/Toxicologist, Berkeley, California, United States. skarch@fdaa.com
International Journal of Cardiology
|July 19, 2011
Summary
Illicit cocaine often contains levamisole, which the body converts to aminorex. This conversion may lead to a new epidemic of idiopathic pulmonary hypertension (IPH) among drug abusers.
Area of Science:
- Toxicology
- Pharmacology
- Public Health
Background:
- Levamisole is a common adulterant in illicit cocaine.
- Levamisole is metabolized to aminorex in both horses and humans.
- Aminorex was previously linked to an epidemic of idiopathic pulmonary hypertension (IPH).
Purpose of the Study:
- To highlight the potential public health risk of levamisole-induced aminorex conversion.
- To raise awareness of a potential emerging epidemic of IPH in cocaine users.
Main Methods:
- Review of existing literature on levamisole, aminorex, and IPH.
- Analysis of the metabolic pathway of levamisole to aminorex in humans.
- Assessment of the potential for IPH development in chronic cocaine abusers.
Main Results:
- Levamisole, present in over 80% of seized cocaine in the US, converts to aminorex in humans.
- Aminorex caused a fatal IPH epidemic in the past.
- High cocaine intake by abusers may lead to sufficient aminorex formation to cause IPH.
Conclusions:
- The conversion of levamisole to aminorex poses a significant risk for developing IPH.
- Early IPH symptoms are vague, and drug abusers are often excluded from registries, complicating tracking.
- This highlights a potential, underrecognized public health crisis among illicit drug users.
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