We wish to report 14 cases involving the detection of levamisole in illicit cocaine-positive coroners’ cases between April 2005 and 2006. Adulteration may occur as part of the refining process, by addition of bulking agents or deliberately to improve pharmacological effect. The commonest adulterants found in samples in Europe are lidocaine and caffeine and sugars. Levamisole is primarily a broad spectrum antihelminth.. It is not presently licensed in the Great Britain. Levamisole would not be expected to have any additional direct pharmacological effect alongside cocaine.
