You've likely seen or read a news report in recent weeks discussing the issue of "flesh-eating cocaine," and the widespread contamination of the U.S. cocaine supply with an animal de-worming agent called levamisole. Now, let's just step back a moment here. SFist first reported on this news in December 2009, and we thought perhaps the whole thing had blown over (or just was, simply, overblown... excuse the puns). Reliable sources (the CDC) said back in 2009 that an estimated 70% of the cocaine supply entering the States was cut with levamisole, a drug that can have adverse affects on humans ranging from rotting skin to agranulocytosis. The theory is that drug cartels in South America, where the white-powdery levamisole is widely available from veterinarians, figured out that it caused a heightened euphoria in humans and was therefore a terrific way to dilute their coke and up their profits. But our question now, given the recent rash of news reports on the subject, is this: Is this actually something everyone who does a key bump now and then ought to be panicking about more than we did two years ago? Or is this just another case of a snowball effect (again, pun) around the web because the frightening term "flesh-eating" was added to the mix?

The first group of patients to show up in S.F. hospitals with bizarre symptoms that doctors linked to levamisole — blackening flesh, painful sores in the mouth and anus, lowered white blood cell count — numbered eight in late 2009. Strangely, they were all female. (Sidebar: Some may recall that DJ AM had levamisole in his system when he died, but no evidence of rotted flesh.) Since then, it's hard to say how many local cases there have been, but they don't appear to have increased in frequency or severity. As one S.F. doctor quoted yesterday by CBS says, "I’ve seen three or four patients [over the last year and a half] where I said this is definitely a case." In these cases, the patient had a spot on their ear, nose, arm, or chest where the flesh had just suddenly rotted and died, turning first purple, and then black.

The new cases to reach the news were in New York and Los Angeles (once again, ahead of the curve S.F.!), via a new paper published in the Journal of American Dermatology. They're now saying they think 80% of the cocaine supply has levamisole in it, but 80% of the nation's cocaine users are not showing up in hospitals. (Back in 2009, 90% of S.F. General patients who tested positive for cocaine also tested positive for levamisole, but did not necessarily show any of these symptoms.)

So, here's our take on this:

1) YES, cocaine is badbadbad (as Courtney Love once warned her daughter, "It's like really evil coffee.").

2) YES, this levamisole thing remains something to be concerned about. However doctors say it's unpredictable who will have the adverse reaction to the stuff and experience the dying flesh -- much like it's unpredictable who will die of a spontaneous heart attack from doing blow in the first place. As always, you take your life in your hands, and party at your own risk.

3) Also, the national media loves a sordid story about drug use that affects the trifecta of Sodoms known as NY, LA, and SF. So we should hear the precaution, warn friends with weird purple lesions on their ears to seek medical attention, and try to stay calm. Doctors seem to agree that the cases are still relatively few, and they say that once the drug leaves patients' systems, the wounds heal and leave a "shiny scar." However the lowered white blood cell situation can be far more severe if undetected, and they're saying the isolated cases are "just the tip of the iceberg in a looming public health problem posed by levamisole." But wouldn't the iceberg have revealed more than its tip over the course of a year and a half or two years?

4) What we'd like to see come of this, for the sake of innocent recreational users everywhere (which does not include us), is that this media hype somehow reaches the cartels and encourages them, for the sake of their business, to start marketing a more organic, levamisole-free type of cocaine. You could probably charge a premium for that shit.

[CBS]
[Gothamist]
PREVIOUSLY: High Percentage of SF Cocaine Cut with Animal Deworming Medication