Adulterated Drugs Now and Then: Cocaine and Jamaican Ginger Extract

March 16, 2010, 8:31 pm


Adulterated Cocaine and Lessons Learned from the Jake Walk Blues.  Wiegand TJ  J Med Toxicol (published online 11 March 2010 ahead of print).

No abstract available online

In this very interesting short article, T.J. Wiegand from the Northern New England Poison Center uses recent reports that a large percentage of cocaine coming into the United States has been contaminated with the veterinary drug levamisole to review the history of adulterated drugs, including the following episodes:

methylcathinon contaminated with manganese in the Soviet Union causes Parkinsonism

• the contaminant MPTP in illegally-prepared meperidine causes Parkinsonism

heroin adulterated with fentanyl causes many fatal overdoses

cocaine contaminated with thallium causes toxicity in users

scopolamine added to heroin causes atypical agitation and hallucinations after the mixture is snorted

Wiegand also goes into some detail about the most widespread episode of adulteration in American history — the epidemic of gait abnormalities and paralysis  during prohibition after bootleggers adulterated Jamaican ginger extract (70-80% ethanol) with the neurotoxic organophosphate tri-ortho cresyl phosphate (TOCP). As a result, tens of thousands were affected.

The toxic effects of “Jake” were so extensive that “Jake Leg” or “Jake Walk” passed into legend and popular culture.  There were many blues songs recorded describing what later came to be known as organophosphate-induced delayed neuropathy (OPIDN).  A representative example is the Allen Brothers’ Jake Walk Blues:


Wiegand also cites a fascinating New York Times article from 1887, demonstrating that the adulteration of street drugs is nothing new.

To read my column on the Jake Walk in Emergency Medicine News, click here.

One Comment:

  1. precordialthump Says:

    Great stuff – looks like a must read.