Mephedrone: scientific background

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What is mephedrone?

Mephedrone (4-methylmethcathinone) is a former legal-high that has now been banned in the UK under the Misuse of Drugs Act. It is a synthetic derivative of cathinone, a naturally occurring amphetamine analogue found in the African shrub “khat”. The recreational use of mephedrone was first noticed in 2007 in Israel and France but it has only been since 2009 that its use has become prevalent in the UK. Surveys conducted during the height of the media frenzy surrounding methedrone suggested that, excluding alcohol and tobacco, mephedrone was the fourth most widely used recreational drug in the UK, behind cannabis, MDMA (ecstasy) and cocaine (Mixmag, 2010). To date, there have been no systematic studies assessing the effects of mephedrone on animals or humans; consequently, little is known about its mechanism of action or its potential harms. It is likely that mephedrone acts in a similar way to other stimulants (e.g., cocaine, amphetamine and MDMA), promoting the release of the neurotransmitters dopamine, noradrenalin and serotonin.

 

Why do people take mephedrone?

The main reason why people take any drug is that they like its effects and mephedrone’s effects appear to be well tolerated. Mephedrone also benefited from a growing dissatisfaction with the availability, quality and illegality of MDMA. MDMA has been the drug of choice for dance music enthusiasts for over two decades but many clubbers switched to mephedrone due its legality (pre-May 2010), availability and assumed purity (Measham et al. 2010). Police seizures indicate that mephedrone use is negatively correlated with the availability of MDMA (UK Focal Point, 2010; Brunt et al. 2010). The media interest that has surrounded mephedrone recently may have attracted a wider, more naive user base (Metro, 2010).


What are the effects of mephedrone?

Users describe the effects of mephedrone as somewhat similar to those of cocaine and MDMA. The comparison with cocaine seems to be based on mephedrone’s fast onset and short-lasting effects and that it is occasionally used via nasal insufflation (snorted). Users also report increased self-confidence and talkativeness on mephedrone, which are cardinal properties of stimulant drugs. The association with MDMA is interesting: most users report that mephedrone’s effects are noticeably different to those of MDMA, being more stimulant-like and lacking the full extent of MDMA’s sensual, empathy-promoting properties. However, users also report definite pro-social effects on mephedrone (e.g. openness) and an enhanced sensitivity to and appreciation of music, effects that are consistent with those of MDMA. Clubbers also report an enhanced desire to dance.  


What are the potential harms of mephedrone?

The absence of systematic research on mephedrone makes it difficult to comment on its relative harms; however, sufficient information is available through user reports, surveys and hospital presentations for us to make some general comments:

The following negative effects have been reported by mephedrone users: paranoia and hallucinations, convulsions, a racing and irregular heartbeat, tightness in chest/shortness of breath, anxiety/panic, cold or blue extremities,  irritability/agitation, nausea, skin discolouration, numbness, insomnia, low mood, headaches, muscular tension (e.g. jaw clenching) and excessive sweating. Surveys and hospital presentations indicate that: a fast and irregular heartbeat, tightness in the chest, agitation, excessive sweating and headaches are especially prevalent side effects of mephedrone use (Brunt et al. 2010; Mixmag, 2010; Bluelight.nu; UK Focal Point, 2010).

A fast and irregular heart beat is a typical effect of stimulant use but this appears to be especially pronounced with mephedrone, with approximately 50% of users reporting this (Brunt et al. 2010; Mixmag, 2010; Bluelight.nu). Agitation and paranoia are also typical side effects of repeated stimulant use (Lieberman et al. 1987) and anxiety and low mood in the days following mephedrone use (reported by approximately 25% of users, Brunt et al. 2010; Bluelight.nu) are consistent with the effects of MDMA (Curran & Travill, 1997). This may indicate a short-term depletion of serotonin in the brain (Selvaraj et al. 2009).

One of the most worrying behaviours associated with mephedrone is compulsive use. Mephedrone’s effects are relatively short-lived, especially when it is snorted, and the compulsion to re-dose has been described by some users as “almost irresistible” (Bluelight.nu). Surveys indicate that drug craving is experienced by as many as 85% of users (Brunt et al. 2010). This significantly raises the harm profile of mephedrone.


Legal status of mephedrone

In March 2010, on request from the then Home Secretary, Alan Johnson, the Advisory Council on the Misuse of Drugs (ACMD) compiled a report recommending a generic control on a number of synthetic cathinone derivatives (including “methylone”, another popular legal high) making them Class B. In April 2010 an amendment was made to the Misuse of Drugs Act which brought this into effect (see www.homeoffice.gov).


References

Brunt T, Poortman A, Niesink R, van den Brink W (2010) Instability of the ecstasy market and a new kid on the block: mephedrone. Journal of Psychopharmacology. In review.

Curran HR, Travill RA (1997) Mood and cognitive effects of +/-3,4-methylenedioxymethamphetamine (MDMA, 'ecstasy'): week-end 'high' followed by mid-week low. Addiction 92(7):821-31.

Measham F, Moore K, Newcombe R, Welch Z (2010) Drugs and Alcohol Today. 10 (1). March issue.

Metro (2010) “School’s 180 drug takers off sick”. 09/03/2010.

Mixmag (2010) February issue. P. 44-53.

Morgan CJ, Muetzelfeldt L, Muetzelfeldt M, Nutt DJ, Curran HV (2010) Harms associated with psychoactive substances: findings of the UK National Drug Survey. J Psychopharmacol 24(2):147-53.

Nutt D, King LA, Saulsbury W, Blakemore C (2007) Development of a rational scale to assess the harm of drugs of potential misuse. Lancet 369(9566):1047-53.

Selvaraj S, Hoshi R, Bhagwagar Z, Murthy NV, Hinz R, Cowen P, Curran HV, Grasby P (2009) Brain serotonin transporter binding in former users of MDMA ('ecstasy'). Br J Psychiatry 194(4):355-9.

UK Focal Point (2010). Information request from the EMCDDA to the Reitox NFPs.


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