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Mephadrone

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Mephedrone (4-methylmethcathinone; ‘meow meow’): chemical, pharmacological and clinical issuesAbstractAbstractAbstractAbstractAbstractIntroductionHistory and prevalence of misuseChemical characteristicsPharmacologyLegal statusMarket and commercial appearanceRoutes of administration, dosage, use in combination with other drugsDesired and untoward mephedrone effectsTreatment and managementAcute management of adverse eventsLonger term therapeutic psychological and harm reduction approachesMephedrone-related deathsConclusionsReferencesREVIEWMephedrone (4-methylmethcathinone; ‘meow meow’):chemical, pharmacological and clinical issuesFabrizio Schifano & Antonio Albanese &Suzanne Fergus & Jackie L. Stair & Paolo Deluca &Ornella Corazza & Zoe Davey & John Corkery &Holger Siemann & Norbert Scherbaum & Magi' Farre’ &Marta Torrens & Zsolt Demetrovics & A. Hamid Ghodse &Psychonaut Web Mapping & ReDNet Research GroupsReceived: 20 August 2010 /Accepted: 23 October 2010#Springer-Verlag 2010AbstractBackground Recently, those substances deriving from the ac-tive ingredient of the Khat plant, cathinone, have been risingin popularity. Indeed, 4-methylmethcathinone (mephedrone;‘meow meow’ and others) has been seen by some as a cheaperalternative to other classified recreational drugs.Aims We aimed here at providing a state-of-the-art reviewon mephedrone history and prevalence of misuse, chemistry,The Psychonaut Web Mapping Group Members are: FabrizioSchifano, Paolo Deluca, Zoe Davey, Ornella Corazza, Lucia Di Furia,Magi’ Farre’, Liv Flesland, Miia Mannonen, Aino Majava, StefaniaPagani, Teuvo Peltoniemi, Manuela Pasinetti, Cinzia Pezzolesi,Norbert Scherbaum, Holger Siemann, Arvid Skutle, Marta Torrens,Peer Van Der Kreeft.The ReDNet Research Group Members are: Fabrizio Schifano;Ornella Corazza, Zoe Davey, Paolo Deluca; Zsolt Demetrovics;Aurora Enea; Giuditta di Melchiorre; Lucia Di Furia; Magi’ Farre’;Liv Flesland; Norbert Scherbaum, Holger Siemann, Arvid Skutle,Marta Torrens, Manuela Pasinetti, Cinzia Pezzolesi; Harry Shapiro;Elias Sferrazza; Peer van der Kreeft, Colin Drummond, AgnieszkaPisarska, Barbara Mervo, Jacek Moskalewicz, Luciano Floridi,Lill Susann Ynnesdal Haugen.Electronic supplementary material The online version of this article(doi:10.1007/s00213-010-2070-x) contains supplementary material,which is available to authorized users.F. Schifano (*):S. Fergus:J. L. Stair:O. CorazzaSchool of Pharmacy, College Lane Campus,University of Hertfordshire,Hatfield, Herftordshire AL10 9AB, UKe-mail: [email protected] Schifano:A. AlbaneseHertfordshire Partnership Foundation Trust,Herftordshire, UKF. Schifano:J. Corkery:A. H. GhodseInternational Centre for Drug Policy,St George’s University of London,London, UKP. Deluca:O. Corazza:Z. DaveyDepartment of Addictions, Institute of Psychiatry London,King’s College London,London, UKH. Siemann:N. ScherbaumLVR-Hospital Essen, University of Duisburg-Essen,Essen, GermanyM. Farre’:M. TorrensConsorci Mar Parc de Salut Barcelona,Barcelona, SpainZ. DemetrovicsEötvös Loránd University,Budapest, HungaryPsychopharmacologyDOI 10.1007/s00213-010-2070-xpharmacology, legal status, product market appearance,clinical/management and related fatalities.Methods Because of the limited evidence, some of theinformation here presented has been obtained from userreports/drug user-orientated web sites. The most commonroutes for mephedrone recreational use include insufflationand oral ingestion. It elicits stimulant and empathogeniceffects similar to amphetamine, methylamphetamine, co-caine and MDMA. Due to its sympathomimetic actions,mephedrone may be associated with a number of both phys-ical and psychopathological side effects. Recent preliminaryanalysis of recent UK data carried out in 48 related caseshave provided positive results for the presence of mephedroneat postmortem.Discussion and Conclusions Within the UK, diffusion ofmephedrone may have been associated with an unprece-dented combination of a particularly aggressive onlinemarketing policy and a decreasing availability/purity ofboth ecstasy and cocaine. Mephedrone has been recentlyclassified in both the UK and in a number of other countriesas a measure to control its availability. Following this, a fewother research psychoactives have recently entered theonline market as yet unregulated substances that maysubstitute for mephedrone. Only international collaborativeefforts may be able to tackle the phenomenon of the regularoffer of novel psychoactive drugs.Keywords Mephedrone.Meow meow.Cathinones.Drug misuse.Drug-related deaths.Psychoactive drugsIntroductionMephedrone (4-methylmethcathinone; ‘plant food’, ‘meowmeow’, ‘miaow’, ‘drone’, ‘meph’, ‘bubbles’, ‘spice E’,‘charge’, ‘M-Cat’, ‘rush’, ‘Ronzio’, ‘Fiskrens’ and ‘MMChammer’) is the most popular of the cathinone derivatives,which also include butylone; methylone and remainingcompounds (ACMD 2010; Mor ris 2010). It has beenreadily available for purchase both online and in headshops and its circulation has been promoted by aggressiveweb-based marketing (Deluca et al. 2009; Mephed rone2you2010; National Treatment Agency 2010).Mephedrone is a psychoactive research chemical thatelicits stimulant and empathogenic effects similar toamphetamines, methylamphetamine, cocaine and MDMA(Winstock et al. 2010a). It has drawn wider attention fromthe media since it has been allegedly linked to a number offatalities. As we write, only few formal papers andexperimental/clinical data have been published (Dargan etal. 20 10;Winstocketal.2010a, b). Some of theinformation contained in this review has been obtainedfrom user reports and drug user-orientated web sites, againhighlighting the lack of peer-reviewed resources. Given thelimited information available, we aimed here at providing astate-of-the-art review on mephedrone chemical, pharma-cological and clinical issues.History and prevalence of misuseIn 1929, Saem de Burnaga Sanchez first described thesynthesis of mephedrone (Saem de Burnaga Sanchez 1929).However, khat-extracted cathinones which first appeared inIsrael in early 2000s, locally named as ‘Hagigat’ (Urquhart2004), were eventually outlawed following a large numberof hospitalisations caused by its exposure (Bentur et al.2008). As a result of the ban, chemists began altering thechemical structure of cathinone to synthesize relatedunscheduled compounds. The first online reference tomephedrone


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