INFORMATION FOR PRIMARY & COMMUNITY HEALTH CARE STAFF IN LOTHIAN No. 121 May 2010 Mephedrone: what you need to know

Mephedrone is one of a group of synthetic drugs derived from Possible drug interactions cathinone (the same chemical found in the plant called Khat). There are reports that when taken in conjunction with other drugs Also known as ‘Meph, meow, MM-Cat, Magic, Drone, Plant such as amphetamine the effects can be marked and lead to Food’. Other cathinones such as butylone and methylone are personality changes, paranoia, and violent episodes. May interact reported to have similar effects. with antidepressant drugs especially tricyclics and SSRIs. Mephedrone is thought to be mainly manufactured in China. It Management is usually available as a white powder or crystals, which are National guidelines have been issued by UK and Scottish snorted or less often swallowed. It is usually sold in bags, or government on the management of someone presenting with the ‘wraps’ of powder and costs around £10-20 for a gramme. A effects of mephedrone use. Recommendations include: typical strong oral dose will be around 100-250+mg, a strong • Less acute physical or psychological problems should be nasal dose will be around 80-125mg. It may also come as a managed symptomatically - more acute toxic effects may tablet or capsule and can be dissolved in liquid. additionally require hospital referral. Effects of mephedrone • Patients may present early with a temporary ‘comedown’ and • Similar to that of stimulant drugs such as amphetamines, low mood from recent drug use, and may require ecstasy, and cocaine. reassurance, support and monitoring. • Desired affects include a sense of euphoria and wellbeing, • Dependence with daily compulsive use may require referral users report becoming more alert, confident, and talkative. to specialist drug agency (see list of agencies below). • As with other stimulant drugs it can cause palpitations, Often the establishment of a balanced diet and good sleep hygiene tachycardia, hypertension, peripheral vasoconstriction and makes a significant positive impact on the way an individual chest pain (sometimes with ECG abnormalities). feels. • Mental health affects include low mood, depression, Harm reduction advice: agitation, anxiety and, rarely, psychosis. These effects are • Take a small amount to start with and wait for the effects usually reported during the ‘come down’ period and are before deciding whether to take more. commonly reported after a prolonged period of use. • Avoid using alone and be clear with friends about what you • Snorting mephedrone can lead to trauma to the throat and are using. nasal passages with severe nose bleeds commonly reported. • Avoid mixing with other drugs / alcohol. Users can also experience; • Ingest within a capsule / cigarette paper. • excessive sweating (sometimes with a ‘chemical’ smell) • If snorting, clean nose out after use and use a straw – don’t • blurred vision share the straw. • hot flushes • Control quantities used in one session (users advise no more • suppressed appetite than ½ gramme in 24 hours). • nausea and vomiting (particularly if mixed with other drugs • stay well hydrated by sipping water. such as alcohol or cannabis) • Avoid if: on antidepressants (risk of serotonin syndrome), Once users have started using the drug it can be very hard to history of cardiovascular problems, pregnant or breastfeeding stop in a particular session and they can consume up to 2g or • If using IV (not advised by users): advise not to use alone, more. In some cases regular or heavy use may develop into advice on anatomy and improved injecting technique, review dependence. current sites, advice on site rotation, nearest Injecting Injecting mephedrone carries high risks due to Equipment Provision site, prevention of BBV transmission, vasoconstrictive effects, its caustic nature, overdose risk, overdose advice (recovery position and phone ambulance). and possible psychosis List of agencies for support Mephedrone has been linked to a number of deaths in the UK Crewe 2000 – For information and support. Website: although the exact mechanism remains unclear and as yet there www.crew2000.org.uk is no conclusive evidence of a direct causal link. Local Voluntary Drug Agencies: info from: Legal status www.scottishdrugservices.com Mephedrone was previously described as a ‘legal high’. The th Community Drug Problem Service, Spittal Street Centre, 22-24 drug was reclassified on 16 April as a Class B substance under Spittal Street, Edinburgh – referral of cases of compulsive the Misuse of Drugs act 1971, along with other cathinone problematic use. derivatives. It now cannot legally be sold, or possessed: Special thanks to Crewe 2000 for their advice on the content of penalties up to a maximum of 14 years in prison and / or an this sheet, and the use of their own mephedrone information unlimited fine can be imposed for dealing in the drug, and up to sheet. 5 years in prison and / or an unlimited fine for possession of the drug.

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