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March

Experts call for urgent guidance on mephedrone

23 March 2010 

Experts from the Institute of Psychiatry (IoP), King's College London (KCL) have called for urgent educational and harm reduction guidance on mephedrone, in an Editorial published in the British Medical Journal today.

“The recent deaths of two young men who are thought to have taken mephedrone (also known as Miaow, 4-MMC, Meph and TopCat) have prompted calls for the drug to be banned” said Adam Winstock, Senior Lecturer in Addiction Psychiatry, IoP KCL “however unlike other stimulant drugs such as cocaine and ecstasy, its toxicity, metabolism and long term consequences are still largely unknown.”

The authors cite mephedrone’s effects to include euphoria, increased energy, feelings of empathy, sweating, rapid heart beat (tachycardia), headache and teeth grinding.  Also, there may be an increase in libido which could lead to risky sexual behaviour. In the days after use, typical comedown symptoms such as lethargy and low mood are common.

 Dr Winstock continues: “Mephedrone is highly likely to be used along with other stimulant drugs or alcohol that moderate or enhance its effects and this may contribute to an increased risk of adverse effects. People with a history of mental health or heart problems, especially those on medication, are likely to be at greatest risk of serious harm from the drug.”  

The authors advise common sense be applied if taking the drug such as avoiding regular use to prevent developing tolerance; not using the drug in combination with other stimulants or large amounts of alcohol and other depressants; not injecting the drug; remaining well hydrated when using the drug; and avoiding becoming overheated.

It is likely that the UK government will move to control the manufacture, distribution and possession of mephedrone but the authors question whether controlling it under the current provisions of the Misuse of Drugs Act is the best public health response.

Dr Winstock warns: “Recent history suggests that manufacturers will merely turn their attention to the nearest effective but unsanctioned alternative substance. Unfortunately, the list of potential synthetic psychoactive compounds is dauntingly long.”

The Editorial can be viewed here: 

www.bmj.com/cgi/doi/10.1136/bmj.c1605

 

 

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