Mephedrone - a new ‘legal’ online drug of abuse. Do we know anything about its safety? [Abstract]

Objective: The UK NPIS are receiving an increasing number of calls about a drug of abuse known as mephedrone or 4-methylmethcathinone, also called ‘bubbles’. It is usually supplied as an off-white crystalline powder with a strong fish-like odour and is either ingested or inhaled. This drug is becoming increasingly popular in the UK as it is currently classed as a legal substance. It is often bought from the Internet as plant food or as a research chemical marked ‘not for human consumption.’ Methods: Enquiries to the UK NPIS for the period 1 January 2008 to 1st January 2009 and also 1st January 2009 to 1st November 2009 involving ‘mephedrone’ or ‘methcathinone’ were retrieved. Each call was examined in detail and all reported symptoms and the results of any investigations noted. Internet websites were also investigated for details of mephedrone exposures to try and compare symptoms experienced by regular users with those reported to the UK NPIS. Results: No enquiries concerning mephedrone were received by UK NPIS between 1st January 2008 and 1st January 2009 compared with 29 enquiries which were received between 1st January 2009 and 1st November 2009. Of these, the main symptoms reported were agitation/anxiety, headache, sweating, chest pain, mydriasis, loin or back pain and pins and needles. One patient was admitted to ITU with tachycardia, hypotension, rhabdomyolysis and coma following a seizure. The symptoms reported on the Internet (from 13 user information reports) included euphoria, addictive behaviour, dilated pupils, jaw clenching and sweating as well as increased heart rate. There have been some reports of vasoconstriction causing purple extremities and joints. One death has been reported in Sweden although causal links with mephedrone have not yet been confirmed. Conclusion: Mephedrone is a very new and increasingly popular drug; its legal status in the UK may falsely imply safety. It is, however, a synthetic drug that, from UK NPIS data and Internet reports, causes some potentially dangerous symptoms that are similar to stimulant drugs of abuse. The clinical effects of this chemical need further investigation