Mephedrone

Mephedrone, chemically known as 4-methyl methcathinone, is a synthetic stimulant drug belonging to a class of compounds called cathinones.¹ It is structurally related to methcathinone, a compound in the khat plant native to East Africa.² Mephedrone was initially synthesised in 1929 but gained popularity much later, around the early 2000s, as a legal high.³ This substance rose to prominence primarily through online vendors under the guise of ‘plant food’ or ‘bath salts’, offering a legal alternative to traditional illicit substances like MDMA, cocaine, or amphetamines.

In terms of its pharmacological profile, mephedrone is known to act on monoamine transporters and has effects similar to those of amphetamines and MDMA.⁴ The drug is commonly administered through snorting, but it can also be ingested, injected, or taken rectally.⁵ The effects include euphoria, increased sociability, and heightened sensory perception, but they can also lead to a range of adverse outcomes such as paranoia, hallucinations, and severe panic attacks.²

Public health bodies became increasingly concerned about mephedrone’s potential for abuse and its unknown long-term effects.⁶ This led to legislative actions; the United Kingdom classified mephedrone as a Class B drug in 2010, making its sale, purchase, and possession illegal.⁷

Research into mephedrone’s physiological effects is ongoing, with some studies pointing to potential neuroinflammatory effects.⁸ Other research focuses on the pharmacokinetics and toxicological profiles to better understand the full range of its impacts on human health.⁹

Overall, while mephedrone emerged as a ‘legal high’ and gained rapid popularity for its psychoactive effects, it has also been associated with a range of adverse physical and mental health outcomes. Its legal status has changed in many jurisdictions, including the UK, due to these health risks and the potential for abuse.

Appearance

Mephedrone is commonly observed as a fine, white powder that has a crystalline texture, closely resembling drugs like cocaine and amphetamines.⁵ However, colour variations do exist, and it can sometimes appear as off-white or even slightly yellowish in hue. The drug can also come more crystalline, showcasing larger, more defined particles that glisten in the light. Another format in which mephedrone is distributed is encapsulated, where the powder is contained within small capsules.¹¹ The appearance of mephedrone can be deceptive; its resemblance to other, more well-known stimulants has led some users to mistake it for substances like MDMA or cocaine. Overall, the visual characteristics of mephedrone reveal its synthetic origin and complex chemical structure.¹¹

Tastе

The taste of mephedrone is generally described as bitter and chemical-like.⁷ Some users have noted a medicinal or metallic aftertaste when ingesting the substance orally. This strong, unpleasant taste often lingers in the mouth, which is one reason why users may prefer routes of administration that avoid tasting the drug. Although the bitter taste can be off-putting, it is a common trait among synthetic psychoactive substances. Thus, the taste of mephedrone further underscores its synthetic nature and aligns with its strong, chemical odour.

Smell

Mephedrone carries a distinctive smell often described as strong and chemical-like.⁵ Some users and experts liken the smell to that of bleach or other cleaning agents, emphasizing its synthetic composition. Others have even noted a cat urine-like odour. The smell can vary slightly depending on the purity and source of the drug. The pungent smell is a point of identification and can sometimes serve as a warning of its presence. Overall, the odour of mephedrone is yet another marker of its synthetic origins and chemical complexity.

Mephedrone is a versatile drug with multiple routes of administration. One of the most common ways it is taken is through snorting the powdered form, which produces a rapid onset of effects.⁵

Another method is oral ingestion, either by swallowing the powder wrapped in a cigarette paper (‘bombing’) or by mixing it with a liquid.¹¹ The drug is also known for being taken rectally, an approach known as ‘plugging’.⁷ In some cases, users dissolve the powder in water and inject it, although this is less common due to the associated health risks, such as infection or vein damage.⁵

Additionally, mephedrone can be smoked, although this is a less frequent route of administration.⁷ It’s worth noting that polydrug use is common, with users often combining mephedrone with other substances like alcohol or MDMA, which can complicate its effects and risks.⁴ The choice of administration can influence the drug’s effects, the risk profile, and the speed at which the substance takes effect.

• Minimum to Feel Something (mg): The minimum amount of mephedrone required to feel its effects varies among individuals but generally ranges from 15 to 25mg.⁹ At this dose, users may experience subtle feelings of stimulation and slight mood elevation.
• Low Dose: A low dose of mephedrone is typically around 50mg to 75mg. Users report increased energy, enhanced sensory perception, and moderate euphoria at this dosage.⁹
• Common Dose: The most commonly reported dose for recreational use of mephedrone ranges from 100mg to 150mg. This dose produces significant stimulant effects, including heightened alertness, increased sociability, and strong feelings of euphoria.⁵
• High Dose: Doses above 200mg are considered high and come with increased risks of adverse effects, such as hallucinations, extreme agitation, and cardiovascular issues.⁹ It’s also at these higher doses that the risk of dependency and other long-term health issues significantly escalates.²

What May Happen When Exceeding the High Dose

When it comes to exceeding the high dose, risks escalate dramatically. Users may experience extreme agitation, hallucinations, and even delirium.⁹ High doses also substantially raise the likelihood of cardiovascular complications, such as rapid heart rate and elevated blood pressure.²

Mephedrone is a synthetic stimulant chemically similar to cathinone, a compound found naturally in the khat plant. Users typically report a variety of sensations and psychological effects upon consuming the drug.

• Euphoria and Well-being: One of the most commonly reported effects is a sense of euphoria or intense happiness. Users often describe feelings of increased confidence and well-being.⁴
• Increased Energy and Alertness: Mephedrone is a stimulant, and users often report increased energy and alertness. It may also lead to hyperactivity and an enhanced perception of the senses.
• Empathy and Connection: Some users have reported increased empathy and a stronger emotional connection with others. However, this is less consistently reported than other effects like euphoria and increased energy.⁶
• Decreased Inhibition: A lowered sense of inhibition is also commonly reported, which can lead to risk-taking behaviours. This effect, coupled with the drug’s addictive potential, makes its use particularly hazardous.⁵
• Negative Effects: While the drug is in effect, users may also experience adverse symptoms like increased heart rate, high blood pressure, and hyperthermia (increased body temperature). Once the drug begins to wear off, users may experience a ‘comedown’ that includes symptoms like fatigue, irritability, and depression.

The time it takes for mephedrone to produce its effects can depend on the method of administration, but generally, users report feeling the effects within a relatively short period.

• Oral Consumption: When taken orally, the effects are usually felt within 15 to 45 minutes.⁴
• Intranasal Use: When snorted, the effects can be felt almost immediately, typically within a few minutes.⁶
• Intravenous Use: When injected intravenously, the onset is nearly instantaneous, typically occurring within seconds to a minute. However, this method of use dramatically increases the risks associated with the drug, including the potential for overdose and infection.
• Inhalation: Though less commonly reported, some users vaporise and inhale mephedrone, leading to rapid onset of effects similar to intranasal use.⁵

Mephedrone’s effects can be felt quite rapidly after consumption, with the time to onset varying based on the method of administration. This rapid onset contributes to its potential for abuse and the associated health risks.

The duration of the effects of mephedrone can vary depending on several factors, including the dosage, the method of administration, and individual metabolic differences. However, some general patterns have been identified in the scientific literature.

• Duration of Effects: The effects of mephedrone are often described as being shorter-lived compared to other stimulants like MDMA or cocaine. Users report that the initial euphoric effects can start within minutes of administration and generally last approximately 1 to 2 hours.⁴
• ‘Redosing’ and ‘Fiending’: Because the effects are relatively short-lived, users may often engage in ‘redosing’ or taking additional doses in a short period to maintain the initial euphoric effects. This behaviour, known as ‘fiending’, can lead to increased risks such as overdose and heightened negative side effects.⁶
• Comedown: After the initial effects have worn off, users often experience a ‘comedown’, which can last for several hours or even days. Symptoms during the comedown may include fatigue, irritability, and depression.⁵

The relatively short duration of mephedrone’s effects, often resulting in patterns of redosing, increases the potential for negative health impacts and addiction.

Mephedrone poses a variety of health risks, both acute and long-term, that have been the subject of public health warnings and research studies.

• Cardiovascular Risks: Mephedrone has been shown to increase heart rate and blood pressure, putting users at risk of cardiovascular issues such as heart palpitations, arrhythmias, and, in severe cases, heart attack.⁴
• Neurological Risks: The drug’s neurotoxic effects include potential damage to serotonin and dopamine neurons. This could lead to long-term issues such as depression, anxiety, and cognitive impairments.¹²
• Psychological Risks: Mephedrone usage can lead to a range of psychological issues, including increased anxiety, paranoia, and hallucinations. Additionally, the comedown after the drug wears off can result in severe depression.⁶
• Dependency and Addiction: As discussed in the previous section, mephedrone has a high potential for abuse and dependency, both psychological and possibly physical. This raises concerns about its long-term use and the associated risks of dependency.
• Risks from Polydrug Use: Mixing mephedrone with other substances, such as alcohol, benzodiazepines, or other stimulants, increases the risks of adverse reactions, including toxic interactions that can be fatal.⁵
• Other Health Risks: Other reported adverse effects include digestive issues, nausea and vomiting, and respiratory difficulties.³
• Legal Risks: Being a Class B controlled substance in the UK, possession or distribution of mephedrone can result in severe legal penalties, including imprisonment.

The health risks associated with mephedrone are significant and varied, encompassing cardiovascular, neurological, and psychological domains. Its potential for abuse further elevates its risk profile, and its illegal status in the UK underscores the public health concerns associated with its use.¹⁰

Mephedrone has been identified as a substance with a high potential for abuse and addiction. The addictive properties of mephedrone are attributed to its psychoactive effects, which include increased energy, euphoria, and heightened sensations. These effects are caused by the release of neurotransmitters like dopamine and serotonin, which are associated with pleasure and reward mechanisms in the brain.⁴

• Psychological Dependence: The euphoric and stimulant effects of mephedrone can lead to psychological dependence. Users may find themselves using the drug repeatedly in a short period, a phenomenon known as ‘fiending’, which can also lead to increased dosages over time.⁶
• Physical Dependence: While the evidence for physical dependence is not as robust as for psychological dependence, some users report symptoms of withdrawal, including fatigue, depression, and decreased concentration.¹²
• Harm Reduction and Treatment: Given the potential for addiction, various treatment approaches, including cognitive behavioural therapy and medication, have been proposed. However, as mephedrone is a relatively new drug, effective treatment protocols are still under development.
• Legal Implications: Due to its addictive potential and associated health risks, mephedrone is classified as a Class B drug in the UK, making its possession, distribution, and production illegal. This legal status also serves as a deterrent against its misuse.⁵

The addictive potential of mephedrone is a subject of concern both from a public health and a legal perspective in the UK. Its capacity for psychological and possible physical dependence makes it a high-risk substance, and its legal status as a Class B drug reflects this risk.¹⁰

In the United Kingdom, mephedrone is classified as a Class B controlled substance under the Misuse of Drugs Act 1971. This classification means that it is illegal to possess, distribute, or produce mephedrone. The penalties for offences related to Class B substances are substantial and can include imprisonment.

• Penalties for Possession: Up to 5 years in prison, an unlimited fine, or both.
• Penalties for Supply and Production: Up to 14 years in prison, an unlimited fine, or both.
• Additional Legal Ramifications: In addition to criminal penalties, being caught with mephedrone can have other long-lasting implications, including a criminal record, which can impact future employment prospects and overseas travel. ⁵

The legislation aims to curtail the use and distribution of this drug due to its potential for abuse and the health risks associated with its consumption. Law enforcement agencies in the UK take offences related to controlled substances seriously, and prosecution can be vigorous.

Mixing mephedrone with other drugs, also known as polydrug use, is a practice that carries significant risks, including potential toxic interactions and life-threatening conditions. Different combinations can result in a variety of adverse effects, ranging from cardiovascular issues to severe impairment of cognitive and motor functions. Below is an in-depth look at the dangers associated with combining mephedrone with other substances.

• Alcohol: Mephedrone’s stimulant effects can mask the depressant properties of alcohol, leading to dangerous behaviour such as impulsivity and risky sexual practices. The combination also places considerable stress on the cardiovascular system.⁵
• Stimulants (Cocaine, Amphetamines): Using mephedrone in combination with other stimulants like cocaine or amphetamines escalates the risk for cardiovascular problems, such as elevated blood pressure and heart palpitations.³
• Cannabis: Co-using mephedrone and cannabis can result in a complicated and unpredictable user experience. The stimulant properties of mephedrone may partially counteract the depressant effects of cannabis, but this mixture often leads to higher impairment of cognitive and motor functions.⁴
• MDMA (Ecstasy): Combining mephedrone with MDMA increases the potential risks significantly. Both substances can heighten heart rate and contribute to dehydration, hyperthermia, and even serotonin syndrome, which can be fatal.⁶
• Benzodiazepines: Some users may use benzodiazepines to mitigate the anxious or jittery effects of mephedrone or to manage the ‘comedown’. However, this combination is particularly risky as it can lead to respiratory depression.¹²

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