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Synthetic Cathinones and Related Fatalities in the United Kingdom
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
John M. Corkery, Christine Goodair, Hugh Claridge
At the European Union (EU) level, mephedrone was submitted to control measures in EU Member States by the European Council’s decision of 2 December 2010 (2010/759/EU). Some cathinone derivatives are caught by drug control or equivalent legislation, for example: mephedrone (Belgium, Croatia, Denmark, Estonia, France, Germany, Ireland, Italy, Lithuania, Norway, Romania, and Sweden); methylone (Denmark, Ireland, Romania, and Sweden); butylone (Denmark, Ireland, Norway, Romania, and Sweden); MDPV (Denmark, Ireland, Finland, and Sweden); and flephedrone (Denmark, Ireland, and Romania). Medicines’ legislation is used in Finland and the Netherlands to control mephedrone. Several generations/classes of synthetic cathinones and derivatives have been dealt with by means of generic definitions in the UK under the 1971 Act as Class B drugs and under Schedule I of the Misuse of Drugs Regulations (2003, as amended).
Acute toxicity from the synthetic cathinone N-ethylpentylone (ephylone) in the United Kingdom
Published in Clinical Toxicology, 2021
Georgina Blanco, Dan Vidler, Clair Roper, David M. Wood, Paul I. Dargan, Liza Keating, Rebecca Macfarlane, Stevan Emmett, Graham Johnson, Michael Eddleston, Simon L. Hill, Simon H. L. Thomas
Patients exposed to NEP were aged 18–47 years (median 27 years) and 6 were males (Table 1). Commonly reported clinical features included tachycardia (6), agitation (6) confusion (6), mydriasis (5), hallucinations (4), acidosis (3) and elevated creatine kinase (CK) (3). All patients reported use of other drugs, notably MDMA (6) and mephedrone (1) but none reported NEP use. Other drugs of misuse were identified analytically in 7 patients including MDMA (3), benzodiazepines and related compounds (3, accounted for by therapeutic administration in 1), amphetamine and/or methamphetamine (2), cocaine (2), 5F-NPB 22 (1) and butylone (1). In the 3 patients where no other drugs of misuse were identified, frequent features were agitation (3), mydriasis (2), hallucinations (2) and acidosis (2). Sedation was given for agitation or hallucinations in 3 patients overall and one patient was admitted to the Intensive care unit, although did not need intubation or ventilation. All 9 patients recovered and were discharged from hospital with lengths of hospital stay ranging from 2.8 to 185 h (median 21.6 h).
The influence of viewing a headline about ecstasy/Molly adulteration on future intentions to use
Published in Journal of Substance Use, 2020
Joseph J. Palamar, Patricia Acosta, Charles M. Cleland
Although drug-testing studies are lacking in the US, recent US studies have tested biological specimens of EDM party attendees for unknown exposure to “bath salts.” Mohr, Friscia, Yeakel, and Logan (2017), for example, tested blood, urine, and/or saliva samples from EDM festival attendees in Florida, and “bath salt” exposure was prevalent. For example, in saliva samples, 14% tested positive for ethylone, 7% tested positive for methylone, and 3% tested positive for alpha-PVP (“Flakka”). While it is unknown what drugs these attendees thought they had used, the prevalence of “bath salt” exposure was higher than the prevalence of MDMA exposure, and we hypothesize that most exposures to these compounds were via adulterants in or replacements of ecstasy/Molly. Another study in the US examined (unknown) exposure to “bath salts” among ecstasy users in NYC in 2015. EDM party attendees were surveyed and hair-tested upon entering parties, and samples from 48 lifetime ecstasy users were analyzed. Nearly half (46%) tested positive for one or more “bath salts” (i.e., methylone, butylone, alpha-PVP) (Palamar, Salomone, Vincenti, & Cleland, 2016). In February of 2016, Vice, a popular online media source geared toward younger readers, featured these hair test findings in an online article (Iadarola, 2016).
Prevalence of Stimulant, Hallucinogen, and Dissociative Substances Detected in Biological Samples of NPS-Intoxicated Patients in Italy
Published in Journal of Psychoactive Drugs, 2021
Pietro Papa, Antonella Valli, Marcello Di Tuccio, Eleonora Buscaglia, Elena Brambilla, Giulia Scaravaggi, Mariapina Gallo, Carlo Alessandro Locatelli
Cathinones. Forty-five cases (3.1% of the total and 18.3% of the positive cases) tested positive for cathinones (Table 2). In 30 cases, they represented the solely detected class of NPS (21 cases positive for one cathinone, 9 cases for two cathinones). In six cases the analyses tested positive also for other classes of NPS, that is, the synthetic cannabinoid 5 F-MDMB PICA (methyl (2S)-2-{[1-(5- fluoropentyl)-1 H-indole-3-carbonyl]amino}-3,3-dimethylbutanoate), the designer benzodiazepine flubromazepam, GHB, and ketamine. Moreover, in 14 cases conventional drugs of abuse, namely amphetamine (1 case), ecstasy (6 cases), Delta9-Tetrahydrocannabinol (THC) (4 cases), and cocaine (3 cases) were detected. Methylenedioxypyrovalerone (MDPV) was the most frequently detected cathinone (n = 9) throughout the period 2011–2019 along with mephedrone (n = 8). Our data (Table 2) show a significant turnover of molecules within this class. Some cathinones (i.e., butylone, 2-Amino-1-(4-bromo-2,5-dimethoxyphenyl)ethan-1-one (βK 2 CB) and pentedrone) were present rarely and/or for a short period of time. Other cathinones were detected during a longer period, but disappeared in the last years, while six “new” cathinones (i.e., 4-Methyl-α-ethylaminopentiophenone (4-MEAP), ephylone, 3ʹ, 4ʹ-Methylenedioxy-α-pyrrolidinohexiophenone (MDPHP), eutylone, chloroetcathinone, and ethcathinone) emerged during 2017–2019. This trend is in agreement with recent data from literature that report severe and fatal intoxication by novel cathinones, with particular regard to ephylone (Ikeji et al. 2018; Krotulski et al. 2018; Thirakul et al. 2017). Urine and blood concentration were measured in 11 cases and concentration ranges were 11–15000 ng/ml and 5.7–820 ng/ml, respectively. Low concentrations were due to the time elapsed (> 24 hours) between drug intake and sample collection.