Substance Use Disorders
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
The alpha- and beta-adrenergic properties of amphetamines are responsible for the cardiovascular effects of amphetamines. Release of serotonin is responsible for some of the hallucinogenic effects of amphetamines [155]. Amphetamine use can damage brain structures including the grey matter, temporal lobe, and basal ganglia. Methamphetamine abuse can cause toxic hepatitis, which presents similarly to acute viral hepatitis. Consequences of long-term methamphetamine use include anxiety, confusion, insomnia, memory loss, weight loss, dental problems (“meth mouth”), depression, violence, paranoia, hallucinations, and formication [156]. Symptoms of amphetamine and synthetic cathinone withdrawal are mild and not life-threatening (e.g., depression, insomnia) but some users have reported symptoms of psychological dependence (e.g., drug cravings) weeks after discontinuation.
Khat and the creation of tradition in the Somali diaspora
Jane Fountain, Dirk J Korf in Drugs in Society, 2019
The invigorating qualities of khat derive from two alkaloids, identified as cathine and cathinone, which resemble amphetamine. However, they are highly unstable and disintegrate within 72 hours. Three days after harvest, khat is psychoactively ineffective and commercially worthless. Both cathine and cathinone are controlled substances in the UK, and their extraction is illegal.c However, the khat leaves can be imported legitimately as a vegetable. According to Her Majesty’s Customs and Excise, an estimated 10,000 tons of khat pass through Heathrow airport annually, much of it destined for re-export. London, with good air links to Kenya, Yemen and Ethiopia, serves as a hub for global distribution. Given that khat is sold at £200 per kilo in the USA, compared with £10 in the UK, the incentives for export are obvious.
Synthetic Cathinones and Related Fatalities in the United Kingdom
Ornella Corazza, Andres Roman-Urrestarazu in Handbook of Novel Psychoactive Substances, 2018
Khat (Catha edulis forsk) is a member of the evergreen Celastracae (moonseed or spindle- tree) family (Corkery, 2016). Its fresh leaves contain several phenylpropylamine-type alkaloids, of which the two main psychoactive constituents are the stimulants cathinone (S-(-)-α-aminopropiophenone) and cathine (S,S-(+)-norpseudoephedrine). Cathinone (α-aminopropiophenone) has been isolated in variable amounts from fresh leaves. These molecules act on two main neurochemical pathways—dopamine and noradrenalin. It has been proposed that cathinone, like amphetamine, releases serotonin into the central nervous system (CNS), inducing dopamine release from CNS dopamine terminals, increasing dopaminergic pathway activity (Kalix & Braenden, 1985). Cathinone facilitates the transmission of noradrenalin. It has been suggested that the uptake of noradrenalin is inhibited by cathinone and cathine (Drake, 1988). Cathinone possesses a stronger stimulant effect than cathine and is generally regarded as the more important constituent in khat. However, the presence of oxygen makes cathinone unstable, and it decomposes within just a few days of being picked or if it is dried (Griffiths et al., 1997). Its psychoactivity quickly declines, becoming physiologically inactive after approximately 36 hours.
Perinatal outcomes of synthetic cathinone (“bath salts”) use in pregnancy: a case series
Published in Journal of Substance Use, 2023
Julia R. Frew, Daisy Goodman, Mary Brunette
Research on the impact of synthetic cathinone use during pregnancy is extremely limited. However, in non-pregnant people, cathinone use is associated with profound physiologic effects, including tachycardia, creatine kinase elevation (a marker of cardiac injury), and renal failure, in addition to agitation and psychosis (White, 2016). Neurotoxicity in users is also suspected and thought to be related to neuroinflammation, oxidative stress, and monoamine depletion (Altun & Çok, 2020). Chronic use has been associated with neurocognitive dysfunction, including impaired verbal recall and short-term memory deficits, which may have implications for treatment (Leyrer-Jackson et al., 2019). Many people who use synthetic cathinones also utilize other substances (Lopez-Rodriguez & Viveros, 2019), which may complicate their presentation.
Blood concentrations of synthetic cathinones
Published in Clinical Toxicology, 2021
Synthetic cathinones first appeared on the drug market in 2004 and since then their number has increased. At present, they are the second largest and the second most frequently seized group of new psychoactive substances in Europe [1]. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) currently monitors 138 synthetic cathinones [1]. These substances have stimulating and emphatogenic actions, and are used as alternatives to amphetamine and 3,4-methylenedioxymethamphetamine (MDMA), as well as cocaine. Synthetic cathinone use is often associated with health and life risks. Their toxic effects include aggression, agitation, paranoia, and delusions. The synthetic cathinone ingestion can result in seizures, hyperthermia, rhabdomyolysis, renal and hepatic failure, and can led then to death [2].
“Not for Human Consumption”: A Descriptive Investigation into User Characteristics, Motives, and Consequences Associated with Bath Salt Use
Published in Journal of Psychoactive Drugs, 2019
Lauren Zimmerman, Tess M. Kilwein, Danielle Beyer, Cassidy Marks, Alison Looby
Few studies have assessed motives for synthetic cathinone use. Ashrafioun and colleagues (2016) identified stimulating effects, curiosity, substitution for another drug, and being at a party/music event as the primary reported motives for use, while Johnson and Johnson (2014) reported liking the effect, mind/brain exploration, avoiding a positive test for another drug, staying awake, and improved sexual experience as common motives. A review of the clinical effects of synthetic cathinones (Karila and Reynaud 2011) and a toxicology case review (Marinetti and Antonides 2013) revealed that common effects of mephedrone and synthetic cathinones include euphoria, elevated mood, alertness, empathogenic effects, and sexual arousal, suggesting that many individuals may be using for positive reinforcement purposes, perhaps particularly mood enhancement. Consistently, motives for other psychomotor stimulant use are also generally related to positive reinforcement, such as euphoria or enjoying company (Boys, Marsden, and Strang 2001; Winstock et al. 2011). Continued direct examination of specific motives for BSU may aid in the development of effective prevention and intervention methods that can target individual reasons for use.
Related Knowledge Centers
- Alkaloid
- Cathine
- Functional Group
- Ketone
- Khat
- Methcathinone
- Monoamine Neurotransmitter
- Stimulant
- Ephedrine
- Substituted Amphetamine