Mephedrone

Mephedrone is a short-acting central nervous stimulant drug whose effects resemble those of MDMA as well as cocaine.
Dosage:
Swallowed: 100-200 mg
Snorted (more frequent dosing): 25-75 mg
Duration:
Swallowed: 2-4 hours
Snorted: 1-2 hours
Risks:
Acute toxicity: ⦿⦿⦾⦾⦾ (Low risk)
Long-term toxicity: ⦿⦿⦾⦾⦾ (Low risk)
Dependence: ⦿⦿⦿⦿⦾ (High risk)
Cognitive problems: ⦿⦿⦿⦾⦾ (Moderate risk)
Undesirable events: ⦿⦿⦿⦿⦾ (High risk)
Interactions: ⦿⦿⦿⦾⦾ (Moderate risk)

Scroll down for the full risk profile.
1. Summary
Mephedrone (4-methyl-methcathinone) is a synthetic stimulant drug belonging to the amphetamine class. It is an analogue of cathinone, the main active ingredient found in the leaves of the khat plant (Catha edulis).

Although it was first synthesized in 1929, mephedrone only gained popularity as a recreational drug in the 2000s. It was added to the UN Convention on Psychotropic Substances in 2009 and is currently classified as an illicit drug in Norway.

Mephedrone, like MDMA, is an entactogenic stimulant. This means it releases more serotonin in the brain than other stimulants, which often causes users to feel a strong rush of euphoria and love for others. However, mephedrone also tends to make users want to (and often crave) frequent re-dosing, which is more commonly seen with other stimulants like cocaine than other entactogens. Many people feel a strong desire to have sex when under the influence of mephedrone, and the drug is especially common in the chemsex subculture.

When compared with other, more common stimulants, mephedrone appears to be less toxic to certain organs in the body, and its use rarely leads to lethal overdose. However, it does appear to be highly addictive, and (excessive) use may trigger depression and psychoses.


2. Rules for sensible drug use
Please see our 10 general rules for sensible drug use. You should also be mindful of the following:

  • Ensure that the drug you have really is mephedrone, either by using a rapid color test or, ideally, an analysis service such as Energy Control.

  • Be especially careful if you have a medical diagnosis or are taking prescription medications. Do not use mephedrone if:

    • you have cardiac issues, or are taking any form of antidepressant, antipsychotic, lithium, or tramadol;

    • you or anyone in your immediate family has ever come down with malignant hyperthermia or rhabdomyolosis after taking prescription medications.

  • Never use mephedrone at the same time as (or soon after) taking ayahuasca/pharmahuasca/changa, drugs in the 2C-T-series, or any other recreational or medical drug with strong monoamine oxidase inhibitor (MAOI) effects.

  • Avoid combining mephedrone with other central nervous stimulants and/or large amounts of alcohol.

  • If you are trying mephedrone for the first time, you should start with a very low dose (e.g. 70 mg swallowed) and monitor the effects before you consider taking more. There is a chance you are hypersensitive to mephedrone, in which case a normal recreational dose could be harmful to you.

  • Avoid taking large doses if you are female, and avoid using mephedrone at all immediately after menstruation. If you nevertheless choose to do the latter, consider at least halving the dose and monitoring the effects.

  • Avoid using mephedrone frequently, and make sure to give yourself enough time to recover between each session.

  • Do not use mephedrone with anyone you don't trust, or anyone you don't trust yourself around. Mephedrone can lead people to overstep their sexual boundaries, especially when higher doses are involved, which can in turn lead to unwanted or unpleasant experiences.

  • If your body temperature rises to an uncomfortable level after taking a normal dose, remove any warm clothing and try to cool yourself down, e.g. by sitting in front of a fan and/or putting an ice pack on your neck. If that doesn't help, or if the temperature rise happened rapidly without you engaging in any physical activity or being in a warm place, you need to call 113 and request an ambulance.

3. Risk profile
We employ a five-step risk scale with values ranging from "very low" to "very high" within six categories: Acute toxicity, Long-term toxicity, Dependence, Cognitive problems, Unpleasant events, and Interactions.

These values are based on qualitative reviews of available knowledge, and should only be viewed as guidelines. They are also relative, so a score of "very low risk" does not mean the substance is risk-free. The scale assumes users are normal, healthy individuals; beware that even drugs which are well-tolerated by most people may nevertheless be harmful to some users. It also assumes normal use patterns; that is, if a given drug is only harmful when used in a certain way, yet is almost never used in that way, then the drug will be considered less harmful compared to a similar drug which is commonly used in a harmful way.


ACUTE TOXICITY

⦿⦿⦾⦾⦾ (Low risk)

Relatively few overdose deaths have been linked to mephedrone when considering how many people are assumed to have used the drug at some point. A literature review from 2015 found that mephedrone had been implicated in only 15 drug-related deaths, of which nine were registered as being caused by mephedrone alone [1]. UK authorities estimate, based on national surveys done in 2010, that around 300,000 brits between the ages of 16 and 24 had used mephedrone in the previous year [15].

LONG-TERM TOXICITY

⦿⦿⦾⦾⦾ (Low risk)

Mephedrone appears to cause less damage to the heart than does cocaine, amphetamine, and MDMA. It appears to also be less harmful to the brain's serotonin system than MDMA, and less harmful for the dopamine system than methamphetamine [4]. However, many people use mephedrone in relatively large doses at a time, and often more frequently than people use MDMA, which means that the total damage to the body from mephedrone use may be greater than this relative harm potential might suggest [3].

DEPENDENCE

⦿⦿⦿⦿⦾ (High risik)

The risk of addiction from mephedrone use appears to be similar to that of amphetamine and cocaine. A study involving 1,006 mephedrone users reported that roughly half of the users found the drug addictive, while a different study involving 205 users found reports of addiction symptoms in only 17% of users [3].

Unlike MDMA, mephedrone can be used frequently without any major loss of effectiveness, i.e. without the user rapidly developing a tolerance to its effects. However, users commonly need to increase the dose considerably with more frequent use [3]. The risk of becoming addicted to mephedrone probably increases if the drug is combined with alcohol, and possibly also nicotine [6, 10].

COGNITIVE PROBLEMS

⦿⦿⦿⦾⦾ (Moderate risik)

Mephedrone use can lead to many of the same hangover effects as MDMA, including low mood, anxiety, irritability, and problems with memory and sleep. These effects may last for anywhere from a few days to a few weeks after the drug is last used. Frequent mephedrone users score lower on memory recall tests, and animal testing has demonstrated reduced memory recall for extended periods after using mephedrone, albeit without visible signs of damage to the animals' brains.

Some research indicates that mephedrone produces more transient (i.e. less long-lasting) after-effects on the brain's serotonin system when compared with MDMA. However, because mephedrone users tend to re-dose several times over the course of a session, it is not uncommon to experience a worse "crash" after mephedrone than after MDMA.

Mephedrone can, like most strong central nervous stimulants, trigger psychoses. This happens primarily in individuals with a predisposition to psychoses, but also in cases of overdose or severe sleep deprivation [3].

UNDESIRABLE EVENTS

⦿⦿⦿⦿⦾ (High risk)

Mephedrone, like MDMA, tends to make users more open and sociable, and lowers inhibitions regarding intimacy with others. This may lead people to tell others things about themselves that they normally wouldn't divulge, or initiate a close relationship with someone they would normally want to keep at a safe distance. Many people also experience a heightened sex drive on mephedrone, and there are reports from the chemsex community of people consenting to sexual encounters that they would normally not consent to [11]. This means it is generally a bad idea to take mephedrone with people one either cannot trust, or does not trust oneself around, since situations might arise that one will regret once the drug's effects have worn off. This risk is likely amplified by combining mephedrone with central nervous depressants such as alcohol, GHB, benzodiazepines, or z-hypnotics, as these all tend to lower inhibitions as well.

People with suicidal thoughts or severe depression should be especially wary of using mephedrone due to the potentially severe emotional "crash" after a heavy session. Among deaths where mephedrone use has been implicated as a factor, some reported self-harm as the proximate cause of death [3].

INTERACTIONS

⦿⦿⦿⦾⦾ (Moderate risik)

Mephedrone should, like all central nervous stimulants, never be used in combination with any monoamine oxidase-inhibiting drugs or medications, known as MAOIs. This includes recreational drugs such as ayahuasca, changa, and psychedelics in the 2C-T-series, atypical antidepressants such as phenelzine and moclobemide, and anti-Parkinsons drugs such as rasagiline and selegiline. Taking mephedrone at the same time as (or soon after) an MAOI can lead to serotonin syndrome, an acute, potentially life-threatening medical emergency. Also, taking mephedrone with lithium or tramadol may lead to seizures.

In theory, any central nervous stimulant that releases large amounts of serotonin may lead to serotonin syndrome when combined with SSRI or SNRI-type antidepressants. However, this does not appear to be the case with MDMA, where such antidepressants merely (greatly) reduce the desirable drug effects [14]. For mephedrone, the picture is somewhat less clear. There appears to be only one known case of someone on an SSRI developing serotonin syndrome after taking a very large amount of mephedrone (roughly 40 doses over the course of 4 hours) [13]. For safety's sake, it is best to avoid combining mephedrone with antidepressants.

Mephedrone should never be combined with other central nervous stimulants, as this appears to amplify their harmful effects on the brain [4]. Combining mephedrone with central nervous depressants, meanwhile, may delay the effects of a depressant overdose until the effects of mephedrone have worn off. If one nevertheless chooses to combine mephedrone with central nervous depressants, one must keep a close eye on both the dosage (in order to avoid taking too much) and the duration of the depressant in question (so as to not remain sedated long after the relatively short-lived effects of mephedrone have worn off).

It is generally not advisable to combine mephedrone with cannabis or psychedelics. Although the effects of mephedrone are similar to MDMA, the short-lived effects and often brutal comedown after mephedrone means there is a higher risk of the comedown triggering acute anxiety or psychosis, compared to equivalent combinations with MDMA instead of mephedrone. Dissociatives such as ketamine appear to be less of a problem in combination with mephedrone, as indicated by the fact that some people take ketamine near the end of a mephedrone session specifically to reduce the severity of the comedown.



Kombinasjon av mefedron med cannabis eller psykedelika frarådes som hovedregel. Den korte virketiden og kraftige "nedturen" til mefedron gjør dette mer risikabelt enn tilsvarende kombinasjoner ved MDMA-bruk, grunnet faren for en angst- eller psykosereaksjon. Dissosiativer som ketamin er trolig mindre problematiske å kombinere med mefedron, da disse i enkelte miljø brukes nettopp for å gjøre "nedturen" fra sentralstimulerende mer håndterlig.
4. Color changes with test kits
Before taking any drug, it is very important to make sure that the substance you have in front of you really is what you think it is, or what it is claimed to be. By far the safest and best way to do this is through a professional chemical analysis service (such as Energy Control in Spain), but if this is not possible, it is highly recommended to at least use a reagent test kit (such as those offered by DanceSafe in the UK). These are easy-to-use reagents that produce a characteristic color change when they come into contact with a particular drug, allowing users to identify the drug from a table of known color changes. Remember to store the reagents in the fridge and check the expiration date before using them, as expired tests can give misleading color changes.

Start with the Marquis and/or Mecke reagents. These should both give a colorless reaction with mephedrone.

Then move onto the Liebermann reagent. This should give a yellow reaction with mephedrone.

Then move onto the Froehde and/or Zimmermann reagents. These should both give a colorless reaction with mephedrone.

CAUTION: A number of other cathinone analogues are often sold as mephedrone. It is therefore especially important to test your substance before taking it, ideally by sending in a sample for professional analysis.
5. Dosage and route of administration
DOSAGE

For someone with no tolerance to mephedrone, a typical recreational dose will be in the range of 100–200 milligrams if ingested (swallowed), or 25–75 milligrams if insufflated (snorted) at more frequent intervals [2, 3]. People who have never used mephedrone before and are trying it for the first time should start with a lower dose, for instance by ingesting only 70 milligrams and then monitoring the effects for a few hours, before considering taking more.

FORM

Mephedrone usually comes in the form of crystals or powder, although ecstasy-like pills have also been known to occur on the market [2, 3].

ROUTE OF ADMINISTRATION

Mephedrone is most commonly taken by mouth (swallowing/ingesting) or nose (snorting/insufflating), often in combination with one another. It is also possible to take mephedrone rectally, in which case the effects and duration are similar to insufflating; this is normally done by dissolving the drug in lukewarm water before using a plastic syringe (without a needle) to inject it up inside the rectum. Mephedrone can also be absorbed directly through the mucus lining of the mouth, for instance by placing it under the tongue or between the gums and cheek and allowing it to absorb for some time. However, it should be noted that mephedrone is an irritant to mucus membranes (whether in the nose, rectum, or mouth), and that taking the drug in any of these ways tends to shorten the duration of both the come-up and the drug effects themselves, both of which are generally associated with an increased risk of addiction. A small number of users also inject mephedrone, which yields both the quickest effects come-up and the highest risk of addiction [2].
6. Mechanism and subjective effects
MECHANISM OF ACTION

Mephedrone inhibits the brain's reuptake of the neurotransmitters noradrenaline, dopamine, and serotonin, while at the same time causing all three to be released into the brain in large amounts [5]. Animal studies have shown that mephedrone releases more serotonin and dopamine than does MDMA. It also releases more dopamine in the nucleus accumbens, which is associated with a higher risk of addiction [9]. It is believed that the tendency to crave re-dosing once the drug wears off is due to serotonin levels falling despite dopamine levels remaining high for a while longer [3].

DURATION

When ingested, the effects of mephedrone are normally felt after 15–45 minutes and then last for a total of 2–4 hours. The main effects last for 60–90 minutes, and the drug is normally not very noticeable after about three hours. When insufflated, the effects are felt much more quickly and last roughly half as long [3, 5].

SUBJECTIVE EFFECTS

Mefedron beskrives av mange som en mellomting mellom MDMA og kokain i rusvirkning [3]. Brukeren kan bli våken, pratsom, åpen og empatisk på en måte som kan minne om MDMA, men også oppleve økt selvtillit eller sexlyst på en måte som minner mer om kokain eller amfetamin. Den korte varigheten og sterke trangen til redosering kan også føre til at "jaget" etter mer rus blir fremtredende i brukerens bevissthet på en måte som er mer typisk for kokain enn amfetamin.

SIDE-EFFECTS

Mephedrone shares many of MDMA's side-effects, including bruxism (tight, clenched jaw and involuntary teeth grinding), rapid pulse, high blood pressure, sweating, dilated pupils, blurred vision, and nystagmus (involuntary eye movements) [5]. Male users may also experience erectile dysfunction and difficulty in achieving orgasm after taking a high dose of mephedrone, albeit possibly to a lesser degree than after taking cocaine [11].

As the drug wears off, users may experience a low mood and a headache. It is also not uncommon to experience a low mood, irritability, and lethargy (low energy) over the course of a few days after taking mephedrone, especially after taking higher or several doses. Frequent users may also experience problems with memory recall for longer periods after ceasing mephedrone use [3].




7. Legal status
Mephedrone is considered an illicit drug (legemiddelloven § 22) in Norway. This means it is illegal to use, possess, manufacture, import, export, procure, store, send, or give away without a special license for medical or scientific use (legemiddelloven § 31, § 24; straffeloven § 231).

The State Attorney has not set a fixed limit on what amount of mephedrone should warrant a prison sentence rather than a fine; however, legal practice dictates that mephedrone should be treated the same as amphetamine in such cases. This means that fines will normally be given for procurement or storage of up to 2 grams, or for import of up to 1 gram, as long as the drug is assumed to be for personal use. (However, in response to COVID-19, the State Attorney has temporarily decreed that fines can be administered in all drug cases where the punishment would normally not exceed a probation sentence.)
8. Sources
1. Mephedrone related fatalities: a review
https://pubmed.ncbi.nlm.nih.gov/26502870/

2. Mephedrone (4-methylmethcathinone; 'meow meow'): chemical, pharmacological and clinical issues
https://pubmed.ncbi.nlm.nih.gov/21072502/

3. Mephedrone and MDMA: A comparative review
https://pubmed.ncbi.nlm.nih.gov/32087112/

4. Mephedrone Does not Damage Dopamine Nerve Endings of the Striatum but Enhances the Neurotoxicity of Methamphetamine, Amphetamine and MDMA
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC36040...

5. Human Pharmacology of Mephedrone in Comparison with MDMA
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC50267...

6. Mephedrone and Alcohol Interactions in Humans
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC69996...

7. Pharmacological characterization of designer cathinones in vitro
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC35725...

8. Neurotoxicity Induced by Mephedrone: An up-to-date Review
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC57710...

9. Mephedrone, compared with MDMA (ecstasy) and amphetamine, rapidly increases both dopamine and 5-HT levels in nucleus accumbens of awake rats
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC32466...

10. The impact of cigarette smoking on stimulant addiction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC26331...

11. "Bump and grind": an exploratory study of Mephedrone users' perceptions of sexuality and sexual risk
https://www.researchgate.net/publication/238045134_Bump_and_grind_an_exploratory_study_of_Mephedrone_users'_perceptions_of_sexuality_and_sexual_risk

12. Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change
https://academic.oup.com/qjmed/article/103/11/875/...

13. The serotonin syndrome as a result of mephedrone toxicity
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC30295...

14. Acute Psychological Effects of 3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy") are Attenuated by the Serotonin Uptake Inhibitor Citalopram
https://www.nature.com/articles/1395472

15. Mephedrone, or 'meow meow', as popular as cocaine, drugs survey says
https://www.theguardian.com/society/2011/jul/28/me...

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