Mephedrone, also known as 4-methylmethcathinone, 4-MMC, and 4-methylephedrone, is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, M-CAT, White Magic, and meow meow. It is chemically similar to the cathinone compounds found in the khat plant of eastern Africa. It comes in the form of tablets or a powder, which users can swallow, snort or inject, producing effects similar to those of MDMA, amphetamines and cocaine.
In addition to its stimulant effects, mephedrone produces side effects, of which bruxism is the most common. The metabolism of mephedrone has been studied in rats and humans and the metabolites can be detected in urine after usage.
Users have reported that mephedrone causes euphoria, stimulation, an enhanced appreciation for music, an elevated mood, decreased hostility, improved mental function and mild sexual stimulation; these effects are similar to the effects of cocaine, amphetamines and MDMA, and last different amounts of time depending on the way the drug is taken. Of 70 Dutch users of mephedrone, 58 described it as an overall pleasant experience and 12 described it as an unpleasant experience. In a survey of UK users who had previously taken cocaine, most users found it produced a better-quality and longer-lasting high and was less addictive. The users were also asked to compare the “risk”, and they answered that it was equal. A study of users in Northern Ireland found they did not equate the fact that mephedrone was legal with it being safe to use. This was contrary to another study in New Zealand, where users of benzylpiperazine thought that because it was legal, it was safe.
Mephedrone can come in the form of capsules, tablets or white powder that users may swallow, snort, inject, smoke or use rectally.:12 When taken orally, users reported they could feel the effects within 15–45 minutes; when snorted, the effects were felt within minutes and peaked within half an hour. The effects last for between two and three hours when taken orally or nasally, but only half an hour if taken intravenously.:12 It is sometimes sold mixed with methylone in a product called bubbles in the UK and also mixed with other cathinones, including ethcathinone, butylone, fluoromethcathinone and methedrone.:9
One published study that analysed samples of mephedrone bought using the internet in the UK in 2010 found it was racemic (a mixture of both stereoisomers) and of high purity. An unpublished study of six samples also ordered off the internet in the UK in 2010 found they contained very few organic impurities. Four products sold in Irish head shops were tested in 2010 and were found to contain between 82% and 14% mephedrone, with some products containing benzocaine and caffeine.
The EMCDDA reported mephedrone can cause various unintended side effects including: dilated pupils, poor concentration, teeth grinding, problems focusing visually, poor short-term memory, hallucinations, delusions, and erratic behaviour.:13 They noted the most severe effects appear anecdotally to be linked with high doses or prolonged use, and the effects may be due to users taking other intoxicants at the same time. Other effects users in internet forums have noted include changes in body temperature, increased heart rate, breathing difficulties, loss of appetite, increased sweating, discolouration of extremities, anxiety, paranoia and depression.:13 When snorted, it can also cause nose bleeds and nose burns.:13 A survey conducted by the UK National Addiction Centre found 67% of mephedrone users experienced sweating, 51% suffered from headaches, 43% from heart palpitations, 27% from nausea and 15% from cold or blue fingers, indicative of vasoconstriction occurring. Doctors at Guy’s Hospital in London reported that of 15 patients they treated after taking mephedrone in 2009, 53% were agitated, 40% had increased heart rates, 20% had systolic hypertension and 20% had seizures; three required treatment with benzodiazepines, predominantly to control their agitation. They reported none of their patients suffered from cold or blue peripheries, contrary to other reports. Nine of the 15 of patients had a Glasgow coma scale (GCS) of 15, indicating they were in a normal mental state, four had a GCS below 8, but these patients all reported using a central nervous system depressant, most commonly GHB, with mephedrone. The patients also reported polydrug use of a variety of compounds.
Neurotoxic effect of mephedrone on serotonin (5-HT) and dopamine (DA) systems remains controversial. Although some studies in animal models reported no damage to DA nerve endings in the striatum and no significant changes in brain monoamine levels, some others suggested a rapid reduction in 5-HT and DA transporter function. Persistent serotonergic deficits were observed after binge like treatment in a warm environment and in both serotonergic and dopaminergic nerve endings at high ambient temperature. Oxidative stress cytotoxicity and an increase in frontal cortex lipid peroxidation were also reported