Docs admit we know little about mephedrone

Doctors say that people with a history of mental health or heart problems are likely to be at greatest risk of serious harm from the currently legal high mephedrone - but they admit that nobody really has a clue about what the drugs does.

The recent deaths of two young men who are thought to have taken mephedrone (also known as Miaow, 4-MMC, Meph, MMCAT and TopCat) have prompted urgent calls for the drug to be banned. But, write Adam Winstock, Senior Lecturer in Addiction Psychiatry at Institute of Psychiatry, King's College London, and colleagues in the BMJ, unlike other stimulant drugs such as cocaine and ecstasy, its effects on the body are still largely unknown. 'We know nothing of its potential toxicity or the long term consequences of (mephedrone's) use and guidance is urgently needed,' they say.

Like other stimulants, the effects of mephedrone include euphoria, increased energy, feelings of empathy, increased libido, sweating, rapid heart beat (tachycardia), headache, and teeth grinding. Typical comedown symptoms include lethargy and low mood .

Mephedrone is highly likely to be used along with other stimulant drugs or alcohol that moderate or enhance its effects, and this may contribute to an increased risk of adverse effects, warn the authors. A drug induced increase in libido may also lead to risky sexual behaviour.

Credible educational and harm reduction advice about this drug are urgently needed, they say.

Commonsense advice

In the meantime, commonsense advice should include avoiding regular use to avoid developing tolerance; not using the drug in combination with other stimulants or large amounts of alcohol and other depressants; not injecting the drug; remaining well hydrated when using the drug; and avoiding becoming overheated.

It is likely that the UK government will move to control the manufacture, distribution, and possession of this drug. But the authors question whether controlling mephedrone under the current provisions of the Misuse of Drugs Act is the best public health response.

Recent history suggests that manufacturers will merely turn their attention to the nearest effective but unsanctioned alternative substance, the doctors say. 'Unfortunately, the list of potential synthetic psychoactive compounds is dauntingly long.'