|Systematic (IUPAC) name|
|Legal status||See legal status section|
|Routes||Oral, insufflation, IV, rectal, smoking|
|Mol. mass||177.242 g/mol|
|(what is this?)|
Mephedrone, also known as 4-methylmethcathinone (4-MMC) or 4-methylephedrone, is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, M-CAT, 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 similar effects to MDMA, amphetamines and cocaine.
In addition to its stimulant effects, mephedrone produces side effects, of which teeth grinding 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. Despite similarities to known neurotoxins such as methamphetamine and cathinone derivatives, mephedrone does not appear to produce neurotoxic effects in the dopamine system of mice.
Mephedrone was first synthesised in 1929, but did not become widely known until it was rediscovered in 2003. By 2007, mephedrone was reported to be available for sale on the internet, by 2008 law enforcement agencies had become aware of the compound, and by 2010, it had been reported in most of Europe, becoming particularly prevalent in the United Kingdom. Mephedrone was first made illegal in Israel in 2008, followed by Sweden later that year. In 2010, it was made illegal in many European countries and in December 2010, the EU ruled it illegal. In Australia, New Zealand and the USA, it is considered an analog of other illegal drugs and can be controlled by laws similar to the Federal Analog Act. In September 2011, the USA temporarily classified mephedrone as illegal, in effect from October 2011.
- 1 History
- 2 Effects
- 3 Typical use and consumption
- 4 Pharmacology
- 5 Chemistry
- 6 Legal status
- 7 See also
- 8 References
- 9 External links
Mephedrone is one of hundreds of designer drugs or legal highs that have been reported in recent years, including artificial chemicals such as synthetic cannabis and semisynthetic substances such as methylhexanamine. These drugs are primarily developed to avoid being controlled by laws against illegal drugs, thus giving them the label of designer drugs. According to the European Monitoring Centre for Drugs and Drug Addiction, the synthesis of mephedrone was first reported in 1929 by Saem de Burnaga Sanchez in the Bulletin de la Société Chimique de France, under the name "toluyl-alpha-monomethylaminoethylcetone",:17 but the compound remained an obscure product of academia until 2003, when it was "re-discovered" and publicised by an underground chemist on The Hive website, working under the pseudonym "Kinetic". Kinetic posted on the site, "I’ve been bored over the last couple of days and had a few fun reagents lying around, so I thought I’d try and make some 1-(4-methylphenyl)-2-methylaminopropanone hydrochloride, or 4-methylmethcathinone." before going on to describe that after taking it, the user had a "fantastic sense of well-being that I haven’t got from any drug before except my beloved Ecstasy." In interviews Kinetic was described as "a mathematician who used to design sleeping pills for a major pharmaceutical company" and he stated that he was based in Israel when he rediscovered mephedrone.
A drug similar to mephedrone, containing cathinone, was sold legally in Israel from around 2004, under the name hagigat. When this was made illegal, the cathinone was modified and the new products were sold by the Israeli company, Neorganics. The products had names such as Neodoves pills, but the range was discontinued in January 2008 after the Israeli government made mephedrone illegal. The Psychonaut Research Project, an EU organisation that searches the internet for information regarding new drugs, first identified mephedrone in 2008. Their research suggested the drug first became available to purchase on the internet in 2007, when it was also discussed on internet forums. Mephedrone was first seized in France in May 2007, after police sent a tablet they assumed to be ecstasy to be analysed, with the discovery published in a paper titled "Is 4-methylephedrone, an "Ecstasy" of the twenty first century?" Mephedrone was reported as having been sold as ecstasy in the Australian city of Cairns, along with ethylcathinone, in 2008. An annual survey of regular ecstasy users in Australia in 2010 found 21% of those surveyed had used mephedrone, with 17% having done so in the previous six months. The price they paid per gram varied from A$16 to $320.
Europol noted they became aware of it in 2008, after it was found in Denmark, Finland and the UK. The Drug Enforcement Administration noted it was present in the United States in July 2009. By May 2010, mephedrone had been detected in all 22 EU member states that reported to Europol, as well as in Croatia and Norway.:21 The Daily Telegraph reported in April 2009 that it was manufactured in China, but it has since been made illegal there. In March 2009, Druglink magazine reported it only cost a "couple of hundred pounds" to synthesise a kilogram of mephedrone, the same month, The Daily Telegraph reported manufacturers were making "huge amounts of money" from selling it. In January 2010, Druglink magazine reported dealers in Britain spent £2,500 to ship one kilogram from China, but could sell it for £10 a gram, making a profit of £7,500. A later report, in March 2010, stated the wholesale price of mephedrone was £4000 per kilogram.
In March 2011, the International Narcotics Control Board published a report about designer drugs, noting mephedrone was by then being used recreationally in Europe, North America, Southeast Asia, New Zealand and Australia.
In the UK
Between the summer of 2009 and March 2010, the use of mephedrone grew rapidly in the UK, with it becoming readily available at music festivals, head shops and on the internet. A survey of Mixmag readers in 2009, found it was the fourth most popular street drug in the United Kingdom, behind cannabis, cocaine, and ecstasy. The drug was used by a diverse range of social groups. Whilst the evidence was anecdotal, researchers, charity workers, teachers and users reported widespread and increasing use of the drug in 2009. The drug's rapid growth in popularity was believed to be related to both its availability and legality.
Fiona Measham, a criminologist at The University of Lancaster, thought the emergence of mephedrone was also related to the decreasing purity of ecstasy and cocaine on sale in the UK, a view reinforced in a report by the National Treatment Agency for Substance Misuse. The average cocaine purity fell from 60% in 1999 to 22% in 2009 and about half of ecstasy pills seized in 2009 contained no MDMA, and by June 2010 almost all ecstasy pills seized in the UK contained no MDMA. A similar pattern was observed in the Netherlands, with the number of ecstasy tablets containing no MDMA rising from 10% in mid-2008 to 60% by mid-2009, with mephedrone being detected in 20% of ecstasy tablets by mid-2009. The decrease of MDMA was thought to be partly due to the seizure of 33 tonnes of sassafras oil, the precursor to MDMA, in Cambodia in June 2008, which could have been used to make 245 million doses of MDMA. According to John Ramsey, a toxicologist at St George's, University of London, the emergence of mephedrone was also related to the UK government banning the benzylpiperazine class of drugs in December 2009. gamma-Butyrolactone (GBL), another previously "legal high", was also banned in August 2009 despite concerns it would be replaced by other drugs.
By December 2009 mephedrone was available on at least 31 websites based in the UK and by March 2010 there were at least 78 online shops, half of which sold amounts of less than 200 grams and half that also sold bulk quantities. The price per gram varied from £9.50 to £14.:11 Between July 2009 and February 2010, UK health professionals accessed the National Poisons Information Service's (NPIS) entry on mephedrone 1664 times and made 157 telephone inquiries; the requests increased month on month over this period. In comparison over a similar time period, the entries for cocaine and MDMA were accessed approximately 2400 times. After mephedrone was made illegal the number of inquiries to the NPIS fell substantially, to only 19 in June 2010.
Media organisations including the BBC and The Guardian incorrectly reported mephedrone was commonly used as a plant fertiliser. In fact sellers of the drug described it as "plant food" because it was illegal to sell the compound for human consumption. In late 2009 UK newspapers began referring to the drug as meow or miaow (sometimes doubled as meow meow or miaow miaow), a name that was almost unknown on the street at the time. In November 2009, the tabloid newspaper, The Sun published a story stating that a man had ripped off his own scrotum whilst using mephedrone. The story was later shown to be an online joke posted on mephedrone.com, later included in a police report with the caveat that it could be unreliable. The police report was used as a source for the story in The Sun. Other myths the media often repeated during 2010 were that mephedrone had led to the deaths of over 20 people, teachers were unable to confiscate the drug from pupils and the government was too slow to ban the drug. Parallels were drawn between the media coverage of mephedrone and a piece of satire by Chris Morris in 1997 on Brass Eye when he tricked public figures into talking of the dangers of taking the fictional legal drug "cake". The Advisory Council on the Misuse of Drugs (ACMD) have suggested that the media coverage of the drug led to its increased usage. Jon Silverman, a former BBC Home Affairs Correspondent, has written two articles discussing how the media had a strong influence over the UK government's drugs policy, particularly in that the government wished to demonstrate they were being "tough" on drugs.
A survey of 1000 secondary school pupils and university students in Tayside conducted in February 2010 found 20% of them had previously taken mephedrone. Although at the time it was available legally over the internet, only 10% of users reported purchasing it online, with most purchasing it from street dealers. Of those who had used mephedrone, 97% said it was easy or very easy to obtain. Around 50% of users reported at least one negative effect associated with the use of mephedrone, of which teeth grinding is the most common. Detailed interviews with users in Northern Ireland similarly found that few purchased mephedrone online, with most interviewees citing concerns that their address would be traced or that family members could intercept the package.
On 30 March 2010, Alan Johnson, the then Home Secretary, announced mephedrone would be made illegal "within weeks" after the ACMD sent him a report on the use of cathinones. The legislation would make all cathinones illegal, which Johnson said would "stop unscrupulous manufacturers and others peddling different but similarly harmful drugs". The ACMD had run into problems with the UK Government in 2009 regarding drugs policy, after the government did not follow the advice of the ACMD to reclassify ecstasy and cannabis, culminating in the dismissal of the ACMD chairman, David Nutt, after he reiterated the ACMD's findings in an academic lecture. Several members resigned after he was sacked, and prior to the announcement that mephedrone was to be banned, the trend continued when Dr Polly Taylor resigned, saying she "did not have trust" in the way the government would use the advice given by the ACMD. Eric Carlin, a member of the ACMD and former chairman of the English Drug Education Forum, also resigned after the announcement. He said the decision by the Home Secretary was "unduly based on media and political pressure" and there was "little or no discussion about how our recommendation to classify this drug would be likely to impact on young people's behaviour." Some former members of the ACMD and various charity groups expressed concern over the banning of the drug, arguing it would inevitably criminalise users, particularly young people. Others expressed concern that the drug would be left in the hands of black market dealers, who will only compound the problem. Carlin's resignation was specifically linked to the criminalisation of mephedrone, he stated: "We need to review our entire approach to drugs, dumping the idea that legally-sanctioned punishments for drug users should constitute a main part of the armoury in helping to solve our country’s drug problems. We need to stop harming people who need help and support".
The parliamentary debate was held on 8 April, one day after the 2010 general election had been announced, meaning it was during the so-called "wash-up period" when legislation is passed with little scrutiny. Only one hour was spent debating the ban and all three parties agreed, meaning no vote was required. In an interview conducted in July 2010, when he was no longer a minister, Johnson admitted the decision to ban mephedrone was sped up after widespread reporting of deaths caused by the drug, and because the government wished to pass the law before parliament was dissolved prior to the upcoming general election. In January 2011, however, Johnson told the Scunthorpe Telegraph that the decision was based only on information from the ACMD. An editorial in the April 2010 edition of The Lancet questioned the decision to ban mephedrone, saying the ACMD did not have enough evidence to judge the potential harms caused by mephedrone and arguing that policy makers should have sought to understand why young people took it and how they could be influenced to not take it. Evan Harris, then the Liberal Democrat science spokesman, stated the ACMD "was not 'legally constituted'" as required by the Misuse of Drugs Act, when the report on cathinones was published, since after Taylor resigned, it lacked a veterinary surgeon. In the rush to make mephedrone illegal, the act that was passed specified the inactive enantiomer of mephedrone, leaving the active form legal until the loophole was closed in February 2011 by another act of parliament. In Chemistry World, John Mann, professor of chemistry at Queen's University Belfast, suggested the UK create a law similar to the Federal Analog Act of the United States, which would have made mephedrone illegal as an analog of cathinone. In August 2010, James Brokenshire, the Home Office drugs minister, announced plans to create a new category in the Misuse of Drugs Act, through the Police Reform and Social Responsibility Bill, that would allow new legal highs to be made temporarily illegal, without the need for a vote in parliament or advice from the ACMD, as was required to categorise mephedrone.
According to the Independent Scientific Committee on Drugs, after mephedrone was made illegal, a street trade in the drug emerged, with prices around double those prior to the ban, at £20–£25 per gram. In September 2010, Druglink reported the ban had had a mixed effect on mephedrone use, with it decreasing in some areas, remaining similar in others and becoming more prevalent in some areas. In an online survey of 150 users after the ban, 63% said they were continuing to use mephedrone, half of those used the same amount and half said they used less. Compared to previous surveys, more users purchased it from dealers, rather than the internet. The average price per gram was £16, compared to around £10 before the ban. The 2010 Mixmag survey of 2500 nightclubbers found one-quarter had used mephedrone in the previous month, the price had roughly doubled since it was made illegal, and it was more likely to be cut with other substances. Of those who had already used mephedrone prior to the ban, 75% had continued to use it after the ban. Of the various drugs used by the survey participants, users were more likely to have concerns about it. Interviews with users in Northern Ireland also found the price had roughly doubled since it was made illegal, to around £30 a gram. Rather than the price rising due to increased scarcity of the drug, it is thought to have risen for two other reasons. Firstly, dealers knew there was still demand for mephedrone, but were aware the supplies may be exhausted in the future. Secondly, the dealers perceived customers were likely to be willing to pay more for an illegal substance.
Professor Shiela Bird, a statistician at the Medical Research Council, suggested the ban of mephedrone may lead to more cocaine-related deaths. In the first six months of 2009, the number of cocaine-related deaths fell for the first time in four years, and fewer soldiers tested positive for cocaine in 2009 than in 2008. She suggested this may have been due to users switching to mephedrone from cocaine, but cautioned that before full figures are available for 2009 and 2010, it will be difficult to determine whether mephedrone saved lives, rather than cost them. Other supposedly legal drugs have filled the gap in the market since mephedrone was made illegal, including naphyrone (NRG-1) (since made illegal) and Ivory Wave, which has been found to contain MDPV, a compound made illegal at the same time as mephedrone. However, some products branded as Ivory Wave possibly do not contain MDPV. When tested, some products sold six weeks after mephedrone was banned, advertised as NRG-1, NRG-2 and MDAI, were found to be mephedrone. A Drugscope survey of drugs workers at the end of 2012 reported that mephedrone use was still widespread in the UK and that there increasing reports of problematic users. It was being taken as not only a "poor man's cocaine" but also amongst users of heroin and crack cocaine. Cases of intravenous use were also reported to be on the increase.
No formal published studies have been conducted into the psychological and/or behavioural effects of mephedrone on humans, nor on animals (from which the potential effects might be extrapolated). As a result, the only information available comes from users themselves and clinical reports of acute mephedrone toxicity.:12 Psychologists at Liverpool John Moores University were to conduct research into the effects of mephedrone on up to 50 students already using the drug, when it was still legal in the UK. At the time the study was proposed, Les Iversen, the chair of the Advisory Council on the Misuse of Drugs called the experiments "pretty unethical". The study was discontinued in August 2010, following the change in the legal status of the drug.
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. 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 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, was less addictive and carried the same risk as using cocaine.
The ECMDDA 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 usage, 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 National Addiction Centre, UK, 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, London reported, 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.
Almost nothing is known about the long-term effects of the drug due to the short history of its use. BBC News reported one person who used the drug for 18 months became dependent on the drug, in the end using it twice a week, and had to be admitted to a psychiatric unit after he started experiencing hallucinations, agitation, excitability and mania.:13
Typical use and consumption
Mephedrone can come in the form of capsules, tablets or white powder that users may swallow, snort, inject, smoke or use rectally.: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 The Guardian reported some users compulsively redose, consuming their whole supply when they only meant to use a small dose, and there have been other similar reports of users craving mephedrone, suggesting it may be addictive.:13 A survey conducted in late 2009 by the National Addiction Centre (UK) found 41.3% of readers of Mixmag had used mephedrone in the last month, making it the fourth most popular drug amongst clubbers. Of those, two-thirds snorted the drug and the average dosage per session was 0.9 g; the length of sessions increased as the dosage increased. Users who snorted the drug reported using more per session than those who took it orally (0.97 g compared to 0.74 g) and also reported using it more often (five days per month compared to three days per month). An Irish study of people on a methadone treatment program for heroin addicts found 29 of 209 patients tested positive for mephedrone usage. 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.
The drugs advice charity Lifeline recommends that to reduce the potential harm caused by using mephedrone, users should only use mephedrone occasionally (less than weekly), use less than 0.5 g per session, dose orally rather than snorting the drug, and avoid mixing it with alcohol and other drugs. Users should also drink plenty of water at sensible intervals while taking the drug, as it causes dehydration.
The pharmacology and toxicology of mephedrone had not been studied in detail until well after its sale as a designer drug and its addition to controlled drug lists in many countries. Writing in the British Medical Journal, psychiatrists stated, given its chemical structure, "mephedrone is likely to stimulate the release of, and then inhibit the reuptake of monoamine neurotransmitters". The cathinone derivatives methcathinone and methylone act in a similar way to amphetamines, mainly acting on catecholamine transporters, so mephedrone is expected also to act in this way. The actions of amphetamines and cathinones are determined by the differences in how they bind to noradrenalin, dopamine and serotonin transporters. Molecular modelling of mephedrone suggests it is more hydrophilic than methyl-amphetamines, which may account for the higher doses required to achieve a similar effect, because mephedrone is less able to cross the blood–brain barrier.:12 Mephedrone has a chiral centre, so exists in two forms, called enantiomers; the S form is thought to be more potent than the R form, because this applies to cathinone. Professor David Nutt, former chair of the Advisory Council on the Misuse of Drugs (ACMD) in the UK has said, "people are better off taking ecstasy or amphetamines than those [drugs] we know nothing about" and "Who knows what's in [mephedrone] when you buy it? We don't have a testing system. It could be very dangerous, we just don't know. These chemicals have never been put into animals, let alone humans." Les King, a former member of the ACMD, has stated mephedrone appears to be less potent than amphetamine and ecstasy, but that any benefit associated with this could be negated by users taking larger amounts. He also told the BBC, "all we can say is [mephedrone] is probably as harmful as ecstasy and amphetamines and wait until we have some better scientific evidence to support that."
Several articles published near the end of 2011 examined the effects of mephedrone, compared to the similar drugs MDMA and amphetamine in the nucleus accumbens of rats, as well as examining the reinforcing potential of mephedrone. Dopamine and serotonin were collected using microdialysis, and increases in dopamine and serotonin were measured using HPLC. Reward and drug seeking are linked to increases in dopamine concentrations in the nucleus accumbens, and drug half-life plays a role in drug seeking, as well. Based on histological examination, most of the author's probes were in the nucleus accumbens shell. Mephedrone administration caused about a 500% increase in dopamine, and about a 950% increase in serotonin. They reached their peak concentrations at 40 minutes and 20 minutes, respectively, and returned to baseline by 120 minutes after injection. In comparison, MDMA caused a roughly 900% increase in serotonin at 40 minutes, with an insignificant increase in dopamine. Amphetamine administration resulted in about a 400% increase in dopamine, peaking at 40 minutes, with an insignificant increase in serotonin. Analysis of the ratio of the AUC for dopamine (DA) and serotonin (5-HT) indicated mephedrone was preferentially a serotonin releaser, with a ratio of 1.22:1 (serotonin vs. dopamine). Additionally, half-lives for the decrease in DA and 5-HT were calculated for each drug. Mephedrone had decay rates of 24.5 minutes and 25.5 minutes, respectively. MDMA had decay values of 302.5 minutes and 47.9 minutes, respectively, while amphetamine values were 51 minutes and 84.1 minutes, respectively. Taken together, these findings show mephedrone induces a massive increase in both DA and 5-HT, combined with rapid clearance. The rapid rise and subsequent fall of DA levels could explain some of the addictive properties mephedrone displays in some users.
Based on the analysis of rat and human urine by gas chromatography and mass spectrometry, mephedrone is thought to be metabolised by three phase 1 pathways. It can be demethylated to the primary amine (producing compounds 2, 3 and 5), the ketone group can be reduced (producing 3) or the tolyl group can be oxidised (producing 6). Both 5 and 6 are thought to be further metabolised by conjugation to the glucuronide and sulfate derivatives. Knowledge of the primary routes of metabolism should allow the intake of mephedrone to be confirmed by drug tests, as well as more accurate determination of the causes of side effects and potential for toxicity.
As of March 2010, no studies on the potential neurotoxicity of mephedrone have been reported, nor is the median lethal dose known. In 2009, one case of sympathomimetic toxicity was reported in the UK after a person took 0.2 g of mephedrone orally, and after this did not achieve the desired effect, subcutaneously injected 3.8 g mixed with water into his thighs. Shortly afterwards, the user "developed palpitations, blurred tunnel vision, chest pressure and sweating". The patient was treated with 1 mg of lorazepam and the sympathomimetic features decreased and the user was discharged within six hours of arrival. One case of serotonin syndrome has been reported, where the patient was already prescribed fluoxetine and olanzapine, and then took 40 tablets containing mephedrone in one night. He was treated with lorazepam and discharged 15 hours after admission. Both enantiomers of methcathinone, which differs only in the lack of the methyl group on the aryl ring when compared to mephedrone, have been shown to be toxic to rat dopamine neurons, and the S-enantiomer was also toxic against serotonin neurons. Simon Gibbons and Mire Zloh of the School of Pharmacy, University of London stated, based on the chemical similarities between methcathinone and mephedrone, "it is highly likely that mephedrone will display neurotoxicity". However, Brunt and colleagues stated, "extreme caution" should be used when inferring the toxicity of mephedrone from methcathinone, noting some of the toxicity associated with methcathinone is due to manganese impurities related to its synthesis, rather than the compound itself. They concluded more experimental research is needed to investigate the toxicity of mephedrone. Doctors who treated a 15-year-old female suffering from mephedrone intoxication suggested in The Lancet that, like MDMA, mephedrone may promote serotonin-mediated release of antidiuretic hormone, resulting in hyponatraemia and an altered mental state. In another case, a 19-year-old male was admitted to hospital suffering from inflammation of the heart, 20 hours after taking one gram of mephedrone. The doctors treating the patient stated it was caused by either a direct toxic effect of mephedrone on the heart muscle, or by an immune response. One case of acquired methaemoglobinaemia, where a patient had "bluish lips and fingers", has also been reported, after the user snorted one gram of mephedrone. The patient started to recover after arriving at the hospital and it was not necessary to administer any medication.
Detection in biological specimens
Mephedrone may be quantitated in blood, plasma or urine by gas chromatography-mass spectrometry to confirm a diagnosis of poisoning in hospitalized patients or to provide evidence in a medicolegal death investigation. Blood or plasma mephedrone concentrations are expected to be in a range of 50–100 μg/l in persons using the drug recreationally, >100 μg/l in intoxicated patients and >500 μg/l in victims of acute overdosage.
In 2008, an 18-year-old Swedish woman died in Stockholm after taking mephedrone. The newspaper Svenska Dagbladet reported the woman went into convulsions and turned blue in the face. Doctors reported she was comatose and suffering from hyponatremia and severe hypokalemia; the woman died one and a half days after the onset of symptoms. An autopsy showed severe brain swelling. Mephedrone was scheduled to be classified as a "dangerous substance" in Sweden even before the woman's death at Karolinska University Hospital on 14 December, but the death brought more media attention to the drug. The possession of mephedrone became classified as a criminal offence in Sweden on 15 December 2008.
In 2010, unconfirmed reports speculated about the role mephedrone has played in the deaths of several young people in the UK. By July 2010, mephedrone had been alleged to be involved in 52 fatalities in the UK, but detected in only 38 of these cases. Of the nine that coroners had finished investigating, two were caused directly by mephedrone. The first death reported to be caused by mephedrone use was that of 46-year-old, John Sterling Smith, who had underlying health problems and repeatedly injected the drug. A report in Forensic Science International in August 2010 stated mephedrone intoxication has been recorded as the cause of death in two cases in Scotland. Post mortem samples showed the concentration of mephedrone in their blood was 22 mg/l in one case and 3.3 mg/l in the other. The death of a teenager in the UK in November 2009 was widely reported as being caused by mephedrone, but a report by the coroner concluded she had died from natural causes. In March 2010, the deaths of two teenagers in Scunthorpe were widely reported by the media to be caused by mephedrone. Toxicology reports showed the teenagers had not taken any mephedrone and had died as a result of consuming alcohol and the heroin substitute methadone. According to Fiona Measham, a criminologist who is a member of the ACMD, the reporting of the unconfirmed deaths by newspapers followed "the usual cycle of ‘exaggeration, distortion, inaccuracy and sensationalism'" associated with the reporting of recreational drug use.
Mephedrone has been implicated in the death of a 22-year-old male, who had also injected black tar heroin. Mephedrone was found in his blood at a concentration of 0.50 mg/l and in his urine at a concentration of 198 mg/l. The blood concentration of morphine, a metabolite of heroin, was 0.06 mg/l. For comparison, the average blood morphine concentration resulting from deadly overdoses involving only heroin is around 0.34 mg/l.
Mephedrone is a white substance. It is sold most commonly as crystals or a powder, but also in the form of capsules or pills. It can have a distinctive odour, reported to range from a synthetic fishy smell to the smell of vanilla and bleach, stale urine, or electric circuit boards.
Mephedrone can be synthesised in several ways. The simplest method, due to the availability of the compounds,:17 is to add 4-methylpropiophenone dissolved in glacial acetic acid to bromine, creating an oil fraction of 4'-methyl-2-bromopropiophenone. The oil fraction can then be dissolved in dichloromethane (CH2Cl2) and drops of the solution added to another solution of CH2Cl2-containing methylamine hydrochloride and triethylamine. Hydrochloric acid (HCl) is then added and the aqueous layer is removed and turned alkaline using sodium hydroxide before the amine is extracted using CH2Cl2. The CH2Cl2 is then evaporated using a vacuum, creating an oil which is then dissolved in a nonaqueous ether. Finally, HCl gas is bubbled through the mixture to produce 4-methylmethcathinone hydrochloride. This method produces a mixture of both enantiomers and requires similar knowledge to that required to synthesise amphetamines and MDMA.:17
It can also be produced by oxidising the ephedrine analogue 4-methylephedrine using potassium permanganate dissolved in sulfuric acid. Because 4-methylephedrine can be obtained in a specific enantiomeric form, mephedrone consisting of only one enantiomer can be produced. The danger associated with this method is it may cause manganese poisoning if the product is not correctly purified.:17
A stereospecific form of (S)-mephedrone could be prepared via Friedel–Crafts acylation. The first step in the synthesis would be to react toluene and (S)-N-trifluoroacetylalanoyl chloride in the presence of aluminium chloride, then deprotect the intermediate with hydrochloric acid-propyl alcohol. This would produce (S)-4-methylcathinone, which could then be methylated to produce mephedrone.
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.
When mephedrone was rediscovered in 2003, it was not specifically illegal to possess in any country. As its use has increased, many countries have passed legislation making its possession, sale, and manufacture illegal. It was first made illegal in Israel, where it had been found in products such as Neodoves pills, in January 2008. After the death of a young woman in Sweden in December 2008 was linked to the use of mephedrone, it was classified as a hazardous substance a few days later, making it illegal to sell in Sweden. In June 2009, it was classified as a narcotic with the possession of 15 grams or more resulting in a minimum of two years in prison – a longer sentence, gram for gram than given for the possession of cocaine or heroin. In December 2008, Denmark also made it illegal and through the Medicines Act of Finland, it was made illegal to possess without a prescription. In November 2009, it was classified as a "narcotic or psychotropic" substance and added to the list of controlled substances in Estonia and made illegal to import into Guernsey along with other legal highs, before being classified as a Class B drug in April 2010. It was classified as a Class C drug in Jersey in December 2009.
In 2010, as its use became more prevalent, many countries passed legislation prohibiting mephedrone. It became illegal in Croatia and Germany in January, followed by Romania and the Isle of Man in February. In March 2010, it was classified as an unregulated medicine in the Netherlands, making the sale and distribution of it illegal. The importation of mephedrone into the UK was banned on 29 March 2010. The next day, the ACMD in the UK published a report on the cathinones, including mephedrone, and recommended they be classified as Class B drugs. On 7 April 2010, the Misuse of Drugs Act 1971 (Amendment) Order 2010 was passed by parliament, making mephedrone and other substituted cathinones, Class B drugs from 16 April 2010. Prior to the ban taking effect, mephedrone was not covered by the Misuse of Drugs Act 1971. It was, though, an offence under the Medicines Act to sell it for human consumption, so it was often sold as "plant food" or "bath salts", although it has no use as these products; this, too, was possibly illegal under the Trade Descriptions Act 1968. In the USA, similar descriptions have been used to describe mephedrone, as well as methylenedioxypyrovalerone (MDPV). In May 2010, the Republic of Ireland made mephedrone illegal, followed by Belgium, Italy, Lithuania, France and Norway in June and Russia in July. In August 2010, Austria and Poland made it illegal and China announced it would be illegal as of 1 September 2010. Mephedrone had been reported to be used in Singapore in February 2010, but it was made illegal in November 2010. In December 2010, following the advice of the EMCDDA, mephedrone was made illegal throughout the EU, a move Switzerland also made shortly afterwards. Countries which have not already banned it, such as the Netherlands, Greece and Portugal, will need to change legislation to comply with the EU ruling. In Hungary, a government advisory body recommended mephedrone should be made illegal in August 2010, which was followed, making it illegal in January 2011; Spain followed in February 2011.
In some countries, mephedrone is not specifically listed as illegal, but is controlled under legislation that makes compounds illegal if they are analogs of drugs already listed. In Australia during 2010, it was not specifically listed as prohibited, but the Australian Federal Police stated it is an analogue to methcathinone and therefore illegal. In February 2010, 22 men were arrested in connection with importing mephedrone. By January 2011, every state in Australia, other than Victoria, had listed it as a controlled drug. In New Zealand, it is not included in the Misuse of Drugs Act 1975, but is illegal, as it is similar to controlled substances. In Canada, mephedrone is not explicitly listed in any schedule of the Controlled Drugs and Substances Act, but "amphetamines, their salts, derivatives, isomers and analogues and salts of derivatives, isomers and analogues" are included in Section 19 of Schedule I of the act. Cathinone and methcathinone are listed in separate sections of Schedule III, while diethylpropion and pyrovalerone (also cathinones), are listed in separate sections of Schedule IV, each without language to capture analogues, isomers, etc. Mephedrone is considered a controlled substance by Health Canada. According to the Canadian Medical Association, mephedrone is grouped with other amphetamines as Schedule I controlled substances. There have been several media reports of the Canadian police seizing mephedrone. Mephedrone is also currently scheduled in the United States as of 2011. The Drug Enforcement Administration (DEA) states, as an analogue of methcathinone, possession of mephedrone can be controlled by the Federal Analog Act, but according to the Los Angeles Times, this only applies if it is sold for human consumption. Several cities and states, such as New York, have passed legislation to specifically list mephedrone as illegal, but in most areas it was legal, so long as it is not sold for human consumption, so retailers described it as 'bath salts'. In September 2011, The DEA began using its emergency scheduling authority to temporarily control mephedrone. Except as authorized by law, this action made possessing and selling mephedrone or the products that contain it illegal in the USA for at least one year while the DEA and the United States Department of Health and Human Services conduct further study. Control of these compounds became permanent on 9 July 2012, via passage of the Synthetic Drug Abuse Prevention Act of 2012.
- "Europol–EMCDDA Joint Report on a new psychoactive substance: 4-methylmethcathinone (mephedrone)". European Monitoring Centre for Drugs and Drug Addiction. 27 May 2010. Retrieved 2011-01-29.
- Winstock, A.; Mitcheson, L.; Deluca, P.; Davey, Z.; Corazza, O.; Schifano, F. (2010). "Mephedrone, new kid for the chop?". Addiction 106 (1): 154–61. doi:10.1111/j.1360-0443.2010.03130.x. PMID 20735367.(subscription required)
- Matthews, A.; Bruno, R. (2010). "Mephedrone use among regular ecstasy consumers in Australia". Ecstasy and related drug trends bulletin. Archived from the original on 2011-02-18.
- Meyer; Peters, M (2009). "Metabolism of the new designer drug mephedrone and toxicological detection of the beta keto designer drugs mephedrone, butylone and methylone in urine" (PDF). Annales de Toxicologie Analytique 21 (S1): 22.
- Cumming, E. (22 April 2010). "Mephedrone: Chemistry lessons". London: The Daily Telegraph. Retrieved 2010-09-14.
- "Drugs crackdown hailed a success". BBC News. 8 March 2010. Retrieved 2010-03-31.
- Schifano, F.; Albanese, A.; Fergus, S.; Stair, J. L.; Deluca, P.; Corazza, O.; Davey, Z.; Corkery, J.; Siemann, H.; Scherbaum, N.; Farre', M.; Torrens, M.; Demetrovics, Z.; Ghodse, A. H.; Psychonaut Web, M.; Rednet Research, G. (2010). "Mephedrone (4-methylmethcathinone; 'meow meow'): chemical, pharmacological and clinical issues". Psychopharmacology 214 (3): 593–602. doi:10.1007/s00213-010-2070-x. ISSN 0033-3158. PMID 21072502.
- Angoa-Pérez M, Kane MJ, Francescutti DM, et al. (March 2012). "Mephedrone, an abused psychoactive component of 'bath salts' and methamphetamine congener, does not cause neurotoxicity to dopamine nerve endings of the striatum". Journal of Neurochemistry 120 (6): 1097–107. doi:10.1111/j.1471-4159.2011.07632.x. PMC 3296829. PMID 22191803.
- McElrath, K.; O'Neill, C. (2011). "Experiences with mephedrone pre- and post-legislative controls: Perceptions of safety and sources of supply". International Journal of Drug Policy 22 (2): 120–127. doi:10.1016/j.drugpo.2010.11.001. PMID 21242082.(subscription required)
- Saem de Burnaga Sanchez, J. (1929). "Sur un homologue de l'éphédrine" [On an analogue of ephedrine]. Bulletin de la Societé Chimique de France (in French) 45: 284–286.
- Morris, H. (5 April 2010). "Hamilton’s Pharmacopeia. Mephedrone: the phantom menace". Vice Magazine. Retrieved 2010-07-04.
- Slezak, M. (2014-03-10). "High as a Kiwi: Inside the nation saying yes to drugs". New Scientist.
- Slezak, M. (2014-08-11). "My recreational drugs can defeat organised crime". New Scientist.
- Doward, J.; Shah, O. (26 April 2009). "There are many drugs that help people get out of their minds yet stay within the law – they're called 'legal highs'". The Observer. Retrieved 2010-10-28.
- Bentur, Y.; Bloom-Krasik, A.; Raikhlin-Eisenkraft, B. (2008). "Illicit cathinone ("Hagigat") poisoning". Clinical Toxicology 46 (3): 206–210. doi:10.1080/15563650701517574. PMID 17852166.(subscription required)
- Camilleri, A.; Johnston, M.; Brennan, M.; Davis, S.; Caldicott, D. (2010). "Chemical analysis of four capsules containing the controlled substance analogues 4-methylmethcathinone, 2-fluoromethamphetamine, alpha-phthalimidopropiophenone and N-ethylcathinone". Forensic Science International 197 (1–3): 59–66. doi:10.1016/j.forsciint.2009.12.048. PMID 20074881.(subscription required)
- Davies, S.; Ramsey, J.; Archer, R. (November 2009). "Analytical profiles of Methcathinone Related Compounds". London Toxicology Group. Retrieved 22 March 2010.
- "Psychonaut Web Mapping Project Newsletter". Psychonaut Web Mapping Project. June–September 2009. Archived from the original on 2011-02-10. Retrieved 2009-12-19.
- Roussel, O.; Perrin, M.; Herard, P.; Chevance, M.; Arpino, P. (2009). "La 4-méthyléphédrone sera-t-elle une "Ecstasy" du XXIème siècle" [Is 4-methylephedrone, an "Ecstasy" of the twenty first century?]. Annales de Toxicologie Analytique (in French). doi:10.1051/ata/2009048.
- Guppy, D. (18 June 2008). "Killer pills hit Cairns". Cairns.com.au. Retrieved 2009-08-11.
- "Police warn of potentially fatal 'fake ecstasy'". Abc.net.au. 17 June 2008. Archived from the original on 2011-02-10. Retrieved 2009-08-11.
- "EMCDDA 2008 Annual Report". European Monitoring Centre for Drugs and Drug Addiction. Retrieved 2009-11-26.
- "DEA Microgram Bulletin – 4-Methylmethcathinone in Oregon". The Drug Enforcement Administration. July 2009. Retrieved 2011-01-29.
- Devlin, K. (30 April 2009). "Psychiatrists call for 'legal high' drug 4-MMC to be banned". London: The Daily Telegraph. Retrieved 2010-09-16.
- "Mephedrone regulated as psychotropic substances". State Food and Drug Administration, P.R. China. 2 August 2010. Archived from the original on 15 August 2010. Retrieved 2010-09-12.
- Gammell, C. (12 March 2009). "Legal online drugs providing real alternative to Class A substances". London: The Daily Telegraph. Retrieved 2010-09-16.
- Campbell, D. (17 January 2010). "Fears grow over safety of 'legal high' mephedrone". London: The Observer. Retrieved 2010-03-19.
- Fleming, N. (18 March 2010). "Briefing: Should miaow-miaow be banned?". New Scientist. Retrieved 2010-09-16.
- "Designer drug abuse out of control: U.N. drugs board; abuse of 4-methyl-methcathinone, or mephedrone". Reuters. 2 March 2011. Retrieved 2012-03-26.
- INCB Annual Report 2010 (Report). International Narcotics Control Board. March 2011. http://www.incb.org/pdf/annual-report/2010/en/AR_2010_English.pdf. Retrieved 2012-03-26.
- Dargan, Paul; Wood, David (July 2010). Annex 1 to the Risk assessment report: Technical report on mephedrone (Report). European Monitoring Centre for Drugs and Drug Addiction. Archived from the original on 2011-02-10. http://www.webcitation.org/5wOjNS5Nj. Retrieved 2010-09-24.
- Measham, F.; Moore, K.; Newcombe, R.; Smith), Z. (12 March 2010). "Tweaking, bombing, dabbing and stockpiling: the emergence of mephedrone and the perversity of prohibition". Drugs and Alcohol Today 10 (1): 14–21. doi:10.5042/daat.2010.0123.(subscription required)
- Drug Treatment in 2009–10 (Report). National Treatment Agency for Substance Misuse. October 2010. Archived from the original on 2011-02-10. http://www.webcitation.org/5wOichfYy. Retrieved 2010-10-27.
- Fleming, N. (29 March 2010). "Miaow-miaow on trial: Truth or trumped-up charges?". New Scientist. Retrieved 2010-04-01.
- Reed, J. (20 June 2010). "Newsbeat – Ecstasy 'disappearing' from British clubs". BBC. Retrieved 2010-08-30.
- Brunt, T.; Poortman, A.; Niesink, R.; Van Den Brink, W. (2011). "Instability of the ecstasy market and a new kid on the block: mephedrone". Journal of Psychopharmacology 25 (11): 1543–1547. doi:10.1177/0269881110378370. PMID 20826554.(subscription required)
- "The Misuse of Drugs Act 1971 (Amendment) Order 2009". UK government. October 2009. Retrieved 2011-01-31.
- Silverman, J. (2010). "Addicted to distortion: the media and UK drugs policy". Safer Communities 9 (4): 26–31. doi:10.5042/sc.2010.0582.(subscription required)
- James, D.; Adams, R.; Spears, R.; Cooper, G.; Lupton, D.; Thompson, J.; Thomas, S.; National Poisons Information Service (2010). "Clinical characteristics of mephedrone toxicity reported to the UK National Poisons Information Service". Emergency Medicine Journal 28 (8): 686–9. doi:10.1136/emj.2010.096636. PMC 3143586. PMID 20798084.
- "Inquiries over mephedrone effects". Press Association. 4 October 2010. Archived from the original on 2011-02-10. Retrieved 2010-10-27.
- Private Eye, "Street of Shame", No. 1259, 2–15 April 2010, p. 6: Way back in January 2009, not long after mephedrone first began to be sold online, members of the web forum attached to the now-defunct "headshop" Champagne Legals discussed what brand name they might attach to the new product, which has the chemical identity dimethylmethcathinone or MM-Cat. "What shall we call this drug? It's called MM-CAT, so why not Miaow?" suggested one. The name did not catch on ... But on 1 November 2009, someone did add the name "Meow" to the Wikipedia entry for Mephedrone at the head of a list of "street names." Three weeks later ... the Sun declared the arrival of a "new party favourite called 'meow meow'" and the world went cat-call crazy. Among a host of recent headlines the Sunday Times has reported on "the rise of Meow", the Times has heralded "Meow Meow arrests", the Sun shrieked about a "Harman snub for Meow Meow Ban" and the Daily Telegraph took a long hard look at the "Meow Meow Menace in Europe." "No one ever called it Meow seriously till the papers picked up on the Wikipedia entry," one drugs expert tells the Eye.
- Soodin, V. (26 November 2009). "'Meow meow' drug teen ripped his scrotum off". The Sun. Archived from the original on 2011-02-10. Retrieved 2010-09-15.
- Davey, Z.; Corazza, O.; Schifano, F.; Deluca, P. (2010). "Mass-information: mephedrone, myths, and the new generation of legal highs". Drugs and Alcohol Today 10 (3): 24. doi:10.5042/daat.2010.0467.(subscription required)
- Fleming, N. (5 April 2010). "Mephedrone: the anatomy of a media drug scare". London: The Guardian. Retrieved 2010-09-20.
- Greenslade, R. (2 December 2010). "New guide aims to bring sense to the media coverage of drugs". The Guardian. Retrieved 2010-12-19.
- Anonymous editorial (2010). "A collapse in integrity of scientific advice in the UK". The Lancet 375 (9723): 1319–1319. doi:10.1016/S0140-6736(10)60556-9. PMID 20399965.
- Silverman, J. (2010). "Addicted to getting drugs wrong". British Journalism Review 21 (4): 31–36. doi:10.1177/0956474810393603. Archived from the original on 2011-01-31.
- Dargan, P. I.; Albert, S.; Wood, D. M. (2010). "Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change". QJM 103 (11): 875–9. doi:10.1093/qjmed/hcq134. PMID 20675396.
- "Mephedrone to be made Class B drug 'within weeks'". BBC News. 29 March 2010. Retrieved 2010-03-31.
- "Consideration of the cathinones". Advisory Council on the Misuse of Drugs. 31 March 2010. p. 25. Archived from the original on 2011-02-10. Retrieved 2011-02-10.
- Kmietowicz, Z. (2010). "Home secretary bans mephedrone after taking advice from depleted council". British Medical Journal 340: c1784. doi:10.1136/bmj.c1784. PMID 20356967.
- Taylor, P. (2010-03-29). "Drug adviser Dr Polly Taylor's full resignation letter". BBC News. Retrieved 2010-09-15.
- "Resignation 'threatens drug ban'". BBC News. 29 March 2010. Retrieved 2010-03-29.
- "Government adviser Eric Carlin resigns over mephedrone". BBC News. 2 April 2010. Retrieved 2010-04-02.
- Rolles, S. (18 March 2010). "Mephredone and the ACMD: lessons from BZP and New Zealand's "Class D' experiment?". Transform Drug Policy Foundation. Archived from the original on 2011-02-10. Retrieved 13 April 2010.
- Doward, J. (4 April 2010). "Mephedrone row grows as seventh member of drugs panel". London: The Observer. Retrieved 2010-09-15.
- Carlin, E. (2 April 2010). "Eric Carlin's letter of resignation from the ACMD". BBC News. Retrieved 2010-04-13.
- Eastwood, N. (June 2010). "Legal Eye – Mephedrone becomes a class B drug". Drugs and Alcohol Today 10 (2): 6–9. doi:10.5042/daat.2010.0251.(subscription required)
- "Decision to outlaw mephedrone drug not connected to teen deaths". The Scunthorpe Telegraph. 27 January 2011. Archived from the original on 2011-02-10. Retrieved 2011-02-10.
- Nutt, D. (2011). "Perverse effects of the precautionary principle: How banning mephedrone has unexpected implications for pharmaceutical discovery". Therapeutic Advances in Psychopharmacology 1 (2): 35–36. doi:10.1177/2045125311406958. PMC 3736901. PMID 23983925.
- Mann, J. (April 2010). "Can we halt the flow of new designer drugs?". Chemistry World. Retrieved 2010-09-16.
- Stratton, E. (8 December 2010). "Proposals for banning drugs are more draconian than they seem". The Guardian. Retrieved 2010-12-19.
- Van Noorden, R. (2010-12-06). "Science advice not mandatory on drugs council, proposes UK government". Nature News. Archived from the original on 2011-02-10. Retrieved 2010-12-20.
- "Mephedrone: harm reduction advice". Drugscience.org.uk. Independent Scientific Committee on Drugs. 2010. Retrieved 2010-09-15.
- Winstock, A.; Mitcheson, L.; Marsden, J. (November 2010). "Mephedrone: still available and twice the price". The Lancet 376 (9752): 1537. doi:10.1016/S0140-6736(10)62021-1.(subscription required)
- "Clubbers 'still using' banned drug mephedrone". BBC News. 8 February 2011. Retrieved 2011-02-10.
- Garnett, N. (9 February 2011). "Mephedrone freely available on the internet despite ban". BBC Radio 5 Live. Retrieved 2011-02-17.
- Laurance, J. (24 November 2010). "Mephedrone ban blamed for rise in cocaine deaths". The Independent. Retrieved 2010-12-20.
- Bird, S. (22 November 2010). "Banned drug may have saved lives, not cost them". Straight Statistics. Retrieved 2010-12-20.
- "NRG-1 'legal high' drug is banned". BBC News. 12 July 2010. Retrieved 2010-08-23.
- M., S.; Power (17 August 2010). "Ivory Wave drug implicated in death of 24-year-old man". London: The Guardian. Retrieved 2010-08-23.
- Brandt, S.; Sumnall, H.; Measham, F.; Cole, J. (2010). "The confusing case of NRG-1". British Medical Journal 341: c3564. doi:10.1136/bmj.c3564. PMID 20605894.(subscription required)
- Daly, M. (December 2012). "'Drone Strikes". Druglink. Drugscope. pp. 8–11. Retrieved 2013-03-28.
- "Students test mephedrone drug". BBC News. 23 March 2010. Retrieved 23 March 2010.
- "Mephedrone may be banned, chief drug adviser indicates". BBC News. 23 March 2010. Retrieved 2010-03-23.
- Faulkner, A. (16 August 2010). "Mephedrone drugs study scrapped by Liverpool university". Click Liverpool. Retrieved 2010-08-30.
- Winstock, A.; Marsden, J.; Mitcheson, L. (23 March 2010). "What should be done about mephedrone?". British Medical Journal 340: c1605. doi:10.1136/bmj.c1605. PMID 20332508.(subscription required)
- "Police warning over 'bubble' drug". BBC News. 20 November 2009. Retrieved 2009-11-27.
- Reed, J. (13 January 2010). "Clubbers are 'turning to new legal high mephedrone'". BBC News. Retrieved 2010-07-04.
- Wood, D.; Greene, S.; Dargan, P. (2010). "Clinical pattern of toxicity associated with the novel synthetic cathinone mephedrone". Emergency Medicine Journal 28 (4): 280–282. doi:10.1136/emj.2010.092288. PMID 20581379.(subscription required)
- "Call for ban on 'legal high' drug". BBC News. 30 April 2009. Retrieved 2010-09-20.
- "A joined-up approach to drugs is needed now". Herald Scotland. 2010-03-21. Retrieved 2010-09-15.
- Campbell, Duncan (12 March 2009). "Online sales of legal alternatives to class A drugs raise safety fears". London: The Guardian. Retrieved 2010-09-20.
- McNamara, S.; Stokes, S.; Coleman, N. (2009). "Head Shop Compound abuse amongst attendees of The Drug Treatment Centre Board". The Irish Medical Journal 102 (5). Archived from the original on 2011-02-10.
- "Mephedrone – Frequently asked questions" (PDF). Lifeline publications. 2010. Retrieved 2012-10-02.
- Schifano, F.; Albanese, A.; Fergus, S.; Stair, J.; Deluca, P.; Corazza, O.; Davey, Z.; Corkery, J.; Siemann, H.; Scherbaum, Norbert; Farre', Magi’; Torrens, Marta; Demetrovics, Zsolt; Ghodse, A. Hamid; Psychonaut Web, Mapping; Rednet Research, Groups (2010). "Mephedrone (4-methylmethcathinone; 'meow meow'): chemical, pharmacological and clinical issues". Psychopharmacology 214 (3): 593–602. doi:10.1007/s00213-010-2070-x. PMID 21072502.(subscription required)
- Dargan, P. I.; Sedefov, R.; Gallegos, A.; Wood, D. M. (2011). "The pharmacology and toxicology of the synthetic cathinone mephedrone (4-methylmethcathinone)". Drug Testing and Analysis 3 (7–8): 454–463. doi:10.1002/dta.312. PMID 21755604. PMID 21755604
- Gibbons, S.; Zloh, M. (2010). "An analysis of the 'legal high' mephedrone". Bioorganic & Medicinal Chemistry Letters 20 (14): 4135–4139. doi:10.1016/j.bmcl.2010.05.065. PMID 20542690.(subscription required)
- Saner, E. (5 December 2009). "Mephedrone and the problem with 'legal highs'". London: The Guardian. Retrieved 2010-09-20.
- Reed, J. (13 January 2010). "What is legal high mephedrone?". BBC Newsbeat. Retrieved 2010-09-20.
- Kehr, J.; Ichinose, F.; Yoshitake, S.; Goiny, M.; Sievertsson, T.; Nyberg, F.; Yoshitake, T. (April 2011). "Mephedrone, compared to MDMA (ecstasy) and amphetamine, rapidly increases both dopamine and serotonin levels in nucleus accumbens of awake rats". British Journal of Pharmacology 164 (8): 1949–58. doi:10.1111/j.1476-5381.2011.01499.x. PMC 3246659. PMID 21615721.
- Hadlock GC, Webb KM, McFadden LM, Chu PW, Ellis JD, Allen SC, Andrenyak DM, Vieira-Brock PL, German CL, Conrad KM, Hoonakker AJ, Gibb JW, Wilkins DG, Hanson GR, Fleckenstein AE. 4-Methylmethcathinone (mephedrone): neuropharmacological effects of a designer stimulant of abuse. Journal of Pharmacology and Experimental Therapeutics. 2011 Nov;339(2):530–6. PMID 21810934
- Meyer, M.; Wilhelm, J.; Peters, F.; Maurer, H. (2010). "Beta-keto amphetamines: studies on the metabolism of the designer drug mephedrone and toxicological detection of mephedrone, butylone, and methylone in urine using gas chromatography–mass spectrometry". Analytical and Bioanalytical Chemistry 397 (3): 1225–1233. doi:10.1007/s00216-010-3636-5. PMID 20333362.(subscription required)
- Wood, D. M.; Davies, S.; Puchnarewicz, M.; Button, J.; Archer, R.; Ovaska, H.; Ramsey, J.; Lee, T.; Holt, D. W.; Dargan, Paul I. (2010). "Recreational Use of Mephedrone (4-Methylmethcathinone, 4-MMC) with Associated Sympathomimetic Toxicity". Journal of Medical Toxicology 6 (3): 327–30. doi:10.1007/s13181-010-0018-5. PMC 3550484. PMID 20358417.(subscription required)
- Garrett, G.; Sweeney, M. (2010). "The serotonin syndrome as a result of mephedrone toxicity". British Medical Journal Case Reports 2010: bcr0420102925. doi:10.1136/bcr.04.2010.2925.(subscription required)
- Sammler, E.; Foley, P.; Lauder, G.; Wilson, S.; Goudie, A.; O'Riordan, J. (2010). "A harmless high?". The Lancet 376 (9742): 742. doi:10.1016/S0140-6736(10)60891-4.(subscription required)
- Nicholson, P.; Quinn, M.; Dodd, J. (2010). "Headshop heartache: acute mephedrone 'meow' myocarditis". British Medical Journal: Heart 96 (24): 2051–2. doi:10.1136/hrt.2010.209338. PMID 21062771.(subscription required)
- Ahmed, N.; Hoy, B.; McInerney, J. (2010). "Methaemoglobinaemia due to mephedrone ('snow')". British Medical Journal Case Reports 2010: bcr0420102879. doi:10.1136/bcr.04.2010.2879.(subscription required)
- R. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 9th edition, Biomedical Publications, Seal Beach, CA, 2011, pp. 992–993. http://www.biomedicalpublications.com/mephedrone.pdf
- "Teenager dies of 'net drug' overdose". The Local. 15 December 2008. Retrieved 2010-09-20.
- Gustavsson, D.; Escher, C. (20 October 2009). "Mefedron – Internetdrog som tycks ha kommit för att stanna" [Mephedrone – Internet drug that seems to have come to stay]. Lakartidningen (in Swedish).
- Ghodse, H.; Corkery, J.; Ahmed, K.; Naidoo, V.; Oyefeso and, A.; Schifano, F. (July 2010). "Drug-related deaths in the UK: Annual Report 2010" (PDF). International Centre for Drug Policy, St George's University of London. p. 77. Archived from the original on 2010-01-02. Retrieved 2010-01-02.
- "Man from Hove died after injecting mephedrone", BBC News website, 27 May 2010; retrieved on 9 June 2012
- "Teenagers' deaths 'not caused by mephedrone'". BBC News. 28 May 2010. Retrieved 2010-09-20.
- Torrance, H.; Cooper, G. (2010). "The detection of mephedrone (4-methylmethcathinone) in 4 fatalities in Scotland". Forensic Science International 202 (1): e62–e63. doi:10.1016/j.forsciint.2010.07.014. PMID 20685050.
- "Scunthorpe community 'awash with methadone'". BBC News. 25 January 2011. Retrieved 2011-02-10.
- Dickson, AJ; Vorce, SP; Levine, B; Past, MR (2010). "Case report: multiple-drug toxicity caused by the coadministration of 4-methylmethcathinone (mephedrone) and heroin". Journal of Analytical Toxicology 34 (3): 162–168. doi:10.1093/jat/34.3.162. PMID 20406541.(subscription required)
- Shane Darke, Deborah Zador (1996). "Fatal heroin 'overdose': a review". Addiction 91 (12): 1765–1772. doi:10.1046/j.1360-0443.1996.911217652.x. PMID 8997759.
- Power, M.; Parry, S. (24 April 2010). "The Chinese laboratories where scientists are already at work on the new 'meow meow'". Daily Mail (London). Archived from the original on 2011-02-10. Retrieved 2010-09-13.
- Psychonaut WebMapping Research Group (March 2010). "Mephedrone Report" (PDF). Institute of Psychiatry, King's College London. Archived from the original on 2011-02-10. Retrieved 2011-01-31.
- Osorio-Olivares, M.; Rezende, Marcos Caroli; Sepúlveda-Boza, Silvia; Cassels, Bruce K.; Baggio, Ricardo F.; Muñoz-Acevedo, Juan C. (2003). "A two-step method for the preparation of homochiral cathinones". Tetrahedron: Asymmetry 14 (11): 1473–1477. doi:10.1016/S0957-4166(03)00317-3.(subscription required)
- "Risks of banned drug mephedrone revealed in new research". Science Daily. 15 July 2010. Retrieved 2011-02-10.
- Kavanagh, P.; McNamara, S.; Angelov, D.; McDermott, S.; Mullan, D.; Ryder, S. (March 2010). "The Characterization of ‘Legal Highs’ Available from Head Shops in Dublin". The Drug Treatment Centre Board. Retrieved 2011-02-17.
- "Svensk författningssamling Förordning om ändring i förordningen (1999:58) om förbud mot vissa hälsofarliga varor" [Swedish Code of Statutes. Regulation amending the Ordinance (1999:58) banning certain hazardous goods] (in Swedish). 25 November 2008. Archived from the original on 2011-02-10. Retrieved 2011-01-31.
- Stigson, G. (9 June 2010). "15 gram narkotika ger två års fängelse" [15 grams of drugs means two years in prison] (in Swedish). Dala Demokraten. Archived from the original on 2011-02-10. Retrieved 2010-09-20.
- (PDF) 2009 National Report (2008 data) To the EMCDDA by the Reitox National Focal Point – Denmark (Report). 2009. http://www.emcdda.europa.eu/attachements.cfm/att_112008_EN_NR_2009_DK.pdf. Retrieved 2010-09-14.
- "Rapujuhlat saaristossa" [Crayfish parties in the archipelago] (in Finnish). City Magazine. September 2009. Retrieved 2010-09-14.
- Estonian Ministry of Social Affairs (2009-12-08). "Sotsiaalministri 27.11.2009 määrus number 87" [Minister of Social Affairs regulation number 87] (in Estonian). Archived from the original on 2010-09-21. Retrieved 2010-09-21.
- "Guernsey mephedrone ban 'only weeks away'". BBC News. 6 April 2010. Retrieved 2010-09-14.
- "Guernsey makes Mephedrone class B drug". BBC News. 13 April 2010. Retrieved 2010-09-14.
- Campbell, A. (4 March 2010). "Call to ban legal high mephedrone test change". BBC Newsbeat. Retrieved 17 March 2010.
- "Dopuna popisa opojnih droga, psihotropnih tvari i biljaka iz kojih se može dobiti opojna droga te tvari koje se mogu uporabiti za izradu opojnih droga" [List of narcotic drugs, psychotropic substances and plants from which narcotic drugs and substances that may be used to manufacture drugs can be obtained] (in Croatian). Croatian Ministry of Health and Social Welfare. 28 December 2009. Retrieved 2010-07-04.
- "Vierundzwanzigste Verordnung zur Änderung betäubungsmittelrechtlicher Vorschriften" [24th Amendment of narcotics legislation] (in German). Selected laws in Germany – Buzer.de. 22 January 2010. Retrieved 2010-07-04.
- Romanian Health Ministry (10 February 2010). "Comunicat de presă Ministerul Sănătăţii a stabilit lista cu plante şi substanţe cu proprietăţi psihoactive care vor fi interzise, după ce s-au dovedit a fi periculoase pentru sănătate" [Press release: The Health Ministry has established a list of plants and other substances with psychoactive properties that will be banned, after it has been proven that they are dangerous to health] (in Romanian). Romanian Health Ministry. Archived from the original on 2011-02-10. Retrieved 2010-09-21.
- "Now illegal to import drug 'plant food' to Isle of Man". Isle of Man Today. 25 February 2010. Retrieved 2010-07-04.
- "Club drug mephedrone faces ban in U.K.". CBC News. 2010-03-29. Retrieved 2014-03-18.
- "8. Description of the control measures that are applicable to mephedrone in the Member States". Drugtext.org. Retrieved 2014-03-18.
- Ilston, G. (1 April 2010). "Mephedrone to be classified a Class B drug". Police Professional. Archived from the original on 2011-02-10. Retrieved 2010-09-21.
- "BBC – Democracy Live – MPs move to ban mephedrone". BBC News. 7 April 2010. Retrieved 2010-04-08.
- "The Misuse of Drugs (Amendment) (England, Wales and Scotland) Regulations 2010 No. 1144". Office of Public Sector Information. 16 April 2010. Archived from the original on 2011-02-10. Retrieved 2010-04-08.
- Victoria Cumbow (2011-02-06). "Synthetic form of cocaine and methamphetamine being packaged as bath salts". The Huntsville Times. Retrieved 2011-02-10.
- Kelly, F. (3 March 2010). "Head shop substances to be banned". Irish Independent. Retrieved 2010-09-21.
- "Minister for Health and Children announces immediate criminal ban on list of head shop products". Irish Department of Health and Children. 11 May 2010. Retrieved 2010-08-22.
- Gartland, F. (6 November 2009). "Irish youth are fourth highest cocaine users in Europe". The Irish Times. Archived from the original on 2010-02-15. Retrieved 2010-09-21.
- "Arrêté royal du 13 Juin 2010 portant modification de l'arrêté royal du 22 janvier 1998 réglementant certaines substances psychotropes, et relatif à la réduction des risques et à l'avis thérapeutique" [Royal Decree of 13 June 2010 amending the Royal Decree of 22 January 1998 regulating certain psychotropic substances, therapeutic advice and on reducing risk] (in French). Belgian Department of Justice. 13 June 2010. Retrieved 2010-07-05.
- "Tabelle sostanze stupefacenti e psicotrope" [Table of drugs and psychotropics] (in Italian). Italian Ministry of Health. 10 June 2010. Retrieved 2011-01-02.
- Ministry of Health of the Republic of Lithuania (18 June 2010). "2000 m. sausio 6 d. įsakymo nr. 5 "dėl narkotinių ir psichotropinių medžiagų sąrašų patvirtinimo" pakeitimo" [6 January 2000 Order no. 5 of narcotic drugs and psychotropic substances list] (in Lithuanian). Archived from the original on 2010-09-21. Retrieved 2010-09-21.
- AFP (11 June 2010). "Classement comme stupéfiant de la méphédrone, dérivée du khat" [Classification of mephedrone from khat as a narcotic] (in French). france24.com. Archived from the original on 2012-04-04. Retrieved 2010-07-04.
- "La méphédrone classée comme stupéfiant" [Mephedrone classified as a narcotic] (in French). French Ministry of Health and Sports. 11 June 2010. Archived from the original on 2010-10-26. Retrieved 2010-10-26.
- "Ti nye stoffer på narkotikalisten" [Ten new compounds for drug list] (in Norwegian). Norwegian Broadcasting Corporation (NRK). 11 June 2010. Archived from the original on 2011-02-10. Retrieved 2010-08-31.
- Government of the Russian Federation (29 July 2010). "Постановление от 29 июля 2010 г. №578" [Decree of 29 July 2010 number 578] (in Russian). Archived from the original on 2011-02-10. Retrieved 2010-11-19.
- "Mode-Droge Mephedron in Österreich verboten" [Fashionable drug mephedrone illegal in Austria] (in German). Die Presse. 22 August 2010. Archived from the original on 2011-02-10. Retrieved 2010-08-22.
- "Ustawa z dnia 10 czerwca 2010 r. o zmianie ustawy o przeciwdziałaniu narkomanii" [The Law of 10 June 2010 amending the Act on Counteracting Drug Addiction] (in Polish). Polish Internet Database System of Legal Acts. 10 June 2010. Retrieved 2010-08-25.
- Loh, L. (24 February 2010). "Legal in Singapore – the party drug that's banned everywhere else". Cnngo.com. Retrieved 2010-07-04.
- Yeo, A. (13 November 2010). "Three synthetic drugs to be banned". Todayonline. Archived from the original on 2011-02-10. Retrieved 2010-11-16.
- Hermsmeier, K. (28 August 2010). "Ich verfiel der Partydroge "Meow"" [I fell into the party drug "Meow"]. Archived from the original on 2011-02-10. Retrieved 2010-09-21.
- Impey, J. (3 December 2010). "EU bans 'meow meow' party drug". Deutsche Welle. Archived from the original on 2011-02-10. Retrieved 2010-12-19.
- "Eldőlt: betiltják a katit" [Decided: cathinones banned] (in Hungarian). 2 September 2010. Retrieved 2011-01-02.
- "Magyar közlöny 2010. december 15. Kormányrendelet a Mephedrone listáravételéről." [Hungarian Government bans Mephedrone] (in Hungarian). 15 December 2010. Retrieved 2011-01-24.
- "Documento BOE-A-2011-2490". BOE.es. Retrieved 2014-03-18.
- "'Miaow' drug seized in mail busts". Sydney Morning Herald. 12 February 2010. Archived from the original on 2011-02-10. Retrieved 2010-09-21.
- Levy, M. (22 January 2011). "Judge puts users of new drug on notice". The Age. Retrieved 2011-02-17.
- "Misuse of Drugs Act 1975 No 116, Public Act – New Zealand Legislation". New Zealand Ministry of Health. 1 December 2009. Archived from the original on 2011-02-10. Retrieved 2010-07-04.
- Edens, J. (14 September 2010). "Low-quality drugs prompt risk warning". The Southland Times. Archived from the original on 2011-02-10. Retrieved 2010-09-21.
- "Controlled Drugs and Substances Act (1996, c. 19)". Canadian Department of Justice. 20 June 1996. Retrieved 2011-01-29.
- Chan, Kevin (18 March 2010). "Mephedrone: From plant food to Britain’s party drug". Globe and Mail. Archived from the original on 2011-02-10. Retrieved 2010-03-23.
- Elwell, A. (26 April 2010). "Britain moves to curtail new drug craze". Canadian Medical Association Journal 182 (9): E393–4. doi:10.1503/cmaj.109-3245. PMC 2882479. PMID 20421358.
- "U.K. party drug hits St. John's streets". CBC News. 25 June 2010. Retrieved 2010-08-22.
- McCallum, J. (18 August 2010). "'Legal ecstasy' causing concern in Quebec". The Montreal Gazette. Archived from the original on 22 August 2010. Retrieved 2010-08-22.
- "RNC seizes designer drug". The Telegram. 25 June 2010. Retrieved 2010-08-22.
- "United States Drug Enforcement Agency Drug Scheduling". Justice.gov. Archived from the original on 2011-02-10. Retrieved 2010-07-04.
- "Drugs and Chemicals of Concern – 4-Methylmethcathinone". United States Drug Enforcement Agency. July 2010. Archived from the original on 2011-01-31. Retrieved 2010-09-21.
- Sewell, A. (28 January 2011). "'Bath salts' latest drug to raise alarms". Los Angeles Times. Retrieved 2011-02-17.
- "New York State Health Commissioner Bans Sale and Distribution of Dangerous Substances Marketed as Bath Salts". New York State Health Department. 23 May 2011. Retrieved 2011-06-22.
- Ferran L. (2011-09-07). "DEA Announces Emergency Ban on 'Bath Salts'". ABC News. Retrieved 2011-09-08.
- Keim, Brandon (2012-07-12). "New Federal Ban on Synthetic Drugs Already Obsolete". Wired. Retrieved 2014-03-18.
- European Monitoring Center for Drugs and Drug Addiction (2011). Report on the risk assessment of mephedrone in the framework of the Council Decision on new psychoactive substances (Report). http://www.emcdda.europa.eu/html.cfm/index116639EN.html.
- Erowid 4-Methylmethcathinone Vault
- Mephedrone – Frequently asked questions www.lifeline.org.uk
- Guardian Daily Podcast: How dangerous is mephedrone?
- ChemSub Online: Mephedrone