Web-based survey on mephedrone use

by mtaffe

ResearchBlogging.orgA recent Web-based survey paper from Carhart-Harris and colleagues gives us another look at the mephedrone (4-methylmethcathinone; 4-MMC) using population (see Winstock et al, 2011 for additional). The 4-MMC compound is a derivative of cathinone, the active constituent of the plant material khat which is chewed by populations from the Arabian Peninsula and the Horn of Africa. This survey received 1,506 forms from individuals claiming to have used mephedrone on at least one occasion.

Might as well start off with the caveats. This was a web-based survey and the authors did not attempt to verify IP addresses. Correspondingly there could have been individuals returning multiple responses. There was no way to verify that any of the information was factual, even so far as basic demographic information that might be verified in a face-to-face survey or partially verified with a phone survey. It is a limit. However, as the authors note, the survey took 20-30 minutes to complete which may enhance confidence (with the corresponding selection bias for those who were motivated to actually complete the survey). Nevertheless, as additional data are collected using different survey methods or targeting different users, the results can be compared for consistency. The currently available surveys are unfortunately both Web based and seem to primarily target British users, but there are some consistencies of result which enhance confidence in the Web-based survey methodology.

The users sampled by Carhart-Harris and colleagues were primarily male (84%), British (80%) and had a mean age of 26. The population was experienced with the drug, 37% reported using between 11 and 50 times and 28% had used mephedrone over 50 times. Only 20% of the sample had experienced mephedrone prior to 2009. The preferred route of mephedrone use in this population was primarily intranasal (57%), oral (28%) with only 3% reporting a preference for injection use; the balance appeared to use intranasal and oral without preference. This compares well with the population surveyed by Winstock and colleagues (66% intranasal, no injection use; they didn’t specify that the balance of use was oral).

One interesting contribution to the legal/public policy question in this paper was the inclusion of questions for the UK population regarding their plans following the April 2010 decision to control use of the substance. Sixty-four percent said they already use 4-MMC less, 58% say they won’t try to obtain 4-MMC and, interestingly, 49% said they would be more likely to use 3,4-methylenedioxymethamphetamine (MDMA, “Ecstasy”). This confirms an impression that can be gleaned from reviewing user comments on forums such as bluelight.ru and Erowid. I.e., for at least a subpopulation of mephedrone users, they are seeking a MDMA-like experience and that 4-MMC provides a less-preferred substitute. It would appear that the prior licit status of 4-MMC in the UK was a contributor to shifting user preference toward that drug; under equivalent legal controls, apparently MDMA is preferred.

This latter issue was also addressed with relative preference and similarity questions for those users who had experienced both MDMA and 4-MMC and those users who had also experienced cocaine. Of the 1306 who had experienced MDMA and 4-MMC, 73% said they did not prefer the effects of 4-MMC to MDMA. Of the 1143 who had experienced all three, 48% described 4-MMC as more like MDMA, 21% as more like cocaine and 30% as “other”. This may be a little different from the Winstock survey in which those who were experienced with intranasal cocaine and 4-MMC reported the high from 4-MMC to be as good as (20%), or better than (55%), cocaine. There are differences in the question but it could very easily be the case that the mephedrone using population is going to break down, in very broad strokes, between those who are looking for a cocaine-like stimulant experience and those who are looking for a MDMA/Ecstasy-like experience. Clearly the drug proves attractive on both these grounds to at least some fraction of users. Therefore it is very likely that the descriptions of users as to which drug it is most “like” and the relative preference for the drug are going to vary with the drug seeking intentions of subpopulations.

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Winstock AR, Mitcheson LR, Deluca P, Davey Z, Corazza O, & Schifano F (2011). Mephedrone, new kid for the chop? Addiction (Abingdon, England), 106 (1), 154-61 PMID: 20735367

Carhart-Harris RL, King LA, & Nutt DJ (2011). A web-based survey on mephedrone. Drug and alcohol dependence PMID: 21420252

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2 Comments to “Web-based survey on mephedrone use”

  1. Mmm, it’s interesting that most people perceived it as closer to MDMA. (chemistry geek hat on) if you look at the chemical structure this makes a bit of sense. Mephedrone has a methyl group on the 4 position of the phenyl ring of methcathinone which is itself closely related to methamphetamine; the “MD” in MDMA is a substitution on 4 and 5 of the phenyl ring of methamphetamine. So mephedrone is a bit like MDMA – the 4-subtitution is different, but it may be enough to give it the ability to release serotonin like MDMA does – and serotonin release is, probably, what makes MDMA different to amphetamine.

    MDMA has been linked to neurotoxicity of serotonin cells and the evidence there is mixed but it’s concerning; mephedrone might be even worse, or the same, or safer, I don’t think anyone knows.

  2. MDMA has been linked to neurotoxicity of serotonin cells and the evidence there is mixed but it’s concerning;

    err…yes, we are somewhat aware of this effect of MDMA around these parts :-)

    The evidence is in fact not “mixed” it is overwhelming. MDMA is capable of causing significant, lasting (7yrs in squirrel monkey) depletions of several markers for brain serotonin function.

    The only question is to what extent this happens in people, given how they are exposed to the drug. It would be highly unusual for a MDMA-naive human to high-dose 4 times at 2 hr intervals or 8 times at 12 hr intervals, I imagine. The animal models are considerably less clear about episodic low-dose exposure and what happens under repeated high-dosing with MDMA after a prior history of episodic low-dosing.

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