TL neuro

March 6, 2013

MDPV and Mephedrone injection in Budapest

Filed under: Cathinones, MDPV — mtaffe @ 6:18 pm

A new paper by Csák and colleagues describes the emergence of substituted cathinone use in a population of injection drug users in Budapest, Hungary.

Csák R, Demetrovics Z, Rácz J.Transition to injecting 3, 4-methylene-dioxy-pyrovalerone (MDPV) among needle exchange program participants in Hungary. J Psychopharmacol. 2013 Mar 4. [Epub ahead of print] [PubMed][DOI]

Csák13-Fig1The paper describes injection drug use from a Needle Exchange Program located in “one of the poorest districts of Budapest” which is stated to have registered 2500 users by the end of 2011. The study had two main goals. First, the authors report a records review of the primary substance reported by each new registrant from 2007 to 2011. As you can see in Figure 1 from the paper, the number of clients per year is pretty stable. The injection drug population at this NEP was similar from 2007 to 2010 with about two-thirds injecting amphetamines and about a third injecting heroin. This changed in 2011 when there was a new appearance of individuals claiming that mephedrone (7%) or MDPV (17%) were their primary substances. Interestingly, this appeared to be a conversion of opiate injectors since it was still 60% of new clients who stated that amphetamines were their primary drug of abuse.

The second part of the study followed up on this question more directly. They sampled all clients entering the program for one month in late 2011, 183 of 461 visitors agreed to participate. From a brief survey, the author were able to describe pathways for the individuals’ “first regularly injected substance” to their “current primary injected substance”. Of 142 of those who started on amphetamines, 71 continued, 64 converted to MDPV, 4 to opiates and 3 to “other”. Of the 24 who started injecting opiates, 4 were continuing, 10 moved to amphetamines and 10 to MDPV. There were 3 individuals who claimed to have started injecting MDPV who were still describing that as their primary substance. So this shows that the story is a little more complicated than the aggregate statistics might imply. Individuals currently injecting MDPV were those who first regularly injected either amphetamines or opiates. The majority of those who started on heroin had started injecting a stimulant, however those were equally split between MDPV and amphetamines.

The authors speculate in the Discussion that this was related to economics, with MDPV being described as about a quarter of the price of an equivalent dose of heroin during this period in Budapest. No mention was made of the cost or availability of amphetamines so it is hard to determine what was going on with the 64 individuals who converted to MDPV. Nevertheless, this study adds to a growing picture which confirms the substantial presence of MDPV in the repertoire of repeated drug users.

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