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Patterns of presentation and clinical toxicity after reported intravenous use of mephedrone in the United Kingdom. A report from the UK National Poisons Information Service

Author/s Kamour A, James D, Lupton DJ, Eddleston M, Thompson JP, Vale JA, Thanacoody RHK, Hill S, Thomas SHL
Year 2014
Type of publication Conference proceeding

XXXIV International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT)

Background: The use of mephedrone, a synthetic cathinone with amfetamine-like properties, first emerged on the UK recreational drug scene in 2009 and it grew rapidly, although the number of cases reported to the NPIS fell substantially after the drug was subject to legal control in April 2010., Recently, concerns have been raised about an apparent increase in the use of intravenous (IV) mephedrone, sometimes termed “M-Smack.”

Objective: This study was performed to determine the toxicity of IV mephedrone in comparison with mephedrone use via other routes.

Methods: UK National Poisons Information Service (NPIS) telephone enquiries related to mephedrone were reviewed from March 2009 to September 2013.

Results: Of 786 enquiries regarding mephedrone, 20 (2.5%) related to IV exposure, with the first IV case reported in February 2010. Thereafter, NPIS received 4 calls in 2010, 4 in 2011, 7 in 2012, and 4 in the first 9 months of 2013. Compared with other routes, IV users were more likely to be male (90% vs. 69%, P = 0.048) and their median age was older (30y vs. 21y). There were no significant differences in reported features comparing IV use with other routes, including stimulant effects (e.g., tachycardia, hypertension, mydriasis, [40% IV vs. 39% other routes]), agitation (30% vs. 22%), tachycardia (30% vs. 22%), fever (15% vs. 4%), raised creatine kinase (15% vs. 6%), hallucinations (10% vs. 4%), convulsions (0% vs. 3.5%), and death (0% vs. 0.4%).

Conclusion: IV use of mephedrone is reported uncommonly to the NPIS. No differences in the toxicity of IV mephedrone compared to other routes were identified, but the sample size was small.


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  • The Misuse of Drugs (Amendment) (England, Wales and Scotland) Regulations 2010. 
  • Public Health England, National Poisons Information Service. National Poisons Information Service Report 2012/13. 
  • Daly M. 2012 Street Drug Trends Survey: ‘Drone Strikes’. 
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