Rebekah Brennan

Plant food for thought: A qualitative study of mephedrone use in Ireland

The synthetic cathinone derivative club drug ‘mephedrone’ [4-methylmethcathinone (4MMC)] has been recognized in the EMCDDA early warning system since 2008 [EMCDDA (2010a). ‘Article 5 of the Council Decision’ council decision 2005/387/JHA of 10 May 2005 on the information exchange, risk assessment and control of new psychoactive substances. Official Journal, L 127. Retrieved from http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CELEX:32005D0387:EN:HTML] and is currently under legislative control in Ireland. Research on this drug remains scant, and primarily UK based. This exploratory research aimed to present a ‘consumptive snapshot’ of this emerging drug in the Irish drug scene, with specific focus on mephedrone user experiences, social situatedness of use and risk discourses. Twenty two in-depth interviews were undertaken with young Irish people aged 18–35 years, who had used mephedrone in the 6 months prior to fieldwork. The resulting narratives were phenomenologically and thematically analysed; and identified unique mephedrone user decision-making processes, particular drug effects and outcomes, socially contextualized mephedrone use and user harm reducing strategies grounded in prior illicit and poly drug taking careers. The research supports UK-based findings, which suggested the presence of drug displacement patterns between licit and illicit, with Irish mephedrone user preferences centralized in mephedrone availability, competitive pricing and general lack of quality illicit stimulants in the street trade. Policy makers and drug educational specialists are dealing with rapid metamorphoses and re-branding of cathinone derivatives circumventing legislation amid widespread internet availability.

‘Heads Held High’: An Exploratory Study of Legal Highs in Pre-Legislation Ireland

The research aimed to present a unique ‘snapshot’ of legal psychoactive drug use prior to legislative control in Ireland, in relation to the types of products used; sourcings; consumptive practices and particular social settings for use; gauging of dosage; licit and illicit drug transitions, individualisation of drug decision-making and experiences; and future intentions regarding drug switching post legislation. Semi-structured in depth interviews (n = 32) were conducted with adults aged 18–33 years who had used legal highs in the 6 months prior to fieldwork. The findings indicate some support for ‘differentiated’ displacement consumptive patterns between illegal and legal drugs, with user pathways grounded in ‘legal high’ availability; perceived user effect, safety, legality, quality and price. Mephedrone emerged as most popular drug of choice. Internet sales, stockpiling and diversion of previously ‘legal highs’ onto the illegal street drug market remain of concern, against a background of emerging new designer drugs in Ireland.

Gamma-Hydroxybutyrate (GHB): A Scoping Review of Pharmacology, Toxicology, Motives for Use, and User Groups

Abstract Gamma hydroxybutyrate (GHB) is a central nervous system depressant with euphoric and relaxant effects. Documentation of GHB prevalence and the underreporting of abuse remains problematic, given the availability of GHB and its precursors γ-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) and the ease of synthesis from kits available on the Internet. The continued abuse of and dependence on GHB, and associated fatalities, present an on-going public health problem. As the drug GHB remains an underresearched topic, a scoping review was chosen as a technique to map the available literature into a descriptive summarized account. PRISMA was used to assist in data retrieval, with subsequent data charting into three key themes (pharmacology and toxicology, outcomes, and user groups). Administered orally, GHB is dose-dependent and popular for certain uses (therapeutic, body enhancement, sexual assault) and amongst user sub groups (recreational party drug users, homosexual men). Despite the low prevalence of use in comparison to other club drugs, rising abuse of the drug is associated with dependence, withdrawal, acute toxicity, and fatal overdose. Clinical diagnosis and treatment is complicated by the co-ingestion of alcohol and other drugs. Limitations of the scoping review and potential for further research and harm reduction initiatives are discussed.

Curiosity killed M-Cat: A post legislative study on mephedrone use in Ireland.

Mephedrone (4-methylmethcathinone) is a synthetic ‘amphetamine-type stimulant’ (ATS) derived from the Khat plant and collectively known as ‘M-Cats’. Research has indicated the presence of strong displacement patterns in post-legislative timeframes with mephedrone incurred positive effects stimulating user preferences over amphetamine, MDMA and cocaine. The aim of this research was to investigate post-legislative mephedrone consumerist patterns and the presence of (any) incurred displacement patterns, as follow-up to an earlier study on pre-legislative mephedrone use in the Republic of Ireland (Van Hout & Brennan, 2011c. Plantfood for thought: A qualitative study of mephedrone use in Ireland. Drugs Education Prevention and Policy. 1–11. Advance online publication.). A total of 22 in-depth interviews were undertaken with findings indicative of the relative influence of macro- and micro-level club drug markets in determining the continuation of mephedrone use. ‘Temporary displacement’ patterns between mephedrone and club stimulant drugs were observed with 10 users reporting continued use and the remainder reverting back to ‘old favourites’. This was based on user emergent negative psychostimulant experiences with mephedrone, concerns for product contamination and improved quality of club stimulants at that time. The synthetic drug market remains of concern, given the recent evidence for ‘blended’ club drugs using mephedrone, and with the need for continued monitoring on the impact of legislation on drug consumptive patterns and outcomes.

The injecting use of image and performance-enhancing drugs (IPED) in the general population: a systematic review.

Injecting use of image and performance-enhancing drugs (IPED) in the general population is a public health concern. A wide and varied range of IPED are now easily accessible to all through the online market. A comprehensive literature review was undertaken according to Critical Appraisal Skills Programme (CASP) guidelines for systematic review, to identify the relevant literature. No date restrictions were placed on the database search in the case of human growth hormone melanotan I and II, and oil and cosmetic injectables. In the case of anabolic androgenic steroids search dates were restricted to January 2014-2015. Publications not in English and with a lack of specificity to the topic were excluded. The review yielded 133 relevant quantitative and qualitative papers, clinical trials, clinical case presentations and editorials/reports. Findings were examined/reviewed under emergent themes which identified/measured extent of use, user profiling, sourcing, product endorsement, risk behaviours and health outcomes in users. Motivation for IPED use may be grounded in appearance, pursuit of health and youth, and body image disturbance. IPED users can practice moderated use, with pathological use linked to high-risk behaviours, which may be normalised within IPED communities. Many IPED trajectories and pathways of use are not scientifically documented. Much of this information may be available online in IPED specific discussion forums, an underutilised setting for research, where uncensored discourse takes place among users. This review underscores the need for future internet and clinical research to investigate prevalence and patterns of injecting use, and to map health outcomes in IPED users. This paper provides community-based clinical practice and health promotion services with a detailed examination and analysis of the injecting use of IPED, highlighting the patterns of this public health issue. It serves to disseminate updated publication information to health and social policy makers and those in health service practice who are involved in harm reduction intervention.

Heuristics of human enhancement risk: a little chemical help?

Research underscores an emergent public health challenge due to the increasing use of human enhancement (HE) products for aesthetic purposes. Of particular interest is the injecting use of HE products, and the degree to which injecting of these products for muscle building, tanning and body ‘site’ enhancement has entered into mainstream society. The aim of the research was to identify what is currently known about the injecting use of HE products within the context of public health concern. The findings provide a unique consumer profile of users, health consequences and sourcing mechanisms. Users do not identify as injecting drug users and are less informed about risks associated with the injecting of these unregulated products, potential for contamination and needle sharing. Cost-benefit forms of risk negotiation are grounded in inaccurate information via peer groups and online forums. We present a risk heuristics and public health discourse approach to understanding and addressing this concerning form of aesthetic enhancement grounded in the emphasis on appearance as the indicator of being healthy and attractive. We comment on the role of the Internet as driving force for availability and information retrieval, and offer suggestions for potential health educational approaches.

Miaow miaow: a review of the new psychoactive drug mephedrone.

Purpose – Mephedrone is a synthetic stimulant drug causing entactogenic and hallucinogenic effects. A systematic review of all existing empirical research and literature from 2009‐2012 on this new psychoactive drug was conducted. This paper aims to report on that review.Design/methodology/approach – The review was conducted according to PRISMA guidelines. Electronic databases were utilised using the search terms “mephedrone” and product nomenclature; “Plant Food”, “Feeder”, “Meow Meow”, “Miaow”, “Drone”, “Meph” “Bubbles”, “Charge”, and “MCat”. The search was restricted to publications from 2009‐2012, and produced 702 results. Data were collected by one member of the research team and cross checked by another. A primary screening was carried out to exclude inaccurate search results and drugs other than mephedrone. The results were studied and duplicates removed; 598 results were discarded, with 104 deemed suitable for inclusion.Findings – The review underscores mephedrones popularity despite legislative c...

“Saving Face”: An Online Study of the Injecting Use of DIY Botox and Dermal Filler Kits

This study reports on an empirically underdocumented practice in contemporary aesthetic enhancement culture, the self-injection of unregulated DIY Botox and dermal filler kits purchased online. Data were collected from 4 online discussion forums containing disclosures in relation to use of DIY kits and analyzed using ethnographic content analysis. Motivation to source DIY Botox and dermal fillers online was grounded in desire to avoid financial cost of professional services and a lack of confidence in practitioners. Future intentions to order online raw materials and “formulas” to prepare dermal fillers at home were expressed. Individuals taught themselves to inject through watching YouTube tutorials and downloading Botox injection maps from the Internet. Although individuals demonstrated awareness of the health risks involved with self-injection of unregulated products, this was not a deterrent. Future research is warranted to document the injecting practices and health outcomes of individuals who inject DIY Botox and dermal filler kits to inform targeted harm reduction interventions by health-care practitioners.