Suzanne Fergus

Mephedrone (4-methylmethcathinone; 'meow meow'): chemical, pharmacological and clinical issues

BackgroundRecently, those substances deriving from the active ingredient of the Khat plant, cathinone, have been rising in popularity. Indeed, 4-methylmethcathinone (mephedrone; ‘meow meow’ and others) has been seen by some as a cheaper alternative to other classified recreational drugs.AimsWe aimed here at providing a state-of-the-art review on mephedrone history and prevalence of misuse, chemistry, pharmacology, legal status, product market appearance, clinical/management and related fatalities.MethodsBecause of the limited evidence, some of the information here presented has been obtained from user reports/drug user-orientated web sites. The most common routes for mephedrone recreational use include insufflation and oral ingestion. It elicits stimulant and empathogenic effects similar to amphetamine, methylamphetamine, cocaine and MDMA. Due to its sympathomimetic actions, mephedrone may be associated with a number of both physical and psychopathological side effects. Recent preliminary analysis of recent UK data carried out in 48 related cases have provided positive results for the presence of mephedrone at postmortem.Discussion and ConclusionsWithin the UK, diffusion of mephedrone may have been associated with an unprecedented combination of a particularly aggressive online marketing policy and a decreasing availability/purity of both ecstasy and cocaine. Mephedrone has been recently classified in both the UK and in a number of other countries as a measure to control its availability. Following this, a few other research psychoactives have recently entered the online market as yet unregulated substances that may substitute for mephedrone. Only international collaborative efforts may be able to tackle the phenomenon of the regular offer of novel psychoactive drugs.

Phenomenon of new drugs on the Internet: The case of ketamine derivative methoxetamine

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non‐peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast‐growing phenomenon. Copyright

Promoting innovation and excellence to face the rapid diffusion of Novel Psychoactive Substances in the EU: the outcomes of the ReDNet project

The recent emergence of new psychoactive compounds (novel psychoactive substances (NPS)) has raised prominent challenges in the fields of drug policy, substance use research, public health and service provision. The Recreational Drugs European Network project, funded by the European Commission, was implemented to improve the information stream to young people and professionals about effects/risks of NPS by identifying online products and disseminating relevant information through technological tools.

5,6-Methylenedioxy-2-aminoindane: from laboratory curiosity to 'legal high'.

The fully synthetic ‘legal high’ 5,6‐methylenedioxy‐2‐aminoindane (MDAI) is an analogue of 3,4‐methylenedioxymethamphetamine. Although developed in the 1990s, it was not widely abused until 2010. However, mephedrone was banned in the UK in April 2010, and almost immediately, MDAI was widely advertised as a legal alternative. This paper provides both an overview of the current state of knowledge of MDAI and a critical analysis of online available information relating to its psychoactive effects, adverse reactions and use in combination with other drugs.

Analysis of ‘legal high’ substances and common adulterants using handheld spectroscopic techniques

The identification of ‘legal highs’ is challenging as they often do not match their label claim and contain a wide range of impurities and/or adulterants. In addition, there is a need for techniques to be on-site, rapid and non-destructive. The feasibility of using the in-built algorithms of handheld near-infrared (NIR), Raman and attenuated total reflectance Fourier transform-infrared (ATR-FT-IR) spectroscopy for the identification of ‘legal high’ substances was investigated. Spectral libraries were constructed using three substances found in ‘legal highs’ (i.e., dextromethorphan, 2-aminoindane and lidocaine) and their 50 : 50 mixtures with caffeine. Model dilution mixtures with caffeine (i.e., 5–95% m/m) and seven ‘legal high’ Internet products were used to test the method. The ‘legal high’ constituents in most of the model mixtures were identified within a minimum range of 30–60% m/m for NIR, 20–75% m/m for Raman, and 41–85% m/m for ATR-FT-IR. This demonstrates that simple library mixtures could be used to identify test substances when the concentrations are variable. Below and above these levels, the test mixtures often correlated to the component in higher concentration. Collectively, the instruments identified the main constituents in the seven Internet products with varying correlation criteria. The NIR and ATR-FT-IR provided complementary information compared to Raman when carbohydrate cutting agents were added to the product, yet the Raman showed a high fluorescence signal for three products hindering identification. These initial studies indicate the suitability of three complementary techniques for rapid identification of ‘legal high’ products. Further development of spectral libraries, algorithms, and use of alternative Raman excitation wavelengths is needed to provide adequate tools for in-field analysis by non-experts.

Phenomenon of new drugs on the Internet

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non‐peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast‐growing phenomenon. Copyright

Integrated pharmacy case studies: A framework model created to design a contextualized warfarin therapy case in an MPharm program

Objective. To develop and integrate a case study on warfarin into a clinical pharmacy workshop. Methods. A framework model was designed and used to create a case study on warfarin therapy. The case study was implemented in a third-year Master of Pharmacy course. Student feedback was obtained using an online questionnaire and two focus groups. Results. All students agreed that the case study successfully integrated the science of warfarin and concepts of pharmacy practice. The majority of students (94%) agreed that this approach helped them to understand the science of warfarin more than a traditional lecture would have. Students felt the time allocated to the workshop was too short. Conclusion. An integrated case study provides a learning environment that emphasizes the contextualization of chemistry and pharmacology into a clinical pharmacy setting.

Phenomenon of new drugs on the Internet: the case of ketamine derivative methoxetamine: NEW DRUGS ON THE INTERNET

On the basis of the material available both in the scientific literature and on the web, this paper aims to provide a pharmacological, chemical and behavioural overview of the novel compound methoxetamine. This is a dissociative drug related to ketamine, with a much longer duration of action and intensity of effects. A critical discussion of the availability of information on the web of methoxetamine as a new recreational trend is here provided. Those methodological limitations, which are intrinsically associated with the analysis of online, non‐peer reviewed, material, are here discussed as well. It is concluded that the online availability of information on novel psychoactive drugs, such as methoxethanine, may constitute a pressing public health challenge. Better international collaboration levels and novel forms of intervention are necessary to tackle this fast‐growing phenomenon. Copyright