synthetic cathinones

What are synthetic cathinones?

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Synthetic cathinones, more commonly known as bath salts, are human-made stimulants chemically related to cathinone, a substance found in the khat plant. Khat is a shrub grown in East Africa and southern Arabia, where some people chew its leaves for their mild stimulant effects. Human-made versions of cathinone can be much stronger than the natural product and, in some cases, very dangerous.

cathinones usually take the form of a white or brown crystal-like powder and are sold in small plastic or foil packages labeled “not for human consumption.” They can be labeled as bath salts, plant food, jewelry cleaner, or phone screen cleaner.

cathinones are part of a group of drugs that concern public health officials called new psychoactive substances (NPS). NPS are unregulated psychoactive mind-altering substances with no legitimate medical use and are made to copy the effects of controlled substances. They are introduced and reintroduced into the market in quick succession to dodge or hinder law enforcement efforts to address their manufacture and sale.

cathinones are marketed as cheap substitutes for other stimulants such as amphetamines and cocaine. Products sold as Molly often contain synthetic cathinones instead of MDMA (see Synthetic Cathinones and Molly (Ecstasy)).

How do people use cathinones? 

People typically swallow, snort, smoke, or inject synthetic cathinones.

How do cathinones affect the brain?

Much is still unknown about how cathinones affect the human brain. Researchers do know that synthetic cathinones are chemically similar to drugs like amphetamines, cocaine, and MDMA.

A study found that 3,4-methylenedioxypyrovalerone (MDPV), a common synthetic cathinone, affects the brain in a manner similar to cocaine, but is at least 10 times more powerful. MDPV is the most common synthetic cathinone found in the blood and urine of patients admitted to emergency departments after taking bath salts. buy ketamine 

Synthetic cathinones can produce effects that include:

  • paranoia—extreme and unreasonable distrust of others
  • hallucinations—experiencing sensations and images that seem real but are not
  • increased friendliness
  • increased sex drive
  • panic attacks
  • excited delirium—extreme agitation and violent behavior

What are other health effects of cathinones?

Raised heart rate, blood pressure, and chest pain are some other health effects of cathinones. People who experience delirium often suffer from dehydration, breakdown of skeletal muscle tissue, and kidney failure.

The worst outcomes are associated with snorting or needle injection. Intoxication from synthetic cathinones has resulted in death.

A bottle of spilled bath salts

is cathinones addictive?

Yes, cathinones can be addictive. Animal studies show that rats will compulsively self-administer synthetic cathinones. Human users have reported that the drugs trigger intense, uncontrollable urges to use the drug again. Taking cathinones can cause strong withdrawal symptoms that include:

  • depression
  • anxiety
  • tremors
  • problems sleeping
  • paranoia

How can people get treatment for addiction

Behavioral therapy can be used to treat addiction to synthetic cathinones. Examples include:

  • cognitive-behavioral therapy
  • contingency management, or motivational incentives—providing rewards to patients who remain substance free
  • motivational enhancement therapy
  • behavioral treatments geared to teens

As with all addictions, health care providers should screen for co-occurring mental health conditions. While there are no FDA-approved medicines for synthetic cathinone addiction, there are medicines available for common co-occurring conditions.

Table 1

The structural classification of cathinone derivatives found in drug seizures, collected samples or offered for sale on Internet sites (see Figure 8). Those that are or have been used as active pharmaceutical ingredients (API) are shown emboldened.

R1R2R3R4R5Name
HHHHHCathinone
MethylHHHHMethcathinone (ephedrone)
MethylMethylHHHN,N-Dimethylcathinone (metamfepramone)
EthylHHHHN-Ethylcathinone (EC)
MethylHHMethylHBuphedrone
EthylH4-MethylHH4-Methyl-N-ethylcathinone
MethylH4-MethylHHMephedrone (4-MMC; M-CAT)
EthylEthylHHHAmfepramone
t-ButylH3-CIHHBupropion
MethylH3,4-MethylenedioxyHHMethylone (βk-MDMA)
EthylH3,4-MethylenedioxyHHEthylone (βk-MDEA)
MethylH4-MethylMethylHButylone (βk-MBDB)
MethylH4-MethoxyHHMethedrone (βk-PMMA)
MethylH4-FHHFlephedrone (4-FMC)
MethylH3-FHH3-Fluoromethcathinone (3-FMC)
{pyrrolidino}HHHα-Pyrrolidinopropiophenone (PPP)
{pyrrolidino}4-MethylHH4-Methyl-α-pyrrolidinopropiophenone (MPPP)
{pyrrolidino} 4-MeOH H4-methoxy-α-pyrrolidinopropiophenone (MOPPP)
{pyrrolidino}4-MethylPropyl H4-Methyl-α-pyrrolidino-hexanophenone (MPHP)
{pyrrolidino}4-Methyl Ethyl HPyrovalerone
{pyrrolidino}4-Methyl Methyl H4-Methyl-α-pyrrolidino-butyrophenone (MPBP)
{pyrrolidino}4-Methyl H Methyl4-Methyl-α-pyrrolidino-α-methylpropiophenone
{pyrrolidino}3,4-MethylenedioxyHH3,4-Methylenedioxy-α-pyrrolidinopropiophenone (MDPPP)
{pyrrolidino}3,4-MethylenedioxyEthylH3,4-Methylenedioxypyrovalerone (MDPV)

Pharmacology

As with phenethylamines, in the absence of ring-substitution, cathinones behave as central nervous system (CNS) stimulants, although invariably with a lower potency than the corresponding phenethylamine analogue. The lower potency is caused by the β-keto group creating a more polar molecule less able to cross the blood–brain barrier. Studies on the metabolism of methcathinone derivatives in rats and humans have shown that they are N-demethylated, the keto group is reduced to hydroxyl, and ring alkyl groups are oxidised. Otherwise, few formal studies have been made on the pharmacokinetics or pharmacodynamics of ring-substituted cathinones. From observations of patients who presented with suspected mephedrone toxicity, it appears that cathinone derivatives show similar sympathomimetic effects to amphetamine derivatives. The first toxicologically confirmed fatal case directly linked to mephedrone use was recorded in Sweden in 2008.

User reports on Internet sites suggest that a typical dose of mephedrone is 100–250 mg. Depending on the particular substance, the effects are claimed to be similar to those of cocaineamphetamine or MDMA. Like cocaine, the resulting ‘high’ of mephedrone is short-lived. Consequently, users may consume several doses in succession, up to 1 g in a session. This is supported by the finding that the most common ‘wrap size’ of mephedrone found in police seizures in the United Kingdom is close to 750 mg. MAGIC MUSHROOMS

The pyrrolidine ring and the tertiary amino group in MDPV could lead to a more lipophilic, i.e. more potent, molecule; Internet user-forums suggest that the dose is as low as 5–10 mg. Furthermore, it should be noted that p-methoxyphenethylamines (e.g. PMA, PMMA) are known to have a particularly high toxicity, and this property might translate to their βk-analogues. For example, methedrone (p-methoxymethcathinone) has been detected in a few fatalities

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