dr raimondo bruno school of psychology ui ituniversity off...
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Dr Raimondo BrunoDr Raimondo BrunoSchool of Psychology
U i it f T iUniversity of Tasmania
Down the rabbit hole....
Over theOver the counter...counter...
Over the internet...As of March, this one site (of very many) had 35 different ‘ h h i l ’ li d ‘research chemicals’ listed, including:
‐Substituted cathinones‐Cannabinoid agonists‐MDMA analoguesMDMA analogues‐Ketamine analogues
‐Information provided looks ‐Information provided looks ‘scientific’ and helpful but contains substantial errors
Mephedrone / ‘israelis’Mephedrone / israelis•Likely the main source of the
h d d bmephedrone mentioned by Tas consumers •‘neo‐doves’•Sudden flurry of new ‘generations’ of products in response to legal changes 4th generation was not well received4 generation was not well received
Q it l i th i d t l b lli d d i ti (Quite unclear in their product labelling and descriptions (e.g.:
Brand New Product TC True C 'shower invigorator' This is a luxury product for the most wonderful 'showering' experience It comes in capsule or powder form it is recommended that you open capsule showering experience. It comes in capsule or powder form, it is recommended that you open capsule and put powder into 'shower head' small amounts can be used to extend your 'shower'. It will invigorate you and make you feel on top of the world by releasing the product all over your body through the 'shower head' It can also be used in your 'bath' as you would with other Neorganics 'bath' productsshower head . It can also be used in your bath as you would with other Neorganics bath products.
Rules: provide documentation; full chemical structure & CAS; trademarked brands(!); NMR spectrographs provided; overweight; re‐ship if lost; create *custom projects*
Use of emerging psychoactive substances g g p yamong the frequent ecstasy users (n=693)Drug Class Ever
Used (%)Used 6/12
(%)Med Freq(6/12)
Used just once (%)
P h d liPsychedelics2CI Psychedelic Phenethylamine 6 2 1 (1‐3) 71
2CB Psychedelic Phenethylamine 9 3 1 (1‐20) 582CE Psychedelic Phenethylamine 3 2 1 (1‐10) 64
DOI Psychedelic Phenethylamine 2 1 1 (1‐6) 75
Mescaline Psychedelic Phenethylamine 6 2 1 (1‐14) 81syc ede c e et y a e ( )5MEO‐DMT Psychedelic Tryptamine 2 0.5 1 (1‐2) 66DMT Psychedelic Tryptamine 13 7 2 (1‐14) 50
Any psychedelic 23 13Any psychedelic 23 13
StimulantsBZP Stimulant 8 5 2 (1‐24) 47BZP Stimulant 8 5 2 (1 24) 47MDPV Stimulant 1 0.5 2 (1‐5) 50Mephedrone Stimulant 21 17 3 (1‐100) 30
Any stimulant 25 20Any stimulant 25 20
Source: National EDRS 2010
h dKey Emerging Psychoactives Noted in Tasmanian EDRS Cohorts (to 2010)Tasmanian EDRS Cohorts (to 2010)
Drug 2010 %
Summary
Mephedrone 47 Stimulant, entactogen
DMT 7 Psychedelic tryptamine (duration‐)
2C‐E 7 Psychedelic phenethylamine (duration+)
2C‐I 4 Psychedelic (empathogenic) phenethylamine
Methylone (bk‐MDMA) 4 Stimulant / Entactogenic substituted cathinone
DOI 3 Psychedelic phenethylamine (duration+++)
Others: BZP; Salvia; DXM; MDPV; LSA; Mescaline; 2C‐T‐7; Methcathinone; 5‐MeO‐DMT
EPS use in Tasmanian EDRSEPS use in Tasmanian EDRS samples 2003 2010samples 2003‐2010
100
80
90
Mephedrone
2C X (I E B)
60
70
mple
2C‐X (I,E,B)
40
50
% of s
am
20
30
0
10
2003 2004 2005 2006 2007 2008 2009 2010
Mephedrone & relativesArray of other psychoactive Mephedrone & relatives y p ysubstituted cathinones:‐Ethcathinone (S)‐Buphedrone (S)Metamfepramone (S)‐Metamfepramone (S)‐Amfepramone (S)‐Buproprion (Zyban!)‐4‐Methyethcathinone (S) ‘NRG‐1/2’‐3‐Fluoromethcathinone (S)‐Flephedrone (4‐FMC) (S)‐4‐bromomethcathinone (SS/NRI)‐3 4‐Methylenedioxycathinone (bk‐3,4 Methylenedioxycathinone (bkMDA)(E,S)‐Methylone/bk‐MDMA (Arlone;E,S)‐Butylone (E, P, S)P l (bk MBDP) (NRG / )‐Pentylone (bk‐MBDP) (NRG‐1/3)‐α‐Pyrrolidinopropiophenone (S)‐4‐Methoxy‐α‐pyrrolidinopropiophenonepy p p p(MOPPP) (S)‐Pyrovalerone (Centroton, Thymergix)(NDRI) (S) M th l di l‐Methylenedioxypyrovalerone(MDPV) (NDRI)(Ivory Wave)(S)‐Naphyrone (o‐2482)(NRG‐1) (S/N/D/ RI) (S)
Mephedrone: 4‐methylmethcathinone, 4‐methylephedroneStimulant (S) & Entactogen (E)
Mephedrone HistoryMephedrone History 1929
S d B S h th i d (B ll ti d l S iété Chi i d F ) Saem de Burnaga Sanchez synthesised (Bulletin de la Société Chimique de France) 2003
“Kinetic” on ‘The Hive’ website synthesised 2004
Neorganics (Israel): Neodoves (to 2008, when banned) 2007
First picked up by psychonaut system, seized in France 2008
First reports in Aus (Cairns); identified in Tasmaniap ( ); 2009
Mixmag survey UK – 4th most popular drug (after cannabis, cocaine, ecstasy) Bust of NeoBase site (Tasmania)Bust of NeoBase site (Tasmania)
2010 Identified in ALL EU member states February – decent seizure in Tasmania; almost 50% of Hobart REU recent use February decent seizure in Tasmania; almost 50% of Hobart REU recent use Banned in UK in April; across EU in December Late 2010, UK: still available from dealers, price increase, quality decreased, still used
20 March, 2010
I’d been in central London buying a birthday card when I noticed a row of small packets on the counter by the till the front was decorated in bright green and orange and it on the counter by the till.....the front was decorated in bright green and orange and it had pictures of flowers and the words “Buzz Gro”. In tiny letters below it said: “water‐soluble all‐purpose plant feed”.
Out of curiosity I asked the cashier “What do you do with it?” He rolled his eyes at me: Out of curiosity I asked the cashier.... What do you do with it? He rolled his eyes at me: “Snort it, put it in a drink or wrap it in paper and swallow it,” he said with disinterest.
“What are the side effects?” I asked. He...simply shrugged while he continued to chew his gum. No mention that nobody knows the long‐term effects, the correct dose to take, g y g , ,what to expect from it or the risks.
Surely it can’t be that bad if I can buy it in a shop, I reasoned to myself. [...implicit suggestion that because it’s legal it must be safe...]
At first, I felt nothing except a slight burning sensation in my nose. A few minutes later, we were all sitting round in a euphoric haze, smiling benignly but with an incomprehensible, overwhelming desire to dance. It was nearly impossible to keep still. Th thi b i id d l d thi id dd l b Then things became very vivid and real and everything everyone said suddenly became very important. Before we knew it we were piling into a cab, laughing and giggling uncontrollably and going to a club. The effects lasted for about another two hours. Then, as suddenly as they had appeared, they vanished. I was left standing in the club with a as suddenly as they had appeared, they vanished. I was left standing in the club with a pounding headache, wondering what on earth had possessed me to go out. I can now understand why people re‐dose as soon as the effects wear off because the contrast between being intoxicated and not is sharp and sudden.
Acute Subjective Effects of Mephedrone
•Typical stimulant profileyp p•Frequent sympathomommeticphysical effects•Prosocial profileProsocial profile•Relatively infrequent adverse psychological effects
Winstock & Marsden, 2010: National Addiction Centre, London; telephone interviews, urines of n=100, mid‐2010
D C S hif Davey, Corazza, Schifano, Deluca (2010) “Mass information: mephedrone, myths & the new generation of legal highs” Drugs & Alcohol Today, 10, 24‐28.y, , 4
How people usually took mephedronep p y p First use:
>80% first snorted ~0.1g line Minority swallow or dropMinority swallow or drop Average: 6 doses (~0.6g) over next 8 hours most +alcohol ¼‐ 1/3 also +cannabis +ecstasy most +alcohol, ¼ 1/3 also +cannabis, +ecstasy
Current use: Most snort 0 1g line redose 30 60mins Most snort ~0.1g line, redose 30‐60mins Typical session: 14 hrs (SD: 16hr)T i l d / i ( ) Typical dose/session: mean 1.1g (range 0.1‐9g)
TAS EDRS 2010: 64% lifetime; 47% past 6/12, snorted
Winstock & Marsden, 2010: National Addiction Centre, London; telephone interviews, urines of n=100, mid‐2010
Withdrawal / Comedown effects/
Winstock & Marsden, 2010: National Addiction Centre, London; telephone interviews, urines of n=100, mid‐2010
Winstock & Marsden, 2010: National Addiction Centre, London; telephone interviews, urines of n=100, mid‐2010
Why Mephedrone?y p
Mephedrone: easier availability; lower price (~$30/cap vs ~$35/pill); ?mixed purity
Source: TAS EDRS 2003‐2010
Mephedrone: easier availability; lower price (~$30/cap vs ~$35/pill); ?mixed purity
UK: Forensic Science Service(analysis of seizures)(analysis of seizures)
Largely meta‐hl h lChlorophenylpiperazine
(mCPP) (previously common in NZ, strong 5‐HT i t SSRI)HT agonist, SSRI)
Dutch Information & Monitoring System
0 = no influence on use
10 = maximum 10 maximum influence possible
Winstock & Marsden, 2010: National Addiction Centre, London; telephone interviews, urines of n=100, mid‐2010
Acute Toxic EffectsAcute Toxic Effects Most common: Sympathomimetic features
Agitation* Tachycardia *(36% of presentations, 8% severe)Dil d il Dilated pupils
Hypertension Uncommon: Severe clinical features Uncommon: Severe clinical features
Chest pains Seizure (7% of presentations)Seizure (7% of presentations) Marked hypertension (14% of presentations) Arrhythmia
At least two cases where mephedrone was sole cause of death; 37+ where present + 4+ RTA
See; Wood 2010a, b case series of (72, 9) presentations between 2009‐2010
Symptoms ofSymptoms of dependencedependence
Much greater effects than ecstasy
Winstock & Marsden, 2010: National Addiction Centre, London; London; telephone interviews, urines of n=100, mid‐2010
Using khat as a neurobiological modelUsing khat as a neurobiological model Catha edulis (khat) tree leaves
Eff i i ild Effects: optimism, mild euphoria, excitation, talkativeness, increased energy & lf t& self‐esteem
Cathine & cathinone are core components Increase DA (?inducing release
&/or inhibiting re‐uptake) Esp in striatump
Similar to AM but ~1/2 potency In chronic AM use see:
D l ti D t Downregulation D2 receptors in striatum
Reduced functioning in PFC & OFC (control goal directed OFC (control goal‐directed actions)
Based on inferences from amphetamine research
Information processing speed
Executive functions Flexibility inhibiting speed
Sustained attention Complex working memory
Flexibility, inhibiting irrelevant info, abstraction
Strategic planningComplex working memory Memory (learning rather than consolidation – due to
i i &
Decision making Short vs long term
h bstrategic issues & reflecting striatal DA function)
Inhibition Impulsive (?)
function)
Underlines = continue ~months into abstinence
Cognitive deficits associated with gmethamphetamine (dependence)
↓ cog flexiblity(switch);(switch);
↓ strategic planning
↓ i hibit ↓ inhibitory control (SST; go‐nogo; stroop)stroop)
↓ sustained attention
k Riskier decision making, h short‐term focus
↓memory d l
yand learning
Scott et al, 2007 Meta‐analysis
Cohen’s d = 1.8
Demographics of EPS consumersDemographics of EPS consumers(National EDRS 2010 n=693)(National EDRS, 2010, n=693)
No EPS Stimulant EPS Psychedelic (n=497) (n=104) EPS (n=92)
Male 56 61 71***
( ) ***Age (<21) 37 58*** 45
Jurisdiction (small/isolated) 40 61*** 42
S l f (%GLBT)Sexual preference (%GLBT) 14 13 19
Did not complete year 12 18 17 20
U l dUnemployed 14 12 20
In drug treatment 4 3 3
Ecstasy useEcstasy use
Age first used <16 11 5 23***
Used ecstasy weekly+ 21 23 19Used ecstasy weekly+ 21 23 19
Usually take 2+ tablets 71 78 75
Drug use of EPS consumersDrug use of EPS consumers(National EDRS 2010 n=693)(National EDRS, 2010, n=693)
No EPS Stimulant EPS Psychedelic (n=497) (n=104) EPS (n=92)
Use ‘party drugs’ weekly+ 30 40* 41*
l h l d l *Alcohol – daily 8 7 15*
Tobacco – daily 34 42 60***
C bi d il ***Cannabis – daily 11 11 32***
Methamphetamine – last 6/12 53 57 67**
C i l t 6/Cocaine – last 6/12 47 52 52
Psychedelics – last 6/12 35 51** 75***
Ketamine last 6/12 10 17* 19*Ketamine – last 6/12 10 17* 19*
GHB – last 6/12 4 7 12**
Amyl nitrate / nitrous last 6/12 33 47** 66***Amyl nitrate / nitrous – last 6/12 33 47 66
kRisks & Harms amongst EPS consumers(National EDRS 2010 n=693)(National EDRS, 2010, n=693)Last 6 months No EPS Stimulant EPS Psychedelic
(n=497) (n=104) EPS (n=92)Mental health problem 27 25 44**
l dStimulant overdose 9 8 13
Depressant overdose 14 18 13
A d h l h i d d 6Accessed health services due to drugs 17 16 20
Access psychotherapy due to drugs 13 12 22*
Bi ti l t ( 8h ) * ***Binge stimulant use (48hr+) 30 41* 49***
Use cause repeated social problems 19 19 28*
DSM IV ‘Substance Abuse’ 54 64 63DSM‐IV Substance Abuse 54 64 63
Drive under influence drugs 41 50 44
Unprotected sex casual partner 38 49* 40Unprotected sex casual partner 38 49 40
Income from crime in past month 7 12 21***
Harm reduction suggestions for EPSHarm reduction suggestions for EPS Don’t use
Especially if existing conditions (inc pregnancy!) & psychotropic medications
Don’t think that the online sellers actually know what Dont think that the online sellers actually know what they are doing, despite the ‘scientific’ presentation
Don’t the first be to useDon t the first be to use The ‘new line’; a new delivery; or amongst your group
If you do usey Avoid other drugs (inc alcohol), especially stimulants Minimise psychobiological distress (inc binges) Don’t use regularly, and cap the amount per session Bombing > Shelving/Shafting > Snorting > Injecting Think safe sex Think safe sex Don’t be afraid to access help early if things aren’t good
Incoming!Incoming!1‐(benzofuran‐6‐l) N methyl 1 (thiophen 2 yl) yl)propan‐2‐aminePhenethylamine analogStimulant/entactogen
N‐methyl‐1‐(thiophen‐2‐yl) propan‐2‐amineSubstituted methamphetamine
1‐ethynyl‐1‐cyclohexanolAlcohol family ?g like?
2‐(1H‐indol‐3‐yl)‐1‐methyl‐ethylamineSubstituted tryptamine Alcohol family, ?g‐like?Substituted tryptamine(? Monoamine releaser)
5,6‐Methylenedioxy‐2‐aminoindane“woof woof”(h il ) b d
2‐(3‐methoxphenyl)‐2‐(ethylamino) (heavily) substuted
phenethylamineMonoamine reuptake inhibiter; weaker effects
(ethylamino) cyclohexanoneMXE; MKETKetamine analog;
than MDMAKetamine analogDissociative anesthetic
Where to hunt for informationWhere to hunt for information