Synthetic cathinones

What are synthetic cathinones?

Synthetic cathinones is the name of a category of drugs related to the naturally occurring khat plant.¹ They are stimulants, meaning that they speed up the messages between the brain and the body and have similar effects to amphetamines.

Synthetic cathinones are also part of a group of drugs known as New Psychoactive Substances (NPS). NPSs are a range of drugs that first appeared on the recreational drug market in the mid 2000s, that have been designed to mimic established illicit drugs, such as cannabis, cocaine, ecstasy and LSD. Between 2005 and 2014 more than 81 synthetic cathinone derivatives were reported to the EU Early Warning System.²

Synthetic cathinones are mostly white or brown powders but also exist in the form of small, chunky crystals. They are sometimes found as capsules and less commonly as tablets.³

Types of cathinones commonly used

• Mephedrone (4-MMC), M-CAT)
• Methylone
• Methcathinone
• Buphedrone
• Bupropion
• Pyrovalerone
• Alpha-Pyrrolidinovalerophenone (alpha-PVP)
• MDPV.^3,4,5

How are they used?

Synthetic cathinones are usually snorted, swallowed or injected.

When taken orally the desired effects are typically seen within 15–45 minutes. After snorting the desired effect is anecdotally reported to occur within a few minutes. The effects usually last for approximately 2-4 hours.⁶

Effects of synthetic cathinones

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Synthetic cathinones affect everyone differently, based on:

• the amount taken
• a person’s size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the strength of the drug (which can vary from batch to batch).

The individual effects and toxicity of each cathinone are distinct and can vary greatly between each person using them.

Generally speaking, in small doses the following effects may be experienced and may last for approximately 2-4 hours:

• rush of intense pleasure
• feeling happy, energetic and wanting to talk more
• intense connection with music
• restless sleep
• muscle tension (face and jaw)
• blurred vision
• light-headedness, dizziness
• distorted sense of time
• enlarged (dilated) pupils, blurred vision
• dry mouth, thirst
• sweating
• memory loss
• reduced appetite.⁵

Higher doses may result in the following adverse affects:

• anxiety
• paranoia
• nose bleeds from snorting the drug
• stomach pains, nausea, vomiting
• skin rashes
• fast or irregular heartbeat
• high blood pressure and hot flushes
• strong urge to re-dose
• chest pain
• tremors, convulsions, death.⁵

Using synthetic cathinones with other drugs

The effects of combining cathinones with other drugs – including over-the-counter or prescribed medications – can be unpredictable and dangerous. The following combinations could have the following effects:

• Synthetic cathinones + ice, speed or ecstasy: increase the risk of cardiovascular (heart) problems and substance-induced psychosis.7
• Synthetic cathinones + alcohol + cannabis: nausea and vomiting.⁶

Health and safety

If possible, find out the specific cathinone you are using so you know what to expect and what a common dose is. Synthetic cathinone harm reduction advice is partly based on what is known of related drugs like amphetamines and MDMA, as not enough research has been done on individual synthetic cathinones specifically.

Use of synthetic cathinones is likely to be more dangerous when:

• taken in combination with alcohol or other drugs, particularly stimulants such as crystal methamphetamine (‘ice’) or ecstasy
• driving or operating heavy machinery
• judgment or motor coordination is required
• alone (in case medical assistance is required)
• the person has a mental health problem
• the person has an existing heart problem.

In Australia, poisons information centres and clinical toxicology units around Australia are often contacted for advice on poisonings from synthetic cathinones. Features of these poisonings include agitation, tachycardia (increased heart rate), hypertension and in severe cases delirium, aggressive behaviour, hallucinations, hyperthermia, cardiac dysrhythmia (irregular heart beat) and seizures. Deaths have occurred due to alpha-PVP toxicity.⁴

Injecting synthetic cathinones can cause soft tissue and vascular damage.⁴

Sharing needles may also transmit:

• Tetanus
• Hepatitis B
• Hepatitis C
• HIV/AIDS.

Dependence and tolerance

There is limited data regarding people seeking treatment for synthetic cathinone dependence, however, people who use synthetic cathinones have reported a strong compulsion to redose, as well dependence.

Coming down

In the days after synthetic cathinone use, the following may be experienced:

• restless sleep
• tiredness
• dizziness
• low mood
• wounds, sores taking longer to heal
• memory loss
• depression
• anxiety
• tremors
• problems sleeping
• paranoia.