Synthetic cathinones

What are synthetic cathinones?

Synthetic cathinones is the name of a category of drugs related to the naturally occurring khat plant.² 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.

Synthetic cathinones are the second largest group of new substances monitored by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), with 130 detected in total — including 12 detected for the first time in 2017.³

Synthetic cathinones are mostly white or brown powders but can also be in the form of small, chunky crystals. They are sometimes found as capsules and less commonly as tablets.⁴

Other types of cathinones:

• Mephedrone (4-MMC), M-CAT)
• Methylone
• Methcathinone
• Buphedrone
• Bupropion
• Pyrovalerone
• Alpha-Pyrrolidinovalerophenone (alpha-PVP) · MDPV. ^4,5,6

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.⁷

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.⁶

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.⁶

Mixing synthetic cathinones with other drugs

Mixing synthetic cathinones with other drugs can have unpredictable effects and increase the risk of harm.

• Synthetic cathinone's and opioids: can increase the risk of heart strain and respiratory arrest.
• Synthetic cathinone's and MDMA: can cause anxiety, heart strain, and increased neurotoxic effects.
• Synthetic cathinone's and cocaine: can cause anxiety and heart strain which can lead to stroke.
• Synthetic cathinone's and benzodiazepines: can decrease/mask the effects of both. Risk of overdose if one wears off before the other – depending on amount taken.
• Synthetic cathinone’s and alcohol: may feel less intoxicated due to stimulant effects of amphetamine and lead to drinking more.^2,7,8,9

Reducing harm

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.

There are ways in which you can reduce the risks associated with using synthetic cathinones:

• Always test a small amount first and wait to feel effects before taking more
• try to eat regularly even if you are not hungry. Eat fresh healthy food such as fruit and vegetables that are high in vitamins and nutrients.
• try to rest and get sleep.
• stay hydrated. People can become dehydrated when using synthetic cathinones, take small sips of water regularly.
• Avoid if you have a history of mental health issues.
• Regular use of synthetic cathinones can increase the risk of heart attack or other heart problems. Using less frequently and smaller amounts of amphetamines may reduce this risk.^4,10

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 (high blood pressure)
• delirium
• aggressive behaviour
• hallucinations
• hyperthermia
• cardiac dysrhythmia (irregular heart beat)
• seizures. Deaths have also occurred due to alpha-PVP toxicity.5 Injecting synthetic cathinones can cause soft tissue and vascular damage.5Sharing 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 heal⁴
• memory loss
• depression
• anxiety
• tremors
• problems sleeping
• paranoia.

Getting help

If your use of synthetic cathinones is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find help and support.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs

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If you're looking for other information or support options, send us an email at druginfo@adf.org.au