Mephedrone (Methylmethcathinone) in Toxicology Casework: A Northern Ireland Perspective

Abstract

Mephedrone (4-methylmethcathinone) is the beta-keto analogue of 4-methylmethylamphetamine. Before its control in April 2010, it became popular as a legal high in the United Kingdom, displacing methylenedioxymethylamphetamine as the stimulant drug of choice. The drug has stimulant and psychoactive properties, and therefore has forensic significance in criminal and morbid toxicology. The purpose of this study was to survey casework involving the drug (impaired driving and sudden death). The cases were received in the laboratory for analysis between late 2009 and the end of 2010. Analysis of blood samples for mephedrone was conducted by liquid chromatography-mass spectrometry (LC-MS). Routine screening for alcohol and a range of other pharmaceuticals and drugs of abuse was conducted using a combination of enzyme-linked immunoassay, gas chromatography (GC) headspace, GC-MS and high-performance liquid chromatography with diode array detection. Mephedrone was detected in a total of 12 fatal cases. Most of these cases involved death by mechanical means; in two cases, death was attributed directly to mephedrone intoxication (blood concentrations of 2.1 and 1.94 mg/L). Mephedrone was detected in a total of 32 impaired driving cases. Blood concentrations ranged up to 0.74 mg/L (mean 0.21, median 0.10). The casework evidence in this study indicated that recreational use of the drug can produce to blood levels as high as 0.74 mg/L, although the most common value encountered is likely to lie between 0.2 and 0.3 mg/L.

Mass Spectrometric Evaluation of Mephedrone In Vivo Human Metabolism: Identification of Phase I and Phase II Metabolites, Including a Novel Succinyl Conjugate

“…There are several reported fatalities in Europe in which mephedrone intoxication appears to be the sole cause of death (Torrance and Cooper, 2010;Lusthof et al, 2011;Maskell et al, 2011;Adamowicz et al, 2013;Cosbey et al, 2013), and it has also been detected in numerous postmortem biologic samples of fatal cases in which the cause of death was not specifically mephedrone (Torrance and Cooper, 2010;Maskell et al, 2011;Schifano et al, 2012;Cosbey et al, 2013). Abuse of mephedrone has been documented since 2007; it was originally a "legal high" drug, but has now been banned in most Western countries.…”

“Legal Highs” – An Emerging Epidemic of Novel Psychoactive Substances

“…The highest number of fatal intoxications have been reported for mephedrone Cosbey, Peters, Quinn, & Bentley, 2013;Elliott & Evans, 2014) and MDPV (Elliott & Evans, 2014;EMCDDA, 2014b). In the majority of those cases, the drugs were identified postmortem.…”

“…Most of the victims were young males with a previous history of drug abuse. In the case of mephedrone, there was a notable number of deaths that involved self-harm, mainly from suicidal hanging Cosbey et al, 2013). Other reported and analytically confirmed fatalities involved BZP (Monteiro et al, 2013), cathinones such as methylone, butylone, 2-methylamino-1-(3,4-methylenedioxyphenyl) butan-1-one (bk-MBDB), methcathinone (ephedrone), and 4-methylethcathinone (Rojek, Kłys, Maciów-Głąb, Kula, & Strona, 2014;Zawilska & Wojcieszak, 2013), 5-IT (EMCDDA, 2014c; Kronstrand et al, 2013;Seetohul & Pounder, 2013), 2-DPMP (Corkery, Elliott, et al, 2012), and MDAI (Corkery et al, 2013).…”

Trends of novel psychoactive substances (NPSs) and their fatal cases

“…A high concentration of mephedrone in the femoral blood (5100 ng/mL) and traces of cocaine, MDMA, and oxazepam were detected by toxicological analysis. Mephedrone was identified in the tablet (approximately 140 mg/tablet) and a trace amount of [19] reported fatal cases from Ireland from 2009 to 2010, among which mephedrone was detected in 12 cases. In two cases among them, the cause of death was confirmed as mephedrone intoxication, where the blood concentrations were 2100 and 1940 ng/mL.…”