Pyrethroid as a Substance of Abuse

Abstract

This is a case of a 22-year-old Hispanic male with a history of bipolar disorder and methamphetamine dependence who was admitted after presenting with suicidal ideations by slashing his throat with a machete. The patient had been smoking and inhaling “processed” pyrethroid for about eight weeks as an inexpensive methamphetamine substitute. He reported experiencing a “rush” similar to methamphetamine after using pyrethroid from liquid insecticide that had been heated (electrocuted) or sprayed on hot metal sheets until it crystallized. The patient presented with no significant physical markings or findings but claimed to have his suicidal ideations precipitated by concerns of ill effects of pyrethroid on his health. He also had positive urine drug screen for methamphetamine, which he admitted to using on the day of admission. We conclude that it is important for physicians to maintain a high level of suspicion for alternate and uncommon substances of abuse as well as risks for suicidal tendencies in these patients.

Emergence of wasp dope in rural Appalachian Kentucky

“…Transportation access was defined by a response to: 'In the past 6 months, have you been unable to do something you needed to do because you did not have a way to get there?'. Rurality and socio-economic indicators were examined because they could impact drug availability and affordability, both of which emerged as factors in prior case studies [14,15]. Rurality was examined at the county-level using a three-level variable corresponding to counties' Rural-Urban Continuum Codes (RUCC), which classifies counties on a scale from 1 (most urban) to 9 (most rural) [22].…”

“…Pyrethroids are known to produce potent sympathetic activation, salivation, hyperexcitability, choreoathetosis and seizures [12] and are probably responsible for giving wasp dope users a 'rush'. Pyrethroids have a half-life of tens of hours [12] and in animal studies of toxicity have produced elevated plasma levels of adrenaline and noradrenaline [12,13], potentially contributing to wasp dope's reported effects [14].…”

“…To our knowledge, there is no published epidemiological or behavioral research on the use of wasp dope, only a letter to an editor [15], a few case reports [14,16] and a conference abstract describing inhalation with synthetic cannabinoids [17]. The letter to the editor described a 56year-old man hospitalized in Tennessee following multiple wasp dope injections after being unable to obtain methamphetamine due to cost.…”

“…Case reports from Texas revealed very similar situations involving two young adult men with a history of methamphetamine use [14,16]. In one case, the man transitioned to inhaling or smoking crystalized cockroach killer containing pyrethroid when he became unable to afford methamphetamine.…”

“…In one case, the man transitioned to inhaling or smoking crystalized cockroach killer containing pyrethroid when he became unable to afford methamphetamine. The man reported a methamphetamine-like high, olfactory hallucinations, increased heart rate and suicidal ideation, although the latter may have been due to untreated bipolar disorder [14]. The other case involved intravenous use of a pyrethroid-containing compound, but details of his transition to wasp dope use and its reported effects were lacking [16].…”