Miaow-miaow on trial: Truth or trumped-up charges?
"Legal high kills two teens," cries the Daily Express. "Legal drug teen ripped his scrotum off," roars The Sun. A steady stream of stories in the UK media about a little-known "legal high" variously called mephedrone, plant food, miaow-miaow or m-cat reached fever pitch this month. Newspapers, teachers and parents demanded an immediate ban. Les Iversen, the UK government's chief drugs adviser, recommended that the drug be put in the same class as amphetamines, making possession punishable by five years in prison. The government is likely to announce plans for an emergency ban that could be enacted within days.
This knee-jerk response may be unsurprising, but what is far from clear is whether criminalisation is the right thing to do to reduce drug harms. While mephedrone has been implicated in at least 27 deaths in the UK, it has been confirmed present in just 11 of these cases and at the time of writing found to be a contributing factor in just one. There is virtually no published research on how the substance affects the human body. Iversen himself recently admitted that "there is no data on toxicity that I could find". Intrigued at the rush to action despite the lack of hard evidence, I decided to try to sort the facts from the frenzied speculation (see "Miaow-miaow myths").
Khat to chat
Mephedrone is a synthetic analogue of the herbal amphetamine cathinone, found naturally in the leaves of the khat plant, Catha edulis. Chewing khat leaves is a popular ritual in some east African communities. Mephedrone, or 4-methylmethcathinone, is part of a family of synthetic cathinones created to mimic khat's stimulant properties.
Its precise origins are unclear, though early reports suggest it was being supplied by an Israeli legal high seller called Neorganics as far back as 2007. Fearing it would affect army conscripts, the government there banned mephedrone later that year.
Around that time, mephedrone began appearing on internet chat forums, and the drug seems to have spread rapidly since then: significant use is now reported in Sweden, Finland, the UK, Ireland and Australia. The vast majority of mephedrone is produced in China and sold to dealers for between £2500 and £4000 per kilogram. No one knows how much is being exported globally.
What is clear is that a lot of people are using it. An online survey of 2222 readers of British clubbing magazine Mixmag, published in January, suggested that mephedrone had become the fourth most popular drug among the readers of the website after cannabis, ecstasy and cocaine. Thirty-four per cent of respondents said they had taken it in the previous month. "We've never had a drug become so popular so quickly about which we know so little," says Fiona Measham, a criminologist at Lancaster University in Bailrigg and member of the UK government's Advisory Council on the Misuse of Drugs (ACMD).
The emergence of legal highs should come as no surprise. "When restrictions are placed on the supply of drugs and demand remains high you get substance displacement," says Danny Kushlick of Transform, a UK think tank opposed to drug prohibition.
Key to mephedrone's extraordinary rise in Europe has been the recent success of crackdowns on ecstasy and cocaine supply: there was a drop in purity of cocaine seized by the police in England and Wales from over 60 per cent in 1999 to 22 per cent in 2009, and about half of ecstasy pills seized last year contained no MDMA, ecstasy's active ingredient.
"When you're buying [controlled] drugs on the street you have no idea what you're getting. You can spend £100 and get nothing," a regular user of mephedrone told me. The 37-year-old, who wishes to remain anonymous, switched from taking ecstasy and speed about two years ago. "With mephedrone you can walk into a head shop or go online and feel safe going back to the same supplier."
I decided to see for myself how easy it would be to get hold of mephedrone. A quick online search for "mephedrone" revealed hundreds of websites. Moments later I was on the phone ordering a special delivery of 5 grams of "plant food" for £60, plus £25 for a courier service. Two hours later a courier called from outside my house. He insisted I sign a disclaimer saying I knew mephedrone was not for human consumption, then handed over a brown, padded envelope. Inside was a small plastic bag half-full of white powder.
I sent a sample to Mark Parkin at the Department of Forensic Science and Drug Monitoring at King's College London. Parkin compared a detailed chemical analysis of the compounds present with a reference sample. He found the two were "95 to 98 per cent identical". The remainder was likely to be unreacted precursor chemicals, Parkin says.
My sample was as pure as they come.
I began to entertain the idea of trying the drug, to find out for myself about its effects and to enable me to gain a more informed perspective. I had concerns about the effects on my health: I had been warned that large doses could probably kill those at particular risk by inducing a heart attack.
Nevertheless, I reasoned, we all take risks. I go rock-climbing and snowboarding, not to mention crossing the roads of London. But I resolved that before trying it I would find out as much as I could about its effects.
The basic problem with any discussion of mephedrone is the lack of reliable data on its effects, toxicity and prevalence of use. While the effects of some substances that have become popular as recreational drugs in recent years have previously been studied for their potential medical use, such as ketamine and GHB, there are practically no published studies on mephedrone – just user surveys and anecdotal accounts.
Users describe taking the drug as similar to taking ecstasy or amphetamine. Reported effects include increased energy levels, euphoria, alertness, sociability, pupil dilation, palpitations, jaw grinding, blurred and twitchy vision, cold or blue fingers, anxiety, paranoia, increased heart rate and a heightened sex drive.
"Any psychoactive substance carries with it a set of unpredictable acute and long-term risks," says Adam Winstock, from the National Addiction Centre at King's College London, who carried out the Mixmag survey. Winstock adds that from the little that is known about the substance's toxicology, groups he would advise to steer clear of mephedrone include those aged 21 or under, anyone with mental health problems, those with neurological, cardiac or blood pressure conditions and anyone with a history of alcohol or drug problems. I fall into none of these categories.
I decided to take a small quantity of mephedrone and measure some of my vital signs throughout the experience to record changes to my heart rate, blood pressure and body temperature (see "My mephedrone moments"). As you will by now have surmised, I survived.
That's not so surprising. In 2001 Alasdair Forsyth, now at Glasgow Caledonian University in the UK, illustrated how the public's perception of drugs' risks is distorted by selective reporting. He published a 10-year review of drug deaths in Scotland which showed that the chances of newspapers reporting a death from an overdose of paracetamol (acetaminophen) was 1 in 250, a death from amphetamine was 1 in 3 and that every death from ecstasy was reported.
David Nutt, who set up the UK's new Independent Scientific Committee on Drugs after being sacked by the government from his position as chairman of the ACMD, published a paper last year stating that there was a serious adverse event when horse-riding in about 1 in 350 exposures, compared with about 1 in 10,000 for those taking ecstasy.
Dirty and dangerous
That's not to say that taking mephedrone is without risk. I experienced a significant increase in heart rate from 80 to a peak of 110 beats per minute after snorting the drug. "A sustained increased heart rate of over 100 beats per minute could mean there is not enough time for the heart to fill properly, leading to a fall in the volume of blood being pumped," says Ann Robinson, a London-based general-practice doctor. "In susceptible individuals, this could trigger a heart attack or even sudden death." I also took a smaller dose compared with what other users report taking. The dangers of larger or more frequent doses are unknown.
The UK's putative ban will add it to a growing number of nations prohibiting the substance. In the US, mephedrone's chemical similarity to MDMA means it is banned under the Controlled Substances Act. Mephedrone possession is a criminal offence in at least 13 other countries.
Some think a ban would do more harm than good. "We know what happens when you make demand-led drugs illegal," says Kushlick. "All you do is push the price up and hand the trade to organised criminals. You make it dirty and dangerous, and you force people into acquisitive crime to support an expensive habit."
And even if the UK ban on mephedrone works, it won't be long before an alternative comes along. "We've seen designer drugs appearing over many years but the rate at which they are appearing is speeding up," says Les King, a former member of the ACMD and current member of the Independent Scientific Committee on Drugs.
Indeed, in the last five years, piperazine derivatives such as BZP and CPP, synthetic cannabinoids including "spice" and now synthetic cathinones including mephedrone have come along in quick succession.
"The internet has provided a whole new business model for selling legal highs," says King. Globalised trade and internet marketing have facilitated the emergence of large numbers of entrepreneurs, mainly in China, Cambodia and other Asian countries, who watch designer-drug trends and develop new varieties in advance of governments banning existing products.
Last year the European Monitoring Centre for Drugs and Drug Addiction warned that the legal highs market was constantly one step ahead of the authorities. It called for improved monitoring of emerging trends and quicker, more flexible approaches to controlling substances.
The Psychonaut Web Mapping Project, a pan-European effort to track trends in legal highs, built up a database of more than 400 novel substances over the last two years by monitoring some 200 internet forums.
In an attempt to avoid having to deliberate on each individual compound as it appears, the ACMD is likely to advised the UK government to control not just mephedrone but a whole group of synthetic cathinones, including those such as methylone and butylone, which are already emerging as recreational drugs, and others not yet in widespread use.
But even that won't stall things for long. Police in Europe and the US have already seized drugs from a completely new family of compounds now being sold as legal highs. Chinese manufacturers are said to be offering this family of substances for sale. If the recent past is anything to go by, large scale production, marketing and sales operations for the new compounds will not take long to set up once synthetic cathinones have been made illegal.
There are those who are opposed to prohibition on the grounds that such legislation infringes a basic human freedom over the control of our states of mind. "Altered states of consciousness are viewed by governments as negative if achieved through drugs," says Richard Glen Boire, a lawyer and founder of the California-based Center for Cognitive Liberty and Ethics. "You can go to a soccer stadium of 60,000 fans who are clearly in altered states, and that's permitted. Societies must come to terms with the fact that the urge to alter our states of consciousness is a natural human drive."
Others say what is needed is a proper assessment weighing the real harms caused by the drug and, crucially, of the harms that criminalisation could cause. Another option is the so-called "Class D" approach. BZP was widely used in New Zealand during the first few years of the new millennium. In 2005 the nation's parliament introduced controls that fell short of a ban, making it illegal to sell the drug to anyone under 18, to give it away or advertise it. The aim was to introduce controls while gathering evidence on harms. Two years later the government's advisory committee reported there was moderate risk of harm and in 2008 it was banned.
This "holding position" was the option proposed in the UK by the ACMD under Nutt last year but rejected by the government, which banned BZP in December. Nutt, who was later sacked over his outspoken opposition to official policy on ecstasy, claims this ban is partly responsible for the rise of mephedrone in the UK.
Meanwhile, the inaccuracies and sensationalism of the mainstream media in its approach to reporting on drugs can only hasten its already diminishing relevance to the generation that is more likely to trust what it reads on Twitter and Facebook. "What we are seeing with mephedrone is an example of the coming-of-age of the internet in terms of disseminating awareness about a drug and as a method of supply and distribution," says Martin Barnes, chief executive of UK drugs charity Drugscope and a member of the ACMD.
How effective the UK government's ban will be against mephedrone and related synthetic cathinones remains to be seen. Recent history suggests that criminalisation is unlikely to significantly reduce overall drug-related harms, while there are clear indications that it will make matters worse overall.
The bottom line is that the demand for thrills from drugs, legal or otherwise, remains undiminished, and those making money by supplying this demand will find a way to continue doing so. Until humans no longer seek to alter their state of mind through intoxication, the cat-and-mouse game over miaow-miaow and its successors will continue.
My mephedrone moments
A powerful rush hits my brain, leaving me light-headed and disorientated. My left nostril burns and a bitter taste leaks into the back of my throat. The rush has hit just 3 minutes after I'd snorted a full line of mephedrone through a banknote off my dining room table…
I have never taken ecstasy or any amphetamine – the drugs mephedrone is most often compared to. I was also warned that large doses could probably kill particularly vulnerable users, by inducing a heart attack. I decided to try it in order to make an informed and objective appraisal of its effects – a first-hand experience seemed the most honest way of doing so.
One evening I got together with a "clean" friend watching over me to try mephedrone. Curious to know its impact on my vital signs, I first measured my heart beat – 80 beats per minute – my blood pressure – 113/66 millimetres of mercury – and body temperature at 35.9 °C. Users report a typical dose to be 100 to 200 milligrams, so I measured out and took 10 milligrams of the drug as a precautionary test. The only effect was a mild burning sensation in my nostril.
I waited for half an hour – by which time, most users say, the effects of a hit begin to subside – and snorted a 30-milligram line of the white powder. This led to a gentle, light-headed feeling and the dilation of my pupils.
After waiting another 30 minutes, I took a further 100 milligrams. This time the burning sensation in my nostril was stronger. I did not have long to wait before a powerful head rush hit. I felt a little unstable, my heart pounded and I felt palpitations. My heart rate was up to 85 bpm and my blood pressure to 175/86. A feeling of euphoria swept over me. I became more sociable, talkative, attentive and relaxed. Sixteen minutes after taking the full dose, my heart rate and blood pressure peaked at 110 bpm and 179/89. My temperature had increased to 36.8°C.
Over the next 90 minutes these effects gradually lessened and my vital signs returned to normal. An hour after that I went to bed and fell asleep easily enough. After 3 hours sleep I woke up from an intense nightmare in which two friends were keeping me prisoner in a room, through intimidation and occasional violence. My heart was pounding and fluttering, and my feet were excessively sweaty. I went back to sleep and awoke a few hours later feeling a bit tired but otherwise normal.
Myth 1: The missing scrotum
In November 2009 The Sun newspaper in the UK published a story under the headline: "Legal drug teen ripped his scrotum off". Quoting a police report, the paper said an unnamed teenager high on mephedrone needed hospital treatment after he tried to "rip off his testicles". Acting Sergeant Michael Urwin, of Barnard Castle, County Durham, later pointed out that this headline-grabbing tale and other aspects of his report to senior officers had been cut-and-pasted from blogs and internet forums. "That particular information came from a section of a mephedrone vendor website under the heading 'Experiences'," Urwin told New Scientist. The Press Association agency, which sends out its copy to most newspapers and TV channels, obtained the police report, wrote up the scrotum story but omitted a warning in this report that it had come from an internet site and so may or may not have been true, says Urwin. The owner of a mephedrone source website told New Scientist that the story had been published online as a joke. It has been repeated as fact by dozens of news outlets around the world.
Myth 2: Girl dies of mephedrone use
Gabrielle Price, 14, died after taking the drug at a party in Brighton in November 2009. News reports linked her death with mephedrone. The results of toxicology tests three weeks later showed the cause of death was "cardiac arrest following broncho-pneumonia which resulted from streptococcal A infection". This received much less coverage. Despite this verdict, her case is still being quoted as "linked" to use of the drug. At the time of writing, only one of 27 fatalities claimed to have been caused by mephedrone have actually turned out to be so.
Myth 3: It's plant food
Virtually every media outlet – including the BBC and The Guardian – described mephedrone as plant food. You might think this was merely a savvy way of using its street name, but you'd be wrong, as were they. BBC Radio 2 presenter Jeremy Vine even expressed his astonishment that people would put plant fertiliser up their nose. A full week later The Guardian still thought it was "commonly used as plant food". It is not. At about £12 per gram, it would be a rather expensive way to boost your tomato crop.
The "plant food" moniker is purely a marketing tool, to get around the fact that it is illegal to sell for human consumption. Had the journalists concerned checked the top Google hit for "mephedrone", they would have found references to legal highs, "head candy", an image of a big yellow smiley face and a photograph of someone snorting "plant food" off a woman's bare bottom. Or they could have just checked with a keen gardener.
29 March 2010
by Nic Fleming
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Miaow-miaow on trial: Truth or trumped-up charges?