Cathinones Use in Paris
BACKGROUND:
The
pattern of recreational drug use has changed over the last decade and now
includes a multitude of substances sold as "research chemicals" or
new psychoactive substances, "NPS". In France, synthetic cathinones
emerged in 2008 (while first mentioned by the French police force in
2007 first alerts among users appeared in 2008) and have grown to be
popular drugs of abuse. Under the Official Journal dated
11th June 2010, only mephedrone has been listed as narcotics but
"designer drugs" have synthesized new substitute cathinones in order
to avoid anti-drug laws. However, since July 2012, in France, all
synthetic drugs from the cathinones family have been banned and listed as
narcotics following the example of United Kingdom. Despite their recent
classification and inclusion on narcotic list, they are readily available on
Internet and used widely. Paris Addictovigilance Centre observed a signal of
derivate cathinones abuse (21 cases over a two-year period).
OBJECTIVE:
Paris
Addictovigilance Centre and Marmottan Hospital wanted to describe the use of
cathinones in the Paris area and alert the health care community about the
abuse identification and risk assessment problems of these compounds. After a
review of derivated cathinone's chemical structure, pharmacology and
toxicology, this article seeks to provide patricians with a clinical
description and treatment's modality.
RESULTS:
Most
users of synthetic cathinones will experience euphoria, increased energy,
talkativeness, openness and increased sexual arousal. Signs and symptoms of
toxicity are consistent with a sympathomimetic toxidrome. The main reasons for
care access are psychiatric (hallucinations, psychotic symptoms, agitation) and
addiction disorders. Somatic complications were described with various patterns
of symptoms such as headache, tachycardia, confusional states, rhabdomyolysis
with renal failure or serotonin syndrome. The most important fact is the
apparition of the "slam" phenomenon among men who have sex with men
(MSM). The "slam" is a compound of three characteristic elements:
injection, sexual party and psychostimulant drug. According to users,
"slam" is convenient for group sex and is used it to put them into a
good mood and a disinhibition state. These compounds cause fast dependence
syndrome with strong craving and prolonged psychiatric symptoms and increase
infectious risk (HIV, VHC, VHB…). The cathinones family is not detected in
conventional urine drug screenings. We point out the lack of confirmatory
analytic testing data which remains the only way to determine the actual
etiology of the clinical effects observed since drug users do not always know
exactly what they took. These substances can be identified by special analyses
using gas chromatography or liquid chromatography and mass spectroscopy
technology.
CONCLUSION:
This
injection drug is used in order to increase sexual desire, delay orgasm and
decrease sexual inhibition and is prevalent in many studies on MSM samples.
Cathinones would popularize the "slam". Harm reduction policy
requires specific MSM interventions on both sexual and drug addiction networks.
- 1CEIP-Addictovigilance, hôpital Fernand-Widal, 200, rue du Faubourg-Saint-Denis, 75010 Paris cedex 10, France. Electronic address: anne.batisse@lrb.aphp.fr.
- 2Centre Marmottan, 17-19, rue d'Armaillé, 75017 Paris, France. Electronic address: murielgreg@hotmail.com.
- 3CEIP-Addictovigilance, hôpital Fernand-Widal, 200, rue du Faubourg-Saint-Denis, 75010 Paris cedex 10, France.
- Encephale. 2016 Feb 1. pii: S0013-7006(15)00163-3. doi: 10.1016/j.encep.2015.09.002.
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