29 November 2009

MMCAT Madness

The bulletin boards of the UK drug scene, the media and drug agencies are all talking about the same drug MMCAT (also known as mephedrone). For those readers unfamilar with this drug there's a briefing on the KFx website at http://www.kfx.org.uk/mmcat2009.pdf

MMCAT is a relative newcomer to the drugs scene and is probably one of the best examples of a true designer drug that has gone global in a couple of years. Developed and marketed in Israel in 2007, it started to crop up in the UK early 2008 and by late 2009 has reached a high level of market penetration.

Drug discussion boards, music and party sites are full of mephedrone discussion. It's become an increasingly popular stimulant, lawful to possess, Ecstasy-like effects and perceived safety all make it a drug likely to be the must-have as the festive season approaches.

The emergence of MMCAT highlights the inadequacies of current Government drugs policy and strategy. Despite the fact that MMCAT has been available for over two years, it has not been the subject to any assessment of risk, review, or any efforts made to regulate or control the trade.

In March 2009 the ACMD wrote to the Home Office http://drugs.homeoffice.gov.uk/ACMD_Letter_to_Home_Secreta1.pdf partly to tellthe Home Secretary that they had an Early Warning system to provide information about trends. On this occasion the system appears to be sadly lacking as, while the letter speaks of looking at Spice, it doesn't mention Mephedrone at all.

However, prodded in to action by a recent flurry of media interest, the Home Office was reported on Sky as saying "The ACMD are looking into it as a priority as part of their review into legal highs....they will report back next year and their advice will inform our response to these substances." http://news.sky.com/skynews/Home/UK-News/Party-Drug-Meow-Meow-Sold-Online-As-Mephedrone-Teenager-Gabi-Prices-Dies-After-Taking-Legal-High/Article/200911415468664?lpos=UK_News_First_Home_Article_Teaser_Region_7&lid=ARTICLE_15468664_Party_Drug_Meow_Meow_Sold_Online_As_Mephedrone%3A_Teenager_Gabi_Prices_Dies_After_Taking_Legal_High

However, with the ACMD currently without Chair, following the Home Office intemperate decision to sack Professor David Nutt, the festive season approaching and a general election after this, the odds are that it will be a good six months before any legislation can be put before Parliament.

The legislation alone could prove challenging. The UK has relatively wide ranging catch-all drug clauses within the Misuse Of Drugs Act, which covers many of the Phenylethylamine family of drugs. This legislation, widened after Ecstasy (MDMA) became popular, was intended to ensure drugs based around the same 'parent' as Ecstasy would also be illegal, even if they had molecular differences.

Now MMCAT is built on a cathinone base; this is the same compound present in Catha Edulis, the African plant Khat which is widely used in Sub-Saharan Africa. While Khat is currently legal in the UK, specific components and related compounds are not: so cathinone and methcathinone are controlled drugs. But compounds built on this base are not controlled. So chemists have been exploring a whole family of drugs - the beta ketones, which are not currently as tightly controlled as the Phenylethylamines.

So any legislative changes would need to be drafted carefully to ensure that they didn't simply create lots of new loopholes.

But this isn't really about legislation to 'control' MMCAT. More than anything MMCAT (and Spice before it) highlight the complete failure of the current control systems. The speed and development of new synthetics will continue to outpace the lumbering progress of Academics, media and politicians. Even if MMCAT is added to the list of controlled drugs, new products will not be far behind. The spread of knowledge, tools, markets and producer countries far outstrips the ability of States to control and remove them.

So for example, although precursor chemicals for many drugs (like Ecstasy and Amphetamine) are closely watched, the precursors for MMCAT are not, making it a relatively easy product to synthesise.

The extent to which producers and users are ahead of the curve, and the researchers and enforcement behind it is well illustrated by a look at some websites. So, for example the site Drugs Forum (http://www.drugs-forum.com/) has a massive compilation of user reports, product descriptions, advice, harm-reduction and dangers. It runs to several hundred pages of resources. In comparison there's a single page on the Government funded Frank website. In comparison you could probably count the number of academic texts or journal articles on one hand without using your thumb.

The inadequacies of the current system are also exemplified by the "no man's land" in which MMCAT suppliers find themselves. It's not a controlled drug so it can be lawfully supplied BUT it can't be supplied for consumption as it runs the risks of falling foul of the regulations relating to the supply of medicine. But the work-around - of labelling the products as "bath salts" or "plant food" and marking them "not for Human consumption" leaves users at greater risk. Rather than being able to accurately label products with dosage information and risks, suppliers use code to suggest how to use the substance. But this leaves much confusion.

Further, as the substances are not sold for "human consumption" there's no protection for consumers - and no holding suppliers to account. So we end up with the worst of all worlds: an unregulated market, no clear information on harm reduction, no consumer protection and a grey area that is in no-ones interest.

But if Government and the ACMD have acquitted themselved badly in the face of Mephedrone, little could be worse than some of the hyperbolic, inaccurate and hysterical media reporting over the past few weeks. Given a new drug, some linked fatalities and an absence of "authoritative information" the media has gone in to overdrive.

So for example the "Sun" reported that "Legal Drug Teen Ripped His Scrotum Off"
but the article backs this up by quoting the police who in turn support their claim, rather than through toxicology reports but through website chatter. So we don't know for example if another drug (e.g. Ketamine) was involved.

The Daily Mail have been worse still. When reporting the tragic death of 14-year old Gabrielle Price they reported that she had taken "plant fertiliser Mephedrone." It may be many things to many people, and although sold as a plant food is not any such thing.

But the Daily Mail is a shining light of journalistic excellence compared to the Evening Telegraph and Post

It quotes local councillor Bill Sangster who flies in the face of Police and Home Office opinion and says "It is illegal, harmful and can become addictive.” Well, two out of three ain't bad.

More ludicrous are the claims "According to the Levenmouth-based Drug and Alcohol Project Ltd., the mixture in the capsules is produced in varying colours to signify its composition and strength, although cocaine is believed to be the main ingredient.
Capsules are broken and the contents are snorted, placed on to the eyeball, or swallowed by the user, who experiences an immediate high described as mix between ecstasy and LSD."

This is either the most ill-informed drug service in the UK or the worst journalism, possibly both.

The article goes on to report that the tested capsules contained a low dose (0.191g) of MMCAT but this fact seems to have escaped the sub-Editor who allowed the rest of the drivel to be printed.

So given an ill-informed media, an unregulated substance, an ill-prepared Government and an impending festive season, we have an almost perfect storm. In the aftermath, there will almost certainly be moves to make MMCAT a controlled drug. But the wider systemic changes that need to be made won't be forthcoming and so this situation will happen again and again and again.


Frugal Dougal said...

I agree with you about the difficulties inherent in the present system of drug classification. My problem is the difficulty experts seem to be having in constructing a robust system of harms which, while undoubtedly placing tobacco and alcohol high up, as they should do, are not loaded with politically-motivated agendas to "punish" the tobacco and alcohol industries for being profitable.

PS great blog - have put it on my blogroll!

drugs said...

It's the worst possible journalism, I think.

Unknown said...

love to see this discussion! It’s great to see you all working through the issues and also, it’s great to see recommendations for testing. In the end, it’s what your actual users do and prefer that should be your biggest driver in making these decisions.

get level

Vorobiev said...

Legislation part is always the hardest to manage...