Mephedrone appears to be used primarily intranasally and to have comparable abuse potential to cocaine, with more than half those who use both reporting that mephedrone gives a better quality high.

AimsTo assess the patterns of use, subjective effect profile and dependence liability of mephedrone, supported by corroborative urine toxicology. Design Cross-sectional structured telephone interview. Setting UK-based drug users associated with the dance music scene. Participants A total of 100 mephedrone users, recruited through their involvement with the dance music scene. Measurements Assessment of pattern of use, acute and after effects, DSM dependence criteria and gas chromatography-mass spectrometry urinalysis. Findings Mephedrone consumption results in typical stimulant-related subjective effects: euphoria, increased concentration, talkativeness, urge to move, empathy, jaw clenching, reduced appetite and insomnia. Thirty per cent of the sample potentially met criteria for DSM-IV dependence and there was evidence of a strong compulsion to use the drug (47% had used the drug for 2 or more consecutive days). Self-reported recent consumption of mephedrone was confirmed by toxicological analysis in all of the 14 participants who submitted a urine sample. Conclusion Mephedrone has a high abuse and health risk liability, with increased tolerance, impaired control and a compulsion to use, the predominant reported dependence symptoms.

Study Type – Symptom prevalence (prospective cohort) Level of Evidence 1b What's known on the subject? and What does the study add? Case series have described lower urinary tract symptoms associated with ketamine use including severe pain, frequency, haematuria and dysuria. Little is known regarding the frequency of symptoms, relationship of symptoms with dose and frequency of use and natural history of symptoms once the ketamine user has stopped. This study describes the prevalence of ketamine use in a population of recreational drug users in a dance music setting. It shows a dose–frequency relationship with ketamine use. It shows that urinary symptoms associated with recreational ketamine use may lead to a considerable demand on health resources in the primary‐, secondary‐ and emergency‐care settings. It shows that symptoms may improve once ketamine use is decreased. OBJECTIVE To investigate the prevalence and natural history of urinary symptoms in a cohort of recreational ketamine users. PATIENTS AND METHODS A purposeful sampling technique was used. Between November 2009 and January 2010 participants were invited to undertake an on‐line questionnaire promoted by a national dance music magazine and website. Data regarding demographics and illicit drug‐use were collected. Among respondents reporting recent ketamine use, additional information detailing their ketamine use, experience of urinary symptoms and use of related healthcare services was obtained. RESULTS In all, 3806 surveys were completed, of which 1285 (33.8%) participants reported ketamine use within the last year. Of the ketamine users, 17% were found to be dependent on the drug; 26.6% (340) of recent ketamine users reported experiencing urinary symptoms. Urinary symptoms were significantly related to both dose of ketamine used and frequency of ketamine use. Of 251 users reporting their experience of symptoms over time in relationship to their use of ketamine, 51% reported improvement in urinary symptoms upon cessation of use with only eight (3.8%) reporting deterioration after stopping use. CONCLUSIONS Urinary tract symptoms are reported in over a quarter of regular ketamine users. A dose and frequency response relationship has been shown between ketamine use and urinary symptoms. Both users and primary‐care providers need to be educated about urinary symptoms that may arise in ketamine users. A multi‐disciplinary approach promoting harm reduction, cessation and early referral is needed to manage individuals with ketamine‐associated urinary tract symptoms to avoid progression to severe and irreversible urological pathologies.

Highlights‘SURE’ is a new patient reported outcome measure of recovery from drug and alcohol dependence.‘SURE’ has been developed with significant input from people in recovery.‘SURE’ has good face and content validity, acceptability and usability for people in recovery.SURE’ comprises 21 items (5 factors) and is psychometrically valid, quick and easy-to-complete.‘SURE’ can be used by individuals in private or in a therapeutic context