3-Methylmethcathinone (3-MMC) Poisonings: Acute Clinical Toxicity and Time Trend Between 2013 and 2021 in the Netherlands

Lonkhuyzen, Johanna J. Nugteren–van; Essink, Sharon; Rietjens, Saskia J.; Ohana, Dana; Lange, Dylan W. de; Riel, Antoinette van; Hondebrink, Laura

doi:10.1016/j.annemergmed.2022.04.022

Cited by 5 publications

(23 citation statements)

References 25 publications

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“…Although poison center data have their limitations, our study on health problems related to N 2 O (ab)use is not the first example to show that toxicovigilance by poison centers is usually one of the first sources to identify a substance-related public health threat [1,[42][43][44][45]. This monitoring role of poison control centers is further corroborated in the report on N 2 O by the EMCDDA [26].…”

Section: Substance Use Disorder For Nitrous Oxide In Intoxicated Pati...supporting

confidence: 61%

High Incidence of Signs of Neuropathy and Self-Reported Substance Use Disorder for Nitrous Oxide in Patients Intoxicated with Nitrous Oxide

et al. 2023

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Introduction: The number of patients with excessive nitrous oxide (N2O) use and neurological disorders has been rising, indicating an addictive potential of N2O. We studied the incidence of self-reported substance use disorder (SUD)-related symptoms, signs of neuropathy, and the patterns of use in N2O-intoxicated patients. Methods: The Dutch Poisons Information Center (DPIC) provides information by telephone on the management of intoxications to healthcare professionals. Retrospective data on signs of neuropathy and patterns of use were collected for all N2O intoxications reported to the DPIC in 2021 and 2022. Frequent and heavy use were self-reported as “often/frequent/weekly use” and as “use of tanks or >50 balloons/session,” respectively. From this cohort, we included patients with excessive N2O use or signs of neuropathy in a prospective observational cohort study. Online surveys were sent 1 week, 1 month, and 3 months after DPIC consultation. The survey included the drug use disorder questionnaire (validated to measure self-reported substance abuse [SA] and substance dependence [SD] based on Diagnostic and Statistical Manual of Mental Disorders [DSM]-IV-TR criteria) and questions on patterns of use and signs of neuropathy. DSM-IV-TR criteria were translated to DSM-V criteria to score for mild, moderate, or severe SUD, with 2–3, 4–5, or ≥6 symptoms, respectively. Results: We included 101 N2O-intoxicated patients in the retrospective study. Of these, 41% showed signs of neuropathy (N = 41), 53% used N2O tanks to fill balloons (N = 53), 71% used them frequently (N = 72), and 76% used them heavily (N = 77). We included 75 patients in the prospective study and 10 (13%) completed the first survey. All 10 patients fulfilled the criteria for SA and SD (DSM-IV-TR, median number of questions answered “yes” = 10/12), all used N2O tanks to fill balloons, and 90% (N = 9) experienced signs of neuropathy. After 1 and 3 months, 6/7 and 1/1 patients, respectively, continued to fulfill SA and SD criteria. Translating to DSM-V criteria, 1/10 patients fulfilled the criteria for (self-reported) mild SUD, 1/10 patients for moderate SUD, and 8/10 patients for severe SUD, 1 week after consultation. Conclusion: The high proportion of N2O-intoxicated patients reporting frequent and heavy use of N2O indicates an addictive potential of N2O. Although follow-up rate was low, all patients fulfilled self-reported SA, SD (DSM-IV-TR), and SUD (DSM-V) criteria for N2O. Somatic healthcare professionals treating patients with N2O intoxications should be aware of possible addictive behavior in patients. The screening, brief intervention, and referral to treatment approach should be considered to treat patients with self-reported SUD symptoms.

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Section: Substance Use Disorder For Nitrous Oxide In Intoxicated Pati...supporting

confidence: 61%

High Incidence of Signs of Neuropathy and Self-Reported Substance Use Disorder for Nitrous Oxide in Patients Intoxicated with Nitrous Oxide

et al. 2023

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“…Since it was first reported in 2012 in Sweden, it has gained in popularity, particularly since 2020 ( European Monitoring Centre for Drugs and Drug Addiction 2022 ). This is reflected in acute poisonings in the Netherlands ( Nugteren-van Lonkhuyzen et al., 2022 ), while it was one of the most common NPS seized in Italy between May and October 2020 ( Vincenti et al., 2021 ), and was also the NPS with the highest mass loads found in a recent national study conducted in Italy ( Salgueiro-González et al., 2022 ). This European prevalence is reflected in Fig.…”

Section: Discussionmentioning

confidence: 99%

Three years of wastewater surveillance for new psychoactive substances from 16 countries

et al. 2023

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“…This group of structurally similar substances originates from cathinone, an amphetamine-like sympathomimetic amine. Cathinone ( Figure 1 ) is the main psychostimulative substance naturally occurring in the leaves of the khat shrub ( Catha edulis ) [ 3 , 4 ]. This molecule was isolated from fresh leaves of khat in 1975 [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…These compounds are marketed as “bath salts”, “plant food”, or “insect repellent”, and are labeled with “not for human consumption” or “research chemical” in order to be sold within legal boundaries [ 3 , 13 , 14 ]. They can be found in stores called “headshops” and on online shops.…”

Section: Introductionmentioning

confidence: 99%

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Metaphedrone (3-Methylmethcathinone): Pharmacological, Clinical, and Toxicological Profile

Kelečević,

Vejnović,

Javorac

et al. 2024

Medicina

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Introduction: Synthetic cathinones are a group of novel psychoactive substances used as an alternative to classical recreational drugs. As a result of legal prohibitions on older generations of these compounds, new formulations appeared on the drug market. One of them is metaphedrone (3-methylmethcathinone, 3-MMC), a structural isomer of 4-methylmethcathinone and a psychostimulant drug. Metaphedrone became popular in a large number of countries in a short period of time. The aim: The collection, analysis, and review of relevant research on the subject of metaphedrone in order to present information about the pharmacological, clinical, and toxicological profile of this compound. An assessment of the significance and role of metaphedrone in consumption patterns of novel psychoactive substances among recreational drug users. Methodology: By using search engines like Google Scholar and PubMed, the relevant literature on metaphedrone was looked for and analyzed. The search was not limited to a specific period of time. All information regarding the compound of interest was analyzed and presented. Key results and discussion: All novel psychoactive substances are abused due to their pronounced stimulatory, hallucinogenic, dissociative, and euphoric and/or relaxing characteristics. Users of 3-methylmethcathinone usually opt for this substance for recreational purposes and/or sexual stimulation. Metaphedrone has the potential to cause a psychological dependence to the users. It was determined in relevant studies that most users are from 17 to 50 years of age. Older users usually administer metaphedrone intravenously, while younger ones usually choose snorting and oral ingestion of the drug. In Serbia, metaphedrone is a legally controlled substance. The pharmacodynamic properties make metaphedrone similar to classical recreational drugs. The method of administration, mainly repeated administration in a single session, could be explained using the pharmacokinetic profile of the drug. The most reported symptoms of intoxication were those of a sympathomimetic nature, such as tachycardia, chest pain, hypertension, diaphoresis, and agitation. Most intoxications and fatal outcomes occurred to users who combined several psychoactive substances. The correlation between measured blood concentrations of the drug and outcomes of intoxication was not found. The mechanisms of metaphedrone’s toxicity are not fully understood. Conclusions: There is an increasing trend of abuse of metaphedrone among recreational drugs users. Future studies should focus on pharmacological and toxicological effects of metaphedrone on animals and humans.

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3-Methylmethcathinone (3-MMC) Poisonings: Acute Clinical Toxicity and Time Trend Between 2013 and 2021 in the Netherlands

Cited by 5 publications

References 25 publications

High Incidence of Signs of Neuropathy and Self-Reported Substance Use Disorder for Nitrous Oxide in Patients Intoxicated with Nitrous Oxide

High Incidence of Signs of Neuropathy and Self-Reported Substance Use Disorder for Nitrous Oxide in Patients Intoxicated with Nitrous Oxide

Three years of wastewater surveillance for new psychoactive substances from 16 countries

Metaphedrone (3-Methylmethcathinone): Pharmacological, Clinical, and Toxicological Profile

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