heroin and mephedrone

Topics: Adult; Amphetamine-Related Disorders; Comorbidity; Cross-Sectional Studies; Female; Hepatitis C; Heroin; Heroin Dependence; Humans; Male; Methadone; Methamphetamine; Middle Aged; Narcotics; Opiate Substitution Treatment; Outcome Assessment, Health Care; Patient Readmission; Program Evaluation; Retrospective Studies; Sex Factors; Young Adult

Important part of the studies on drug use deals with drug use transitions because of their public health consequences. Narrating of drug use change states the active decision making in the centre of the process with adding mental states of the participants to the change process. The transitional narratives can be embedded in the social context of "risk environment".. In the micro-segregation of the Middle-Jozsefvaros (8th district, Budapest) the Blue Point Foundation runs a needle-exchange service in its "Contact Programme". Here the number of registered clients was 2066 in 2010. The study participants were recruited from the clients of this needle-exchange service (from December 2010 to February 2011). The criterion of entering the study sample was injecting mephedrone in the past 30 days. 17 participants were interviewed. The life story interviews had been coded thematically; it had been done until new codes did not carry new meanings.. Study participants speak about rapid tolerance and more intensive use of mephedrone after changing their usual drug. This use is more risky because of more frequent injecting. The effect of mephedrone was described like 3,4- Methylenedioxymethamphetamine (MDMA) and cocaine. In the interviews the usual pattern was narrating the positive effects of mephedrone and after this text the narrating of the negative effects. The "risk narrative" and the "enjoyment narrative" were presented separately in the interviews.. Not the expansion of the drug market, but the drug change was observed: earlier drugs to mephedrone or parallel use of mephedrone with earlier drugs (amphetamine and heroin). The purity and availability of heroin and the increase availability of mephedrone may take a role in this process. The absent of drug market expansion was explained by the closeness of the micro-segregation. Results raise attention of the public health consequences of drug change and the proper training of professionals for this change.

Topics: Adolescent; Adult; Amphetamine; Cocaine; Cocaine-Related Disorders; Designer Drugs; Dopamine Uptake Inhibitors; Drug Users; Female; Heroin; Humans; Hungary; Illicit Drugs; Interview, Psychological; Male; Methamphetamine; Middle Aged; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Narration; Needle-Exchange Programs; Risk-Taking; Substance Abuse, Intravenous; Young Adult

An accidental death caused by the combined use of a new designer drug, 4-methylmethcathinone (mephedrone), and heroin is reported. A 22-year-old Caucasian male was found unresponsive in his living quarters and was transported to the hospital where he died. During autopsy, needle marks were found along the decedent's lower legs and ankles. Investigators discovered the decedent and his roommate had been using "Black Tar" heroin and mephedrone. Routine toxicological analysis detected morphine in the decedent's blood at 0.06 mg/L. Additionally, 6-acetylmorphine, morphine, codeine, and doxylamine were detected in his urine. A designer drug screen, employing a basic liquid-liquid extraction followed by pentafluropropionic anhydride derivatization, was used to isolate mephedrone from both blood and urine specimens. The derivatized extracts were analyzed by gas chromatography- mass spectrometry (GC-MS) operating in full-scan mode. Quantitative analysis of mephedrone was performed by GC-MS operating in selective ion monitoring mode using methamphetamine-d(14) as an internal standard. Mephedrone was confirmed in the decedent's blood and urine at 0.50 and 198 mg/L, respectively. The physiological and pharmacological effects of mephedrone and any associated toxicity have not been reported. However, because of its structural similarities with methcathinone and the high concentration in the decedent's blood, the overall contribution of mephedrone to the death could not be minimized. Therefore, the medical examiner reported the cause of death as multiple-drug toxicity and the manner of death as accidental.

Topics: Amphetamine-Related Disorders; Chromatography, Gas; Codeine; Doxylamine; Drug Overdose; Fatal Outcome; Gas Chromatography-Mass Spectrometry; Heroin; Heroin Dependence; Humans; Immunoassay; Male; Methamphetamine; Morphine; Morphine Derivatives; Reproducibility of Results; Substance Abuse Detection; Young Adult