What Is Cathinone?

Cathinone is a stimulant found in the khat plant. It is mostly grown in the regions of eastern Africa and its surrounding countries. People in these regions usually chew the leaves of this plant for its mild stimulant effects. Cathinone is mostly used in the countries where it is grown, such as Ethiopia, Somalia, Saudi Arabia, and Yemen. This plant material is also trafficked in limited quantities to other countries where emigrants from the earlier-named regions have settled.   

What Are Synthetic Cathinones?                    

Synthetic cathinones are also called “bath salts,” or "psychoactive bath salts," although they are not used for bathing, nor are they related in any way to the bath salts used for bathing. "Bath salts" conveniently describes their appearance, which is similar to actual bath salts and, for a time, helped their earlier forms evade certain laws. 

They are synthetic drugs that are chemically similar to cathinones, but can be much stronger than the natural product and, in some instances, dangerous as well. Synthetic cathinones are among the “new psychoactive substances” (NPS) defined in a 2015 Early Warning Advisory of the United Nations Office on Drugs and Crime as “substances of abuse, either in a pure form or a preparation, that are not controlled by the 1961 Single Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, but which may pose a public health threat.” This group of drugs has been a cause for great concern among public health officials.

Synthetic cathinones are usually marketed as cheap substitutes for methamphetamine and cocaine, and are known to directly impact the central nervous system.

Among the first synthetic cathinones discovered were mephedrone and methylone. Their effects on humans have been thoroughly studied. Once these drugs were banned, however, new substances, such as alpha-PVP and MDPV, were introduced in the market. Of these new substances, fewer facts are known. 

Synthetic cathinones are often sold in small plastic or foil packets labeled “not for human consumption.” When a product is labeled thus, different laws apply to it. The drugs, therefore, manage to evade regulation and oversight of their manufacturing and marketing, thus increasing the danger that users are exposed to when they ingest, snort, smoke, or inject the products. Also, under United States (U.S.) law, the untruthful label is an attempt to put these products outside the scope of the Federal Analogue Act (a section of the United States Controlled Substances Act of 1986), which bans the selling of chemicals that are substantially similar to (analogues of) specified controlled substances, if these chemicals are intended for human consumption. 

While many of the ingredients used in "bath salts" have been made illegal, another problem that public officials face is that the makers of these drugs simply add other active ingredients to cathinones, create new combinations, or make modifications to their chemical structures to avoid their detection or immediate classification as illegal, hence their availability as (still) technically legal substances. Such substances fall under the term "designer drugs," that is, chemicals that are substantially similar in structure or function to drugs that have been banned, designed to imitate the drugs' effects while avoiding classification as an illegal substance and/or detection through drug tests. 

Still, another problem authorities face is that banning does not mean these drugs are no longer manufactured and sold, only that, when they are made and distributed, it is done illegally. 

Synthetic cathinones are usually sold in the form of white or brownish crystals, granules, and powder. They are variously identified and marketed as jewelry cleaner, plant food, phone screen cleaner, herbal incense, and potpourri, and sold online and in drug paraphernalia stores under a variety of brand names. Some of the brand names that have been used for synthetic cathinones are as follows:

• Cloud Nine
• Ivory Wave
• White Lightning
• Lunar Wave
• Scarface
• Bloom
• Vanilla Sky
• Bliss
• Flakka

What Is Flakka?

Flakka is the street name for alpha-PVP, a compound that is a chemical cousin of "bath salts," the now-banned form of synthetic cathinone. Also called "gravel" because of its similar appearance to the gravel used in aquariums, flakka usually comes in the form of white, pink, or blue crystals. The drug is swallowed, crushed, and inhaled as a powder, vaporized and inhaled, or liquefied and injected. Vapor inhalation and liquid injection cause the drug to quickly enter the bloodstream and can thus easily lead to an overdose. High doses of flakka can cause excited and violent delirium, a rise in the body's temperature to as high as 105 degrees, and heart or kidney failure. 

Synthetic Cathinones: Methods of Use

Individuals use synthetic cathinones in a number of ways: they are smoked, injected, swallowed, or snorted. Depending on the method of intake and dosage, there are significant variations in intensity, duration, and effects. Synthetic cathinones are very rarely used on their own, as they are often pre-combined with other drugs, unbeknownst to the user. 

Synthetic Cathinones: Effects 

While not much is known at this time about how synthetic cathinones affect the brain, studies reveal that synthetic cathinones are very similar chemically to cocaine and amphetamines. These drugs are known to have a range of adverse effects, such as anxiety, depression, and lowered inhibition. Based on observations of individuals who have used synthetic cathinones, listed below are the psychological and physiological effects that can be produced by this class of drugs:

Effects related to the mind:

• Self-mutilation
• Sexual urges
• Depression
• Nightmares
• Hallucinations
• Lack of sleep
• Uncontrollable craving for more of the drug
• Agitation
• Violent behavior
• Suicidal thoughts
• Delusions
• Paranoia
• Psychosis

Effects on the body:

• Dizziness
• Rash
• High fever
• Nosebleed
• Excessive teeth grinding 
• Sensation of things crawling on, in, or under the skin
• Seizure
• Headache
• Tingling sensation
• Numbness
• Vision problems
• Chest pain
• Heart attack
• Sweating
• Loss of weight
• Loss of appetite
• Pain in the back of the mouth
• Buzzing or ringing in the ears
• Nausea
• Vomiting
• Rapid movement of the eyes

What Are the Long-Term Effects of Synthetic Cathinones?

Synthetic cathinones are known to cause long-lasting effects or permanent damage if the addiction is not treated quickly, such as:

• Damage to the kidney or kidney failure
• Liver damage
• Increased blood pressure
• Increased heart rate
• Swelling of the brain or brain death
• Skeletal muscle tissue breakdown
• Death

A 2013 study revealed that MDPV, the most common synthetic cathinone found in "bath salts," is about ten times more potent than cocaine. Adverse effects of MDPV can last six to eight hours after dosing. It is known to cause psychosis and panic attacks, and has resulted in a number of deaths.

Addiction to Synthetic Cathinones

Synthetic cathinones are highly addictive, especially if abused. MDPV, in particular, triggers an intense craving for immediate re-dosing, unlike many other drugs. There is a powerful urge to use this drug again and again, and people with psychological or emotional issues are at an especially high risk of developing an addiction. 

There are also strong withdrawal symptoms produced by this drug, including:

• Tremors
• Depression
• Paranoia
• Suicidal thoughts
• Anxiety
• Insomnia

Treatment

To deal with an addiction to synthetic cathinones, behavioral therapy, such as the following, may be employed by a medical professional:

• Contingency management: The use of stimulus control and positive reinforcement/rewards
• Cognitive behavioral therapy (CBT): A type of psychotherapy
• Motivational enhancement therapy (MET): Counseling to help the patient come to a personal decision to go for treatment and stop the drug use 

Currently, there are no known drugs for treating an addiction to synthetic cathinones.

Rehabilitation 

Overcoming an addiction to these life-threatening drugs may require checking into a rehabilitation center. A rehabilitation center would be well-prepared and equipped to deal with the serious effects of the drugs and provide a suitable program for the person to get back on track. Losing a life to drug abuse is a waste, and one needs to get it under control before it is too late. Such rehab centers help save the lives of many individuals.

Drug rehabilitation programs are designed to engage the recovering addict so that s/he does their best to achieve lasting sobriety. While some programs run for predetermined periods, the length of stay may depend on the individual case. Some people need more time to regain their confidence and ability to live a life drug-free.

Important Facts About Synthetic Cathinones

1) Synthetic cathinones are usually used as a substitute for various other illegal stimulants like methamphetamine and cocaine. There have also been cases where capsules of Molly, the pure crystal powder form of MDMA (Ecstasy), were found to contain synthetic cathinones, including highly-dangerous methylone, instead. People who seek out Molly to avoid the dangers of dangerous additives in MDMA pills, such as methamphetamine and caffeine, may be unwittingly exposing themselves to even greater danger.

2) People who use synthetic cathinones usually swallow, snort, smoke, or inject themselves with the drugs.

3) Knowledge of how synthetic cathinones affect the brain is still scant, although scientific studies and research are ongoing.

4) Synthetic cathinones can trigger a number of reactions in the human body, including:

• Nosebleeds
• Feelings of paranoia
• Sudden increase in the need to meet and socialize
• Increased urge to have sex
• Sudden hallucinations
• Sudden panic attacks
• Death
• Severe addiction

Addiction often requires behavioral therapy. At present, there is no drug that treats an addiction to synthetic cathinones.