A look at mephedrone or MCAT - a synthetic verson of the eastern African khat plant – is a strong stimulant, with reports coming from UK, where it has become very popular, of serious overdose issues. Prescription drugs misuse and abuse continues as an escalating problem especially among young people – and the increased possibility of addiction to opiod pain medication leading to heroin use — made more pronounced by the flooding of the market with high potency and low cost heroin coming in from Mexico and Afghanistan. Also more on the implications of legalizing marijuana.
Transcript (edited):
CNS: Hi and welcome once again to the CNS Addiction Podcast. I am Howard LaMere with Dr. Darryl Inaba. Looking at the recent news of addiction, drug use and dependency, I see a lot of stories about things we’ve talked about recently, like the addicting qualities of eating, especially high fat/high flavor items like bacon, chocolate, potato chips and desserts, a big story just came out in Scientific American (http://www.scientificamerican.com/article.cfm?id=addicted-to-fat-eating) about that. Also the continuing story on legalizing marijuana in California where the question will be on the ballot – what will that mean to the people using it medicinally, the people growing it and the government. If it passes in California, it’s still going against federal law. We’ll have to wait to see what happens. Let’s talk more about prescription drugs and some of the substances that are being abused and causing serious illnesses. There are some stories about a sharp upturn in the last few years especially among adolescences in the use of pharmaceuticals and what that leads to. Kids start on the OxyContin from their parent’s drug cabinet and because it is such an expensive drug, they end up substituting heroin. The other interesting item out of the UK is this new craze going on with something called MCAT.
DARRYL: It is mephedrome and it’s been around for awhile. It is related to khat which East Africans have chewed for generations, maybe up to 1000 years. The shrub produces leaves which must be picked fresh because the (drug substance) cathinone is destroyed by the environment within 24 hours. So because it was found Africa and the leaves needed to be fresh – it has never been a big item here. But what happened in the United States in the early 90’s was the development of a synthetic version called “methcathinone” by putting a metho group on it, a CH3 group on the apparent compound cathinone, it became more stable in the environmental and it could be sold off as a pill or powder.
CNS: Is it just as strong?
DARRYL: Yes, they claim it was just as strong. Pharmacologists say it wasn’t as strong, but what we’re seeing now in Europe is a number of deaths related to its (methcathione) use. We don’t see many deaths associated with methamphetamine abuse, so it must be that the methcath is much stronger than even methamphetamine. But it’s growing there (in Europe) and its potential for abuse here stems from the fact that there are no laws that prohibit methcathinone. So, like many other new drugs, it’s finding its way on the internet and you can buy it. I’ve also heard of people in this country gaining access on the internet to fresh cut khat leaves, and have heard that the chemical properties really don’t get destroyed within 24 hours, so it can be cut and shipped and people can get high. On a personal note – Amnesty International contacted me once and asked me to detoxify a person from Somalia who was trying to come into the United States to be with his family, but he was a known khat addict so the US wouldn’t let him in. I said,” Sure we can detoxify him.” We detoxify methamphetamine users so we had it all set up and I never heard from the guy. He never showed up for treatment. About 5 years later he gets busted for growing khat trees in Monterey! So there might be some local crop available on the west coast. Khat is definitely an upper and mephedrome or MCAT or whatever they want to call it – synthetic cathinone – looks like it’s going to be another drug that’s is now on the DEA’s radar to classify very soon.
CNS: I think the UK is talking about taking action immediately because it is apparently being sold as a plant fertilizer.
DARRYL: So is synthetic marijuana which is now causing a lot of problems and sold as incense as well. And I remember isobutyl nitrite – Russian locker room – sold as a room deodorizer, and sometimes it is sold as shoe polish. You know….as long as you don’t call it a food, drug or cosmetic, you don’t come in violation of any drug laws for testing or anything and you can market it for what you’re using, but what happens if it gets abused strongly? Then the government has to look at it a different way and maybe reclassify it.
CNS: Is there anything else we can say to expand on pharming – the off-label use of pharmaceuticals that is becoming an ever increasing phenomenon, especially amongst young people.
DARRYL: Well we’ve been watching that develop for a long time in our area. Over the last 3 years there have been conferences and reports and such indicating an incredible increase in the abuse of diverted prescription drugs, by adolescences They get them from the internet or by raiding their parents and grandparents medicine cabinets, and more often when young kids go to dinner with their parents to their neighbor’s or their parents friend’s home they rush into the bathrooms to see what they’ve got and take everything that’s available. There was a recent bust I believe in Oregon, where millions of dollars worth of pharmaceuticals were stolen. The thieves busted in like a major sophisticated theft operation, like a sting….like a diamond or art theft …they broke in from the ceiling, cutting through and lowered themselves down with these special belts and stuff and hauled off something like 73 million dollars worth of pharmaceuticals.
More kids are taking prescription drugs and diverting prescription drugs than are abusing marijuana, cocaine, heroin and a lot of other drugs. Actually right now, the statistics show that prescription drugs are being abused by 20% of the teen population in the United States and probably a little bit higher here in Oregon because Oregon ranks towards the top. I have noticed that during the last 5 years or so, a 500 or 600% increase in abuse among teenagers than in the previous era. And between 1995 and 2004, there was a 3000% increase in abuse of prescription drugs. OxyContin, Vicodin – those are still the preferred drugs The sad part about that is that once people get addicted to opiates, their thirst and their tolerance for opiates grows exponentially. OxyContin is expensive on the street, selling for like 50 dollars a pill. And the heroin glut that’s on the market from Afghanistan, Mexico, South America, Golden Triangle, Southwest Crescent, the golden crescent – all those areas have now actually decreased the price of heroin to like 5 dollars a bag. A nickel bag or a nickel paper was last heard of during the early 1960’s. So heroin with costing 5 dollars a nickel bag and OxyContin costing 50 dollars a pill, it becomes very attractive for prescription drug abusers to turn their attentions to heroin, and once they turn their attention to heroin, the number of users who use intravenously is so much higher than with other drugs. We are seeing another epidemic of intravenous drug abuse and intravenous heroin abuse because of the way prescription drugs are being diverted.
CNS: And all the complications that leads to – hepatitis and potentially HIV. I know you’re not an economist, but if we legalize marijuana, what will be the fate of all those who have illegally made so much money through the years …it’s not like these people are just going to go straight. They’re going to find something else to sell under the radar. We’re seeing that in California, there is a lot of violence associated with small towns, small operation growers bumping up against people stealing from them, or feeling competition from the major drug smugglers.
DARRYL: Well, the political climate has changed towards legalizing marijuana. Not just for medical purposes, but just to legalize it overall. I think in the 1990’s, in California, only 22% of the polled voters favored legalizing marijuana. In the year 2006 or so, you are looking at 46% and current polls are saying that 56…or over half the voters now favor legalizing marijuana. Not for social or health reasons but purely because of the economic factor involved. Governor Brown…Willy Brown, San Francisco mayor, California governor…writes an op-ed column in the San Francisco Chronicle and he wrote, “truth be told, there’s just too much money to be made both by the people who grow marijuana in the cities and counties that would like to tax it, not to vote for it.” So that whole scene has changed where even Governor Schwarzenegger is saying we need to look at this, we need to look at the potential revenue. There is a 9 block area in Oakland, California called “Oaksterdam” and a guy – Richard Lee is making millions of dollars through several pot shops set up already where you can get weed to smoke a lot faster than you can get a cup of coffee. People like him are going to be in the forefront of financing the lobby to get marijuana legalized. This is too lucrative a thing to pass up and what I don’t understand is why nobody is looking at the long-term costs. You know the short term gains are going to be huge. You know people are going to jump on the bandwagon. They will probably tax the paraphernalia, the names, everything about it. Nicotine….caffeine, heroin, cocaine – they all generate money. People are just going to do whatever they can to get the money necessary to continue accessing these things. But in the long run, what about the traffic accidents? We know marijuana can cause traffic accidents. What about the health issues? We know it causes airway disease. Maybe not as much cancer as does nicotine but certainly emphysema and a lot of airway diseases that come about from it. All of these costs are not being looked at. The fact is….it’s the general public will be voting on this – not the experts – and the general public seems to be of the mind to make marijuana legal. It’s a threat, I think, to recovering people. There are people who recognize that they are addicted to marijuana and are struggling to stay clean. If it becomes legal, it will make it a lot harder because people will be smoking it wherever, and those in recovery will smell it and perhaps make them crave it. Marijuana is one of those psychoactive drugs that operate in the same place in the brain where fat operates and as we predicted a long time ago – does the same thing to a brain as does cocaine, heroin and other drugs. If people who are vulnerable to addiction, or are in recovery use it – it can lead them to relapse by creating a craving for the drug that they most want and prefer.
CNS: As is often the case throughout human history, we tend to act on the basis of short-term gains and don’t consider the long-term picture. To our listeners – if you have comments or questions, send us an email.
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