As harm reduction workers we are faced with the challenge of firstly finding any relevant harm reduction information around the IV use of M Cat to pass onto service users there is very little of this , of educating people who were injecting about possible risks and consequences and of learning from them about the issues that they were beginning to encounter. Much of the Harm reduction advice that we as workers can offer around the use of Mephedrone is similar to other stimulant type drugs that we have worked with but we also began to hear alarming reports from our service users about the impact that their use was having on themselves and people around them.
Stories of assaults and robbery of other people who use drugs became common place. Many people reported that they felt aggressive when using and that they and others were resorting to violence to settle disputes and differences far more quickly than they would have done in the past. As workers we saw a marked change in the way in which people were behaving in and around the project with individuals acting in erratic and aggressive ways towards staff and other service users.
This aggressive behaviour came alongside a reported increase in paranoia and anxiety, particularly after using for several days. Stories of people feeling that they were being watched or followed, strangers in vans, voices from the TV etc are commonplace amongst people injecting large quantities of the drug.
A visible effect of injecting M Cat has been the rapid and significant weight loss that people are experiencing. Most people I have spoken with have been concerned by this but there have been a few female injectors who have identified this as a positive side effect.
One of the most concerning side effects that users have discussed has been the slow healing process of wounds. As with other stimulants people under the influence of M Cat may pick at their skin. These spots do not seem to be healing and are then picked at again , slowing the healing process. People have told me that other cuts and wounds on their body are also healing very slowly or not at all.
This would appear to be related to a vasoconstriction effect where the blood in the veins is flowing far more slowly but I can find little solid information or research to support this particular reported side effect of Mephedrone.
There have also been several reports from people who have suffered fits after injecting, this has generally occurred after extended use of larger amounts, in the region of 3 Grams or more over the course of a session and would appear to be a stimulant type overdose.
It appears that the rise in tolerance that people experience with Mephedrone is rapid. It is not uncommon for people to be injecting in the region of 3 — 5 G on a daily basis. There have also been reports of almost compulsive injecting episodes. I spoke to one person , a long term heroin user who claimed that he had injected approximately 40 times in a 24 hour period, he based this on the number of used filters that he counted afterwards.
The potential vein damage and trauma associated with this number of injections is clear and he himself was deeply concerned about how much Mephedrone he was using and the compulsive nature of his binges.
What is puzzling is why so many in the heroin using community have adopted Mephedrone as their main drug of choice, in some cases ceasing to use heroin completely. I have spoken with people about their motivations for using Mephedrone and there have been a few different explanations that have been offered.
The most common explanation offered is based on the fact that the quality of heroin and Crack has been steadily decreasing and Mephedrone is seen by users as being a cleaner, higher quality drug. This has changed over the last few weeks and there are now complaints that the quality has declined and people who are using claim that it is now being cut with a wide range of substances including salt, sugar or amphetamine.
People who are using back this up with their descriptions of the drug which has changed from being rice sized crystals to a more powder form. The above is really only a snapshot of some of the issues that people injecting Mephedrone have discussed with workers. None of these people have injected it for any longer than 6 months. What the consequences of longer term IV use will be is hard to say and this is the message that we are giving to our service users. Intense burning sensations on injection have been reported, but nevertheless this method is gaining popularity.
There are particular risks associated with injecting mephedrone, above and beyond those associated with the drug in general. The most obvious is the danger of sharing needles, which facilitates the spread of diseases such as HIV and Hepatitis. Academics have found a number of quite horrible side-effects of injecting mephedrone. Groin injecting is particularly harmful, and those who do it are often unaware of the damage caused.
These may be a direct result of the drug, but it could be the case that they are the consequences of experiencing such a powerful high. Indeed, one of the trends that drug workers are noticing is people who regularly injected heroin switching to mephedrone. A charity in south Wales has said that this switch was very sudden. The fact that mephedrone is cheaper may partly explain this. The switch has allowed authorities to claim success in fighting heroin use, but all it means is that drug use is more flexible than they realise.
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