Intended and Unintended Use of Cathinone Mixtures

Introduction: Cathinones are one of the most popular categories of new psychoactive substances (NPS) consumed. Cathinones have different pharmacological activities and receptor selectivity for monoamine transporters based on their chemical structures. They are incorporated into NPS mixtures and used with other NPS or ‘traditional’ drugs. Cathinone use represents significant health risks to individuals, and is a public health burden. Methods Evidence of poly-NPS use with cathinones, seizure information and literature analyses results on NPS mixtures was systematically gathered from online database sources, including Google Scholar, Scopus, Bluelight and Drugs-Forum. Results and Discussion Results highlight the prevalence of NPS with low purity, incorporation of cathinones into NPS mixtures since 2008, multiple members of the cathinone family being present in individual UK-seized samples. Cathinones were identified as adulterants in NPS marketed as being pure NPS, drugs of abuse, branded products, herbal blends and products labelled “not for human consumption”. Toxicity resulting from cathinone mixtures is unpredictable since key attributes remain largely unknown. Symptoms of intoxication include neuro-psychological, psychiatric and metabolic symptoms. Proposed treatment includes holistic approaches involving psychosocial, psychiatric and pharmacological interventions. Conclusion Raising awareness of NPS, education and training of healthcare professionals is paramount in reducing harms related to cathinone use.