It was the methylone that killed him

Sep 13 2013 Published by under Bath Salts, Cathinone, Drug Abuse Science, Drug Fatality

The Daily Mail is reporting followup toxicity findings in the June 17 death of one Matthew Rybarczyk the after attending a rave party.

The Daily Mail:

There are fears that a string of fatal overdoses this summer have been caused by the toxic substance bath salts after it was pushed to young festival-goers as the party drug 'Molly', officials said today.

The substance had been sold to at least one young person as 'molly' - a potent form of ecstasy - but was in fact the meth-like street drug bath salts.

Officially known as methylone, it can have similar effects to ecstasy or MDMA on the user.

It has been confirmed as cause of death of a 20-year-old man and is suspected in the deaths of others.

StructureFig-mdma-vs-cathinones450As you can see in this structural diagram, methylone is the cathinone cousin of 3,4-methylenedioxy-methamphetamine (MDMA) which is the canonical psychoactive of both Ecstasy and Molly.I am delighted to see some actual toxicity data followup reporting. Perhaps other sources will have more specifics with regard to the medical examiner's findings and the various drugs found in the decedent's blood. For now, however, at least we have something to go on.

And I covered one prior Case Report containing three methylone-related deaths. And as I noted there, we know perfectly well that MDMA itself is capable of killing people.

As we've also discussed, MDMA can result in significant medical emergency and death. Yes, really, it is the MDMA.

It would not be at all surprising if methylone deaths were via the same neuropharmacological triggers, see Baumann et al 2012 and Simmler et al, 2013. Certainly what one can glean from the symptoms is very familiar.

I take issue, however, with the Louise Boyle piece in the Daily Mail. We can start from the headline:

Did all these festival-goers die from taking BATH SALTS? One death confirmed as fears others were duped into buying toxic street drug while believing it was 'molly'

See that? Nice trick. Methylone is a "toxic street drug" while apparently 'molly' is no such thing. Bzzzt, wrong. Methylone and MDMA are the same category of thing. Recreational drugs obtained from sources of dubious quality. Trying to distinguish one as a "toxic street drug" as different from the other is silly and nonsensical.

next we have this whopper:

but was in fact the meth-like street drug bath salts

Another report from the NY Post goes down the same path of underinformed sensationalism:

New York club kids who use the party drug Molly ... are often being peddled deadly “bath salts” by ruthless dealers,...The dangerous narcotic — which causes a violent, meth-like high — has killed at least one reveler this year and is being eyed in the deaths of two partiers at the Electric Zoo festival on Randall’s Island two weeks ago...Known to drug regulators as methylone

The term "bath salts" is just a nickname. It is no different than Ecstasy, molly, crack, crystal, weed, smack. It has meaning in so far as there is a consensus use of it, but in the absence of consensus it is near meaningless. I would say that at this point in time "bath salts" in the US can mean any of the substituted cathinone drugs. There was a time when I might have said it was semi-uniquely referring to 3,4-methylenedioxypyrovalerone (MDPV) but given the diversity in the market this is no longer correct.

The above referenced papers from Baumann and Simmler, and this additional one from Baumann, should tell the tale about the "meth-like" charge as well. While some of the substituted cathinones could be argued to be "meth-like", methylone sure isn't one of them. In fact the neuropharmacology suggests "MDMA-like" if anything. And really, given the most popular cathinones being used to date, it is silly to say that bath salts are meth-like. Mephedrone and methylone are MDMA-like in many ways and MDPV is turning out to be more like cocaine in activity. That's neuropharmacology, for the most part. When we look at compulsive use and propensity for addiction it in fact looks like methylone (Watterson et al, 2012) and mephedrone (Hadlock et al, 2011; Aarde et al, 2013a; Motbey et al, 2013) might have more reinforcing effect in rodent models than would be expected for a MDMA-like drug (see Schenk 2009; de la Garza et al, 2007 for review). In some of these studies the authors show data suggesting* the "MDMA-like" cathinones might actually be more effective in self-administration than methamphetamine. MDPV appears to generate more compulsive use than does methamphetamine (Watterson et al, 2012; Aarde et al 2013b). So, I suppose if the journalists mean the compulsive-use or reinforcing value as indexed by rat self-administration studies then they might have some defense for the "meth-like" charge. Somehow I doubt they are so informed.

Nevertheless.

When we are talking the acute overdose profile, the symptoms sure sound like MDMA and the relative reinforcing properties are most likely not directly related.

Oh boy. As I was writing this, some tox reporting from the New York Electric Zoo overdoses (it also repeated the methylone finding for Mr. Rybarczyk). James C. McKinley Jr reports at an Arts Beat blog at the NYT:

Toxicology results showed Ms. Rotondo died from acute intoxication after taking pure MDMA, the euphoria-producing drug sold on the street in pill form as ecstasy and in powdered form as molly, said Ellen Borakove, a spokeswoman for the medical examiner’s office.

Mr. Russ had taken a fatal mix of MDMA and methylone, a closely related stimulant that is also often sold under the name molly.

Nice to see some confirmation since there are definitely other drugs to suspect, like PMA and PMMA, when it comes to rave-drug overdoses.

__
*there are some methodological questions to be answered. I'd like to see a few more comparisons, myself.

12 responses so far

  • physioprof says:

    These drugs would be much safer if they could be obtained in pure form in controlled doses.

  • drugmonkey says:

    Dunno maaang, that girl in NY OD'd on MDMA supplied supposedly as Molly. Any dosing errors were due to her ignorance or intention, not *uncertainty about the product*.

  • physioprof says:

    These drugs would be much safer if they could be obtained in pure form in controlled doses supplied along with dosing information.

  • physioprof says:

    Oh, and BTW, the uncertainty about purity and the expectation that what you are going to get is not very pure surely leads to overdoses when a batch that actually is pretty pure hits the streets.

  • Alex says:

    I thought that a super-pure batch hitting the streets means that a New Mexico chemist has just found a side job.

  • drugmonkey says:

    You got a cite for that speculative assertion PP?

  • physioprof says:

    You think it is even conceivable that drug users don't set their doses on the basis of their previous experiences with the drug and their desired intensity of effect? And if they don't do this, then on what basis do they decide how much to ingest?

  • jjj says:

    phillip plein

  • Lucky Man says:

    The users set expectations based from former experiences. In reality, their dealer should be the one to provide dosage recommendations. Cant sell a steak if youve never tried it. ^_^

  • No one says:

    stating that other sites reporting was poor and misinformed when your reporting is terribly misinformed is like calling the pot calling the kettle black.

    "methylone is the cathinone cousin of 3,4-methylenedioxy-methamphetamine (MDMA) which is the canonical psychoactive of both Ecstasy and Molly."

    Ecstasy is supposed to be pure MDMA maybe with an inert binder to keep it in pill shape. However a pure "roll" or ecstasy has been very uncommon over the last 15 years and is now usually a cocktail of several cheaper and more readily available drugs.

    Due to the rising impurity of ecstasy rolls, Molly came about. Which in its true form IS pure MDMA with no additives. MDMA did make a temporary resurgence when "molly" came about but again it was quickly made disreputable. For some reason people thought if its a crystalline powder it must be pure MDMA, when in fact there are several research chemicals that mimic MDMA's appearance and just like ecstasy, molly became a drug cocktail.

    How/why the media calls all chemicals intended to be used as a recreational drug "Bath Salts" is beyond me. MDMA, crack, heroine, meth are NOT bath salts. the term Bath Salts was intended to be used as a catch-all for research chemicals which are designer drugs with a molecule added or removed in order to avoid an illegal classification. But even calling every research chemical a bath salt is like comparing marijuana to heroin. They're both drugs but that's about as far as the similarities go. Research chemicals cover a very broad aspect.

  • DrugMonkey says:

    What are you objecting to in my post, exactly? I don't see where your comments differ much.

  • Joshua Gunner Johnson says:

    I have a friend that was given an enhanced federal sentence for distribution of methylone resulting in death under 21 U.S.C. 841(b)(1)(C). Since his conviction the Supreme Court clarified in Burrages v. US, 134 S. Ct. 881 (2012), that the substance has to be the sole cause of death. The toxicology report in this case listed a bunch of other substances including alcohol, marijuana, and percocet. The guy who died also had an underlying condition of Krones disease, and some other health issues that required him to have regular blood transfusions.

    My question is: With all these factors can you safely say that methylone was the sole cause of death? I'm sure you would need the exact #s from the tox report, and unfortunately I don't have them yet. Any information about methylone overdose deaths would be helpful though.

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