**8. Fatalities**

During the last few months of 2009 and the first few months of 2010, the UK media were constantly reporting fatalities allegedly related to mephedrone consumption, but only a proportion of them had by that time been formally confirmed. A report on a mephedronerelated fatality first appeared in Sweden, referring to an 18-year-old female death which occurred in December 2008. No other drugs, apart from mephedrone, were identified by the toxicological screenings (Gustaffson & Escher, 2009). Previously, a Danish teenager found in possession of mephedrone died in May 2008, although toxicology reports were inconclusive (Campbell, 2009). The first mephedrone-related death in the USA involved the combined use of mephedrone and heroin (Dickson et al., 2010). More recently, the first cases from the Netherlands (Lusthof et al., 2011) and the Republic of Ireland (EMCDDA, 2011:85) have been reported.

Mephedrone-Related Fatalities in the United Kingdom: Contextual, Clinical and Practical Issues 361

Drugs (ACMD). This information comes both from notifications of deaths and from 'alerts' or other information provided by the various agencies and networks, national and international, with which the Programme maintains contacts. Regular searches of media

Through these channels (including coroners, forensic toxicologists – principally the London Toxicology Group, Drug & Alcohol Action Teams, and the Scottish Crime & Drug Enforcement Agency) the Programme became aware of the emerging issue of the use of methcathinones, especially mephedrone, and similar substances (including chemicals), and of their potential adverse health consequences. It was decided to take a pro-active approach to monitor the situation especially in respect of the potential role of these new substances in causing or contributing to death. For those cases not formally reported to the Programme, contact was made with the relevant coroners to request the submission of an np-SD form so as to obtain the appropriate information. Information on these cases was added to the

The np-SAD database was searched using the terms 'mephedrone' and '4 methylmethcathinone' to identify potentially relevant cases. The database fields searched were those holding data on: drugs present at post-mortem; drugs implicated; cause(s) of death; accident details; and 'other relevant information'. The data presented here relate to all concluded cases for which forms had been submitted to the Programme by 31 August 2011. Details of some of these cases have previously been published (Torrance & Cooper, 2010;

Analyses were performed using IBM® SPSS® Statistics, version 18 for Windows™. Demographic details, risk factors, and categorical data were expressed as frequencies and percentages within groups; ages were compared using Levene's Test for Equality of Variances (two-tailed). The results for statistical tests were regarded as significant at or

A total of 125 alleged or suspected mephedrone-associated fatalities have been identified by the np-SAD team (Fig. 1). However, in 25 cases (20.0%) mephedrone was not found at post mortem and for 13 cases (10.4%) the toxicology results are still pending. For those 87 cases (69.6%) where mephedrone was identified at post mortem, inquests have been concluded in 60 cases. These were considered as confirmed fatalities meeting the above inclusion criteria,

The mean age of the sample was 28.7 years (SD 11.3), range 14-64 years old. The mean age for males was 28.9 years compared to 28.0 years for females; this difference was not statistically significant (t = 0.27 (two-tailed for equality of means) p = 0.79 (95% CI = -5.87 to +7.72). Where known, most victims were described as 'White' (Table 1). Where place of birth was given, 39 were born in the UK and Islands and 8 overseas. Many were in employment

(n = 25), but one-quarter (n = 16) were unemployed, and 11 were students.

database when forms were received by the Programme team.

Wood et al., 2010b; Maskell et al., 2011; EMCDDA, 2011:78-85).

reports are also undertaken.

below the 5% probability level.

and on which the present analysis will focus.

**10. Results** 

**10.1 Demographics** 

Given the potentially large numbers of consumers involved in the use of mephedrone across both the EU and the UK (EMCDDA, 2011), the main aims of this study were to report and analyse information relating to the socio-demographics and clinical circumstances of all recorded mepherone-related deaths for the whole of the UK, both when the index drug was taken on its own and when in combination with other drugs. The rationale for doing this is to make accessible a corpus of material which will help inform treatments and interventions so as to reduce deaths associated with the use of this drug and other methcathinones.
