title: First case report of recreational use of 2,5-dimethoxy-4-chloroamphetamine confirmed by toxicological screening.
abstract: Routine toxicological screening is generally not undertaken in patients with recreational drug toxicity. We report here the benefits of toxicological screening in confirming drugs that have been ingested and potentially detecting drugs that have not previously been reported in the medical literature. In this case, the patient was reported to have ingested a combination of 2,5-dimethoxy-4-iodoamphetamine and methylenedioxymetamphetamine and developed sympathomimetic toxicity, but on extended toxicological screening he was shown to have actually ingested 2,5-dimethoxy-4-chloroamphetamine and methylenedioxymetamphetamine. As 2,5-dimethoxy-4-chloroamphetamine is a substituted amphetamine, it is covered under the generic Misuse of Drugs act (1971) in the UK; although in the majority of the EU it remains uncontrolled, as there is no similar generic drug legislation. We believe that discrepancies in the legal status of recreational drugs in the EU limit the effectiveness of drug enforcement policies and that EU drug legislation should be harmonized to ensure consistency.
authors.affiliation: Department of Clinical Toxicology, Guy's and St Thomas' Poisons Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK. Hanna.Ovaska@gstt.nhs.uk
authors.forename: Hanna
authors.initials: H
authors.lastname: Ovaska
authors.forename: Adie
authors.initials: A
authors.lastname: Viljoen
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Puchnarewicz
authors.forename: Jenny
authors.initials: J
authors.lastname: Button
authors.forename: John
authors.initials: J
authors.lastname: Ramsey
authors.forename: David W
authors.initials: DW
authors.lastname: Holt
authors.forename: Paul I
authors.initials: PI
authors.lastname: Dargan
authors.forename: David M
authors.initials: DM
authors.lastname: Wood
mesh_terms: D004290:DOM 2,5-Dimethoxy-4-Methylamphetamine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood; D000328:Adult; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000097:blood; D005440:Fluid Therapy; D006213:Hallucinogens / Q000009:adverse effects / Q000097:blood; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects* / Q000097:blood*; D008297:Male; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D015813:Substance Abuse Detection / Q000379:methods; D013566:Sympathomimetics / Q000009:adverse effects / Q000097:blood
chemical_list: D000697:Central Nervous System Stimulants; D006213:Hallucinogens; D013287:Illicit Drugs; D013566:Sympathomimetics; D004290:DOM 2,5-Dimethoxy-4-Methylamphetamine; C529482:4-chloro-2,5-dimethoxyamphetamine