Intravenous non-medical mephentermine use among young men: A consecutive case series from a tertiary addiction treatment facility in India

Introduction

Mephentermine, a substituted amphetamine, acts as a sympathomimetic agent with mild central nervous system stimulant properties. Although approved for therapeutic use in hypotensive states, it is banned by the World Anti-Doping Agency (WADA) due to its performance-enhancing potential. Reports of non-medical use, though rare, have primarily emerged from Southeast Asia and the United States.

Methodology

This case series describes 12 consecutive participants presenting with non-medical mephentermine use at a tertiary care addiction treatment facility between September and November 2023. Data were collected through structured interviews, clinical assessments, and confirmatory urine toxicology.

Results

Non-medical mephentermine use was identified in 0.71 % of newly registered cases, with half meeting ICD-11 criteria for dependence. All participants were educated males (mean age: 25.6 years, SD = 5.1); 58.3 % were unemployed, and 50 % were married. Most used mephentermine intravenously for performance enhancement in sports, fitness, or occupational settings. The median daily dose was 300 mg (IQR: 183.8–412.5), typically procured from chemists (41.7 %) or gym trainers (25.0 %) at a median cost of INR 275 (IQR: 250–375). Euphoria was reported by 58.3 %, while 66.7 % experienced psychotic symptoms during intoxication. No participant had a comorbid major psychiatric disorder.

Conclusion

This series highlights an emerging pattern of intravenous mephentermine misuse among young men in performance-oriented contexts. Given the associated psychosis and cardiovascular risks, clinicians should routinely screen for stimulant use. Community awareness campaigns and stricter regulation of over-the-counter stimulants are crucial for harm reduction.