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Expert Peer Review No. 1 Agenda Item 4.4: 3-MMC Expert Committee on Drug Dependence Thirty-eighth Meeting Geneva, 14-18 November 2016 Expert Peer Review No.1 for 3-Methylmethcathinone (3-MMC) 1. Comments based on the review report a. Evidence on dependence and abuse potential There are no formal studies of the abuse or dependence potential of 3-MMC in either animals or humans. However, there is evidence that the drug is widely used, at least in some countries (among the most frequently used stimulant NPS in some instances). Users report repeated dosing within a single session, including binge use in some instances. There are also a number of people who have reported repeated use over longer periods of time (greater than 40 lifetime occasions of use). These findings demonstrate that the drug is actively sought by users and also that there is a desire on the part of some people who try the drug to use it on multiple occasions. The relative popularity of 3-MMC in at least some countries and the patterns of re-use are indicative of abuse potential. b. Risks to individual and society because of misuse The evidence suggests that there are significant risks associated with use of 3-MMC. There is evidence of hospitalizations arising from 3-MMC intoxication. While the interpretation of many cases is complicated by the presence of other drugs, there were 4 analytically confirmed cases of 3-MMC alone leading to hospitalization. Deaths have also occurred in which 3-MMC is likely to have played a significant role, but there are no deaths solely attributable to 3-MMC. Use of the drug has been associated with adverse effects on driving. The types of effects produced by 3-MMC are consistent with those of other cathinones, particularly the closely related 4-MMC (mephedrone) and sympathomimetic drugs in general. Use of 3-MMC is therefore expected to produce a range of medical and psychiatric consequences of both a short and long term nature. Page 1 of 3 Expert Peer Review No. 1 Agenda Item 4.4: 3-MMC c. Magnitude of the problem in countries (misuse, illicit production, smuggling etc) There are multiple sources of evidence indicating that in at least some European countries the levels of use are comparatively high, such that it is regarded as one of the most commonly uses NPSs. There is also evidence of a high rate of internet purchases. d. Need of the substance for medical (including veterinary) practice Not used and unlikely to be used. e. Need of the substance for other purposes (e.g. industrial) Not used and unlikely to be used. f. Measures taken by countries to curb misuse 3-MMC is a controlled substance in a number of countries and is likely to be covered by generic/analogue legislation in a number of other countries. g. Impact if this substance is scheduled Scheduling will have no impact other than to potentially reduce the production, distribution and use of the substance for non-medical purposes. 2. Are there absent data that would be determinative for scheduling? While experimental data on abuse and/or dependence potential could provide some assistance in scheduling, it is very unlikely that such information will ever be collected in human studies. It is possible that animal studies may be conducted in the future that will help determine abuse and/or dependence potential, but this is not certain. While there are no experimental studies, there is a reasonable body of information from reports of users that is relevant to this issue. 3. Other comments or opinions None 4. Expert reviewer’s view on scheduling with rationale It is recommended that 3-MMC should be included in Schedule II of the Convention on Psychotropic Substances of 1971. Based on user reports, there is some evidence that 3MMC produces a state of dependence characterized by persistent drug-seeking behaviour Page 2 of 3 Expert Peer Review No. 1 Agenda Item 4.4: 3-MMC and preoccupation with obtaining and using the drug. It also produces CNS stimulation. Should the Committee not consider the evidence on dependence to be sufficient, 3-MMC has similar abuse and ill-effects as mephedrone (4-MMC), which is included in Schedule II of the 1971 Convention. With regard to the second criterion, there is evidence of widespread use of 3-MMC and of adverse effects of the drug such that it constitutes a significant public health and social problem. The risk to public health is considered to be substantial, but not especially serious, and therefore Schedule II is considered appropriate. Page 3 of 3