‘Special M’ related fatalities in the UK.

Introduction: methoxetamine (MXE; ‘special M’) is a novel psychoactive substance that first appeared in 2010 as a legal alternative to ketamine and, despite now being a Class B drug, is still widely marketed via the internet as a research chemical. MXE acts similarly to a non-competitive antagonist at the N-methyl-D-aspartate receptor and as well as a dopamine reuptake inhibitor. It presents with behavioural effects of dissociative anaesthetics, including euphoria; empathy; dissociation from the physical body; and hallucinations. Adverse side effects include: cognitive impairment; cardiovascular symptoms; and cerebellar signs. This poster provides an overview of MXE-related fatalities reported in the UK in 2011-2013. Methods: deaths involving MXE data were extracted from the database of the National Programme on Substance Abuse Deaths (NPSAD), which receives information on drug-related deaths from Coroners in the UK and Islands (Isle of Man, Jersey, Guernsey), and maintains a database of about 30,000 cases, with Coroners and relevant regional authorities voluntarily submitting information on drug-related deaths since 1997. Results: between 2011-2013, MXE was reported as involved in the deaths of eight individuals: seven males and one female, with a median age of 27 years. MXE was used together with other substances in 7/8 cases. MXE was found at post-mortem in all cases, and implicated in the deaths of seven. Conclusions: further research needs to be carried out on MXE health effects and toxicity potential. Health care professionals should be made aware of the MXE health effects, in order to develop early intervention measures and minimize the number of MXE-related poisonings and fatalities.