Keywords: synthesis, drugs, irreversible brain damage, next-level idiocy, prejudice
Since I haven’t seen this particular story in other media or even in English before, here goes a quick-and-dirty translation of an excerpt of: Läkartidningen 2009, 106, 1358-1361. (Journal of the Swedish Medical Association; full version in Swedish)
[...] Simultaneously, a much riskier procedure for the synthesis of metcathinone, hereafter referred to as ephedrone, for intravenous injection surfaced in Eastern Europe. The first reports of severe neurological symptoms due to manganese poisonings among 21 ephedrone users were published in a Russian Journal in 2005.
At the same time a syndrome characterized by hypophonia [soft speech], hypomimia [loss of facial expressions], balance disorder and dystonia [movement disorder] had been noted among young drug users in Estonia, and a collaboration between the neurological departments in Tartu, Estonia and in Uppsala, Sweden was established. In Uppsala, a test synthesis of ephedrone was performed according to the recipe found online: A box (12 pills) of Sudafed, containing 60 mg pseudoephedrine hydrochloride per pill, 1-2 mL acetic acid and “a dash” of potassium permanganate were added to 100 mL boiling water.
During this procedure, about 45 % of the pseudoephedrine is converted to metcathinone. The solution contains manganese in a concentration of approx. 0.6 gram per liter, and is used directly for intravenous injection, after cooling and simple filtration. Since the drug user often injects 300 mL daily, this corresponds to a manganese loading that is 2000 times higher than the recommended intake.
During 2007, case reports from Estonia and Ukraine based on etiology, a characteristic clinical picture and brain MRI findings, it was possible to confirm that the irreversible motor impairments were indeed caused by manganese poisoning. In Latvia in 2007, a case report of a further 23 patients was published with a unison clinical picture. At the symposium “The ephedrone epidemic – a new cause of chronic manganism” held in Tartu, September 2008, it became evident that a significant spread had occurred to for instance Georgia and Turkey. Several hundreds of cases are known to the profession today, but these are likely the tip of the iceberg. So far only one case of an ephedrone related manganese poisoning has been reported outside Eastern Europe and the Baltic states. This case dealt with a man from Azerbaijan living in Canada.
The symptoms build up quietly after months of substance misuse. Brain damage is chiefly irreversible and the symptoms are not relieved by anti-Parkinson drugs. Many of the victims suffer from severe handicaps, which require significant medical attention. [...]