What is a stardust drug? (+3 facts)

In this article, we will discuss the stardust drug and its ingredients. We will also discuss the symptoms and legal status of the stardust drug.

What is a stardust drug?

Stardust is a powdery white narcotic which is a strong stimulant. Stardust drug is a common street name for an illicit synthetic cathinone known as ‘bath salt’. Here, bath salt does not refer to a hygienic product used in bathing, but a lab-made synthetic chemical to get high.

Stardust was first synthesized from vertigo, a strong narcotic that affects the thalamus. Stardust is considered a designer drug of abuse and produces intense intoxication. Stardust has similar activity to that of classical drugs of abuse, such as amphetamine, and cocaine.

Stardust is considered a Schedule I controlled substance in the USA and other countries. The law also bans the use of stardust, its manufacturing, clinical use, and chemical modification to form a new product similar to the stardust.

What is the pharmacological composition of a stardust drug?

The common ingredient found in stardust includes:

  • Methylenedioxypyrovalerone (MDPV),
  • Mephedrone (4-methyl methcathinone), and
  • Pyrovalerone.

MDPV is a norepinephrine and dopamine transporter blocker that is ten times more potent and effective as a locomotor stimulant than cocaine. MDPV structurally resembles methylenedioxymethamphetamine (MDMA), and cathinone derivatives that may cause ecstasy (1).

Mephedrone is known to stimulate the central nervous system by increasing the release of monoamine neurotransmitters (serotonin, dopamine, and norepinephrine) and perhaps limiting their uptake. Unlike MDPV, mephedrone has a lower affinity to cross the blood-brain barrier (2). 

Pyrivalerone has been shown to inhibit dopamine and norepinephrine reuptake but does not affect the serotonin transporters at concentrations of less than 10µM. The psychostimulant activity of pyrovalerone is ten times greater than cocaine because of its lipophilic nature to cross the blood-brain barrier (4).

What does research suggest?

In one of the clinical reports, three individuals using stardust presented with sympathomimetic symptoms including hypothermia and severe agitation. They also had severe rhabdomyolysis (release of protein in blood due to muscle damage) and a delayed onset of acute compartment syndrome.

Amongst the three patients, two individuals experienced paraspinal compartment syndrome (characterized by chronic lower back pain), while one experienced bilateral forearm compartment syndrome (characterized by swollen, tender and stiff forearm) (5).

In a retrospective study of the National Poison Data system, 1633 patients experienced toxicity due to the stardust drug. Amongst them around 68% were males. In addition, almost 15.5% of the patients had serious medical effects with a mortality rate of 0.6% (6).

Another study reported hallucination (40%), tachycardia (63%) and agitation (66%) in 35 patients who had taken stardust in high doses. Almost 77% of the patients presented with cardiovascular disorders including increased heart rate, palpitations, and tachycardia (7). 

How does the body respond to stardust abuse?

Stardust is a central nervous system stimulant and is known to cause agitation, aggressiveness, violence, confusion, seizures, and self-destructive behaviour at high doses or when symptoms begin to wear off. Individual components may produce variable effects including,

MDPV

  • Hypoperfusion,
  • Vasoconstriction,
  • Tachycardia,
  • Agitation,
  • Hypertension, and
  • Increased body temperature.

Mephedrone

  • Euphoria,
  • Elevated mood and sociability,
  • Mild sexual stimulation,
  • Increased feelings of empathy and kindness,
  • Intense connection to music.

Pyrivalerone

  • Heightened alertness and awareness,
  • Improved mood,
  • Increased sensory excitations,
  • Insomnia,
  • Reduced appetite,
  • Euphoria, and
  • Sociability and excitement (4).

The users report the euphoric high to last for 2-4 hours, with noticeable aftereffects lasting many hours. Stardust is usually inhaled, but can also be taken orally or injected intravenously.

How to manage the effects produced by stardust?

There is no antidote for stardust. Therefore, the management is often symptomatic. Benzodiazepines are the first choice of drug for the management of seizures and agitation associated with stardust. Lorazepam is often prescribed, however, phenytoin should be avoided.

Lorazepam has a fast onset of action and usually exerts its effect within 20-30 minutes after administration. When benzodiazepines do not produce the intended effect, antipsychotic agents may be added to the treatment regimen to reduce agitation, violence, and psychosis.

In clinical settings, lorazepam (6mg, intravenous) is followed by the administration of haloperidol (5 mg, intramuscular) (8). If the patient has hyperthermia, aggressive cooling is recommended. In the case of hyponatremia, the patient is given hypertonic saline or water restriction.

As a pharmacist, I would highly recommend you to avoid stardust. Although you may feel good in the initial hours, the symptoms worsen as the effect wears off. At high doses, you may feel heart pounding, hallucination, and delirium and no one would be there to help you. Value your life over temporary pleasures.

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References

1.-

Anizan S, Ellefsen K, Concheiro M, Suzuki M, Rice KC, Baumann MH, Huestis MA. 3, 4-Methylenedioxypyrovalerone (MDPV) and metabolites quantification in human and rat plasma by liquid chromatography–high resolution mass spectrometry. Analytica chimica acta. 2014 May 27;827:54-63. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4150738/

2.-

Schifano F, Albanese A, Fergus S, Stair JL, Deluca P, Corazza O, Davey Z, Corkery J, Siemann H, Scherbaum N, Farre’ M. Mephedrone (4-methylmethcathinone;‘meow meow’): chemical, pharmacological and clinical issues. Psychopharmacology. 2011 Apr;214:593-602. https://link.springer.com/article/10.1007/s00213-010-2070-x

3.-

Kolaczynska KE, Thomann J, Hoener MC, Liechti ME. The pharmacological profile of second generation pyrovalerone cathinones and related cathinone derivative. International journal of molecular sciences. 2021 Jul 31;22(15):8277.. https://www.mdpi.com/1422-0067/22/15/8277

4.-

Zawilska JB, Wojcieszak J. α-Pyrrolidinophenones: a new wave of designer cathinones. Forensic Toxicology. 2017 Jul;35:201-16. https://link.springer.com/article/10.1007/s11419-016-0353-6

5.-

Levine M, Levitan R, Skolnik A. Compartment syndrome after “bath salts” use: a case series. Annals of emergency medicine. 2013 Apr 1;61(4):480-3. https://www.sciencedirect.com/science/article/abs/pii/S0196064412018112

6.-

Warrick BJ, Hill M, Hekman K, Christensen R, Goetz R, Casavant MJ, Wahl M, Mowry JB, Spiller H, Anderson D, Aleguas A. A 9-state analysis of designer stimulant,“bath salt,” hospital visits reported to poison control centers. Annals of emergency medicine. 2013 Sep 1;62(3):244-51. https://www.sciencedirect.com/science/article/abs/pii/S0196064412018495

7.-

Winstock AR, Mitcheson LR, Deluca P, Davey Z, Corazza O, Schifano F. Mephedrone, new kid for the chop?. Addiction. 2011 Jan;106(1):154-61. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1360-0443.2010.03130.x

8.-

Kasick DP, McKnight CA, Klisovic E. “Bath salt” ingestion leading to severe intoxication delirium: two cases and a brief review of the emergence of mephedrone use. The American journal of drug and alcohol abuse. 2012 Mar 1;38(2):176-80. https://www.tandfonline.com/doi/abs/10.3109/00952990.2011.643999