“Foxy” Drug Causes Rhabdomyolysis

[GDxCAT]

Newswise — A hallucinogenic drug commonly known as “foxy methoxy” (5-MeO-DIPT) has been abused with increasing frequency since the late 1990s, and physicians detail what may be the first report of rhabdomyolysis associated with ingestion of the drug.

According to the case report from the Cleveland Clinic Foundation in Ohio, a 23-year-old man was brought to the emergency department because of combative behavior and hallucinations. He’d ingested 25 milligrams (mg) of “foxy” about 30 minutes before his symptoms began.

After conducting laboratory studies and assessing the patient, physicians started treating the man for rhabdomyolysis. Rhabdomyolysis is a condition characterized by disintegration or dissolution of muscle and a known complication of multiple drugs of abuse, but prior to this study hadn’t been identified as a risk factor for “foxy.”

The case report’s authors say physicians should be aware of the potentially serious morbidity and mortality associated with “foxy,” as well as with other hallucinogenic drugs that are increasingly being abused.

Authors of the Cleveland case report are Gheath Alatrash, D.O., Ph.D., now with the University of Texas MD Anderson Cancer Center in Houston; Navneet Majhail, M.D., now with the University of Minnesota in Minneapolis; and James Pile, M.D., of MetroHealth Medical Center in Cleveland, Ohio.

http://www.newswise.com/articles/view/520079/

Any opinions about this?

Im thinking it may have been a coincidence.

Reputation Comments on this post:

	interesting find
	Good find... keep scanning for hard RC data

[Abrad]

Surely there would have been more cases considering the poularity of this chemical a few years ago. Could it have been some kind of allergic reaction?

[Pinkavvy]

Seems like a coincidence.... but they are "unresearched" chemicals. Let's see if there are any other cases of it. Swip did a lot of foxy over the last 10 years. lol

[grandbaby]

This is exactly the kind of thing I posted about here. I don't know whether Foxy caused this. It could have been just about anything. The point is, nobody's ever going to KNOW until governments stop driving these things underground and effectively using the psychonautical community as guinea pigs in random, uncontrolled trials.

(Although my monkey tells me he doesn't mind being a guinea pig. We'll let it ride.)

[snapper]

This is a condition associated with excessive muscle activity, seizures, excessive exercise, inherited disorders, crushing injuries, drug reactions and a lot of other things, but it could potentially be triggered by anything. It causes a muscle breakdown product, myoglobin (and other goodies), to go into circulation. Myoglobin is a big gummy protein, and can clog organ's blood supply, esp. kidneys. Often sufferers have orange - brown greasy urine (from the myoglobin). Many other deadly metabolic perturbations ensue as well.

SWIM has eaten 2.5 g of foxy in the past (long gone now) and never had a problem other than occasional sharp pains in the kidneys which seems to happen with many RCs and hallucinogenics. This guy probably had a predisposing factor which a high dose of the right drug helped bring to the fore. Malignant hyperthermia comes to mind...

Snapper

Reputation Comments on this post:

very nicely researched

[Dogears]

IS this an acute condition? Or a chronic condition of muscle wasting, such as caused by excessive use of amphetamines and malnutrition? Is the condition self-correcting, even with out medical aid?

Considering the large number of people that have done Foxy, and the many causes of this condition, I would not assume just yet that Foxy was the cause of this. After all we are talking about just one case here.

Also other tryptamines are not currently known to induce this condition.

[snapper]

5meodipt is not the cause of this unless more cases arise, which is unlikely since the stuff is perishable and hard to come by since US schedule. Hell, very few people liked it anyways.
The more acute, the more damaging. Bodies undergo some degree of this all the time. If you crush or kill a bunch of muscle cells at once, however, like having a boulder fall on your legs, or you have a seizure for a long time, it will release the contents of the cells into your bloodstream fast, essentially poisoning you. Happens for a lot of reasons, though, and probably can occur with any stimulant drug.

Snapper

[snapper]

Sound familiar ?

Methamphetamine abuse and rhabdomyolysis in the ED: a 5-year study.
Richards JR, Johnson EB, Stark RW, Derlet RW.
Division of Emergency Medicine, University of California, Davis Medical Center, Sacramento, USA.

Patients with methamphetamine toxicity are presenting in greater numbers each year to emergency departments (ED) in the US. These patients are frequently agitated, violent, and often require physical and chemical restraint. The incidence and risk of rhabdomyolysis in this subpopulation is unknown. We conducted a 5-year retrospective review of all ED patients who received the final diagnosis of rhabdomyolysis. Patients with toxicology screens positive for methamphetamine were identified, and demographics, laboratory results, resource utilization, disposition, and outcome were compared to the remaining patients. Of the total 367 patients identified, 166 (43%) were toxicology positive for methamphetamine. Methamphetamine patients differed significantly from nonmethamphetamine patients with regard to demographics and hospital utilization. Methamphetamine patients had significantly higher mean initial creatine phosphokinase (CK), 12,439 U/L versus 5,678 U/L (P = 0.02), and lower mean peak CK, 16,827 U/L versus 19,426 U/L (P = 0.03). The development of acute renal failure was not significantly different between the 2 groups. There were 16 total deaths in the study population, 11 from concomitant infection/sepsis. An association between methamphetamine abuse and rhabdomyolysis may exist, and CK should be measured in the ED as a screen for potential muscle injury in this subpopulation. Patients with rhabdomyolysis with an unclear cause should be screened for methamphetamine or other illicit drugs. (from PubMed)

They didn't mention that this guy might have been acting out and struggling against restraints, as well as being very overstimulated (25 mg is a steep dose and has a strong body load).

Too bad some moron is bringing negative attention to RCs, even defunct ones, but at least this RC is already prohibited most places.

Snapper

[fastandbulbous]

I think it's got something to do with the malignant hyperthermia mentioned earlier. The reason you get rhabdomyolysis with methamphetamine is because of the increase in body temp seen with large (usually) doses. Serotonogic drugs can also create the conditions that lead to fucked up thermal regulation (rhabdomyolysis is one of the things that happen with MDMA emergencies), one of them being malignant hyperthermia

I think the person has probably done something, that in conjunction with a fair sized dose of 5-methoxy DiPT (I got effects with 8mg as I remember) has lead to body temp going up and not being compensated for - like having a long sauna or doing something vigourous in direct sunshine on a hot day. the 'foxy' propably only had a small contribution to the overall condition, but because it was there it had to be the culprit...

[fatal]

Originally Posted by snapper

Hell, very few people liked it anyways.

swim was under the impression that it was actually highly popular and that is the reason it was scheduled. what the hell does swim know though?

[Dogears]

Is rhabdomyolysis even a seirous medical condition most of the time? I really don't know much about this, but are we just talking about a little skelatal muscle loss here? Muscle loss is highly reversable.

[fastandbulbous]

^ Kidneys being damaged due to the myoglobin released into the bloodstream isn't though (well maybe there are things you can do to maximize the oitput from any nephrons left indamaged). It's not the muscle loss per se that's a big problem, it's the breahdown products from the muscle getting into the blood that's the major worry (& cause of damage)

Reputation Comments on this post:

Clear, Concise and Absolutely Correct!

[fatmanstan]

About a week after SWIM's first real run with 2C-I, he had to go to the hospital with blood in his urine and high fever. He had built up slowly over more than a month to check toxicity with no signs of distress, then waited a few weeks before jumping in at 14mg. (Very worthwhile experience by the way, report still to come. Absolutely no discomfort at all during experience)

Being that it was a week after the experience, he has not attributed it to 2C-I, but thought that maybe it was worth mentioning here. Of note, the day before symptoms, he had a more-intense-than-usual workout (likely cause) and also had some chicken thighs that were slightly undercooked (not likely?). He had also been diagnosed in the past with HSP, an autoimmune disorder, that had kidney involvement with similar symptoms, but this had cleared up more than 5 years ago.

Also of note, when checking melting point of specific sample, it was pretty low, first starting to melt at about 228, finishing at 239. Compared to stated MP of 246-247, sample may have had some impurities.

SWIM went for daily bloodwork and urinalysis for about a week, as well as an ultrasound that showed slightly inflamed kidneys. Things cleared up after 3-4 days, and he is still undergoing weekly bloodwork and urinalysis, with specialist consultation to come. Asked attending specialist regarding possible causes, mentioning food, drink, chemical exposures, and was told that it was really impossible to tell.

Again, not specifically attributing to 2C-I, as it has been used by many people, although it, or perhaps some impurities, may have contributed. SWIM has since sampled 2mg, as kind of a test. No symptoms noted, however, it may be interesting to note that it was slightly (+1) active at this level for swim, slight mood lift and socialibilty.

He is waiting for bloodwork to finish/decrease in frequency before cautiously testing the waters again. Also worthy to note, kidney function returned to normal very quickly (3-4 days).

Just contributing to the body of knowledge.

[Nagognog2]

Bongo found blood in his urine before. He guessed it was an infection of the urinary-tract. Which are quite common. So Bongo went for the standard remedy - before screaming to a doctor: He drank lots of cranberry juice.

It went away in a day. No further symptoms/problems.

[snapper]

Was there myoglobin in your urine, fatmanstan ? If not, then it was not from muscle breakdown. Typically myoglobin will cause orange to dark brown urine shortly after the insult to your muscles, so I doubt 2-CI had anything to do with it .. Who knows, though ?

Snapper

[Jatelka]

In the medical textbooks myoglobinuria is described as "Coca-Cola" coloured. SWIJ has never seen it herself therefore doesn't know how reliable these tomes might be.

[fatmanstan]

Yeah, it was dark brown the first day, very much like coca-cola. Then shifting more towards red by day three. At times, it almost seemed like it was nearly straight blood, with little urine, very thick. Normally he wouldn't have gone to the hospital, but there was a day and a half of high fever, waking up in the middle of the night drenched in sweat, and of course, brown/red pee isn't exactly normal. Plus SWIM's wife was pretty concerned. Had it not been for her, SWIM would have likely just rode it out. Again, SWIM doesn't attribute this to 2C-I, mainly because it was a week after. However, since this is the community to share this type of information in, thought SWIM would at least make mention.

The doctor(s) didn't really give swim a complete breakdown of what was found, although blood, high protein levels, elevated urea and sodium, and high creatine levels were mentioned. No treatment was given, and condition cleared up on it's own.

Will keep the board informed if anything further develops.

[dmax]

Certainly, whoever went into medical treatment didn't disclose all the drugs they had been taking prior to their problems. Experience tells us not to tell anyone about drugs we've been doing, lest the admission cause us more problems than the remedy. Although the advice is always given, "go to the damn hospital", people are paranoid, and it's much better to be admitted for 5meo-dipt related problems than meth or substantial drug coctail problems. I've heard that some of the precursors to 5meo-dipt are chemicals that people commonly have allergies to, but I'm not a chemist or a physician, so do your own research. Blah Blah Blah etc. This drug has never caused problems in anyone in my drug community, and it's been heavily used for quite a long time now. Don't believe the hype.

[Alfa]

Originally Posted by snapper

They didn't mention that this guy might have been acting out and struggling against restraints, as well as being very overstimulated (25 mg is a steep dose and has a strong body load).

I think you are right on the spot here Snapper. Rhabdomyolysis is a very common result of strugling against restraints under the influence of psychoactives. The Dutch national drug information line reports that a lot of the drug related hospitalisations are not caused by the efects of drugs themselves, but by physical violence of restraining the victim. Violent bouncers, police officers and accidents are a factor in this. After detaining the druggy gone mad, the victim usually ends up restrained to a stretcher and hospital bed flipping out. Such experience can cause major damage to body and mind. I know cases(2C-T-7 combined with a accident and severe restraint & XTC combined with rough bouncer) where it took up to 2 weeks to come near to normal physical state.
I'm glad the cops do not have tasers in The Netherlands.

[Jatelka]

The full case report has been uploaded to the archive.