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We studied 23 adults in Latvia who had extrapyramidal symptoms and who had injected methcathinone for a mean (±SD) of 6.7±5.1 years. The methcathinone was manufactured under home conditions by potassium permanganate oxidation of ephedrine or pseudoephedrine. All patients were positive for hepatitis C virus, and 20 were also positive for the human immunodeficiency virus (HIV)... The patients reported that the onset of their first neurologic symptoms (gait disturbance in 20 and hypophonia in 3) occurred after a mean of 5.8±4.5 years of methcathinone use. At the time of neurologic evaluation, all 23 patients had gait disturbance and difficulty walking backward; 11 patients were falling daily, and 1 of these patients used a wheelchair. Twenty-one patients had hypophonic speech in addition to gait disturbance, and one of these patients was mute.
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http://content.nejm.org/cgi/content/full/358/10/1009
The study only says that IV users of many years developed these symptoms and that they were also HIV positive making them susceptible to Parkinson's.
People would have to draw their own conclusions about whether snorting/ smoking home manufactured methcathinone is safe. The authors conclude that 'manganese toxicity' appears to be the cause of the subject's condition but it took five years for symptoms to develop.