When a group of powerful, legal stimulants burst onto the drug scene in the UK and U.S. a decade ago, they caused a media frenzy.

In Britain, mephedrone came virtually out of nowhere in 2009 to become a hugely popular drug with university students, clubbers and rural teenagers. Dubbed "meow meow" by newspapers and sold online as plant food, it was the killer drug that made people rip off their own scrotums. Yet behind the hype, to young people using it, the drug ticked all the boxes: it was legal, it got you very high and you didnt have to buy it from a street dealer. You could buy it online and get it delivered to your front door in 24 hours.

Meanwhile in the U.S., mephedrone and other synthetic cathinones such as methylone and MDPVsome of which were sold as bath saltsand later alpha-PVP, which became known as "flakka," became popular. Some of these drugs were either mixed in with, or replaced, the MDMA that fueled the EDM scene. Others inspired media coverage around their alleged ability to turn people into flesh-eating zombies (though it was later discovered that particular attacker had only used weed).

But then these drugstechnically called synthetic cathinonesvanished from the mainstream. Synthetic cathinones were banned in the UK and U.S. in 2010 and 2011, swiftly removing their unique selling point as a legal hit. Meanwhile, the purity of the drugs they were designed to replicate, such as MDMA and cocaine, had begun to rise. Cathinones fell out of favor with most users and dealers. Instead they went underground in the UK and U.S., used in the main by much smaller, more socially excluded populations, such as the street homeless and long-term drug injectors, as well as in chemsex scenes.

While synthetic cathinones are mainly drugs of historical note now in the UK and U.S., their arrival having kick-started the modern online drug trade, elsewhere on the planet they have become major drug market players. Now, a decade after becoming the go-to drugs of a new generation of young party kids in the U.S. and UK, mephedrone and other synthetic cathinones are now all over Russia, Eastern Europe and some countries in Asia.

While Silicon Valley millionaires pay $1,000 a night for organic magic mushrooms with a trip guide, and middle-class Londoners pick up deluxe cocaine for 100 a gram in West End bars, people living in relative poverty are snorting and injecting the psychoactive equivalents of knock-off designer clothes to get their stimulant high. Cathinones of varying quality and toxicity have become part of a new wave of cheap highs feeding the bargain basement of an increasingly divided global drug market.

So how did they come to dominate traditional drugs in some parts of the world?

Until four years ago, most prohibited substances entered Russia through its seaports. Cocaine from South America, ecstasy from the Netherlands and amphetamine from Belgiumall of them arrived in St. Petersburg and Ust-Luga to disperse to Russian cities and European transit destinations.

But in 2016, the situation in Russia changed. A huge clampdown on the smuggling trade, of everything from illegal furs to alcohol and drugs, and the arrest of key smugglers momentarily strangled the supply of banned substances in the country. Well-established dealing networks were lost. Drugs imported from Europe such as ecstasy, amphetamine and cannabis stopped going through ports so easily. With diminished supply, these drugs soared in price.

Wholesale drug suppliers came to the conclusion that Russia needed a new product. The criteria were simple: its manufacture should be easy and inexpensive, and the potency strong. Despite it having been banned in Russia in 2010, mephedrone was their solution.

Russian police raided a drug lab near Moscow Jan 17, 2020, and seized at least 66 kg of mephedrone and 600 liters of liquid containing synthetic drugs. IMAGE: Russian Federal Security ServiceTASS via Getty Images

Russia has little data on drug prevalence, forensics, drug-related deaths and convictions. But the evidence from online markets, police seizures and drug experts indicates cathinones have risen to usurp a variety of drug scenes in Russia. Earlier this month a clandestine lab outside Moscow producing mephedrone for online sales was busted. Police arrested five suspects and found 66 kg of mephedrone, 600 litres of liquid containing synthetic drugs and precursor chemicals.

On Hydra, the largest Russian darknet market, mephedrone is more popular than weed. There are more clandestine online shops selling mephedrone than any other drug and the most drug reviews on the site are about mephedrone.

Teenagers wear Metallica-logo "Mephedrone" t-shirts, while the musician Mukka has a song called Girl With A Bob Cut, with the chorus: "In my yard, there is a girl with a bob cut walking/She loves mephedrone, she loves mephedrone. And I am so in love with her." The video, which has 11 million views, features a couple meeting in a club and getting trashed before the girl ODs and is buried the next day by her lover in the snow.

On the encrypted messenger app Telegram, numerous channels talk about using mephedrone and alpha-PVP. Many of these mini-blogs are written in Beatnik style, like cult Russian underground writer Bayan Shiryanov, and describe addiction to cathinones. Some have 10,000 subscribers and act as entry points into online drug markets.

Mom, we are all sick with mephedrone, less often alpha, writes Deep in sin. You and Iwe go crazy for these two and die on withdrawal. The authors are mostly teenage girls, or people who pretend to be teenage girls, hoping to get cash by posting referral links to shops or by leaving their card number and asking people to donate.

According to data analysis from a Telegram channel called DrugStat, prices for a gram of mephedrone in Russia start from $25. In contrast, a gram of cocaine starts from $130. Synthesis of mephedrone in Russia can get as cheap as 30 cents a gram from what I've heard, said Andrey Kaganskikh, a freelance Russian journalist who has investigated Russias drug problem. Prices for mephedrone dont differ that much around the country because it can be synthesized almost anywhere. Underground labs making synthetic cathinones have also been found in Eastern Europe. Since 2013, a number of factories related to cathinone production have been dismantled in Poland and Slovakia.

As with the drugs they are slowly replacing, synthetic cathinones come with risks. Their ingredients are far more varied and unpredictable than their traditional counterparts. Because most are habit-forming, and have been adopted by injectors, they have been responsible for a rise in acute psychosis, blood-borne infections, and deaths in the regions in which they are used.

According to Nikolay Tumanov, a Russian doctor-narcologist, cathinones can cause "anxiety, pseudo-depressive disorders, sleep disturbances, aggressiveness, panic attacks, in fact a destabilization of the nervous system." While synthetic cathinones have been linked to a significant number of deaths in Eastern Europe, many of these are poly-drug poisonings, making the risk difficult to gauge.

Cathinones, mainly mephedrone and alpha-PVP, have also gained a market foothold in Georgia, a country situated at the juncture of Western Asia and Eastern Europe.

Since Georgia declared independence from the Soviet Union in 1991, personal freedom is valued highly and the country now has a flourishing, young electronic dance music scene. Here, the media calls mephedrone killer salt after several fatal overdoses linked to mephedrone at clubs and festivals in 2017, resulting in the drug being banned in 2018. Even though it has an even more dangerous reputation than mephedrone, alpha-PVP has become prevalent in the country among students and older users who often vape or inject the drug.

In Georgia, unlike in many countries, cathinones are not just cheap substitutes for other drugs, they are rival products. On Matanga, a popular clearnet website for buying illegal drugs, both mephedrone and alpha-PVP are more expensive than MDMA. The potency of alpha-PVP, which makes it more cost-effective than mephedrone and cocaine, likely explains its popularity in a country where the minimum wage now amounts to only $7 a month.

In Poland, mephedrone has become a growing problem among young people, according to the number of patients admitted to Nowowiejski Hospital in Warsaw after a mephedrone binge, which rose steadily between 2010 and 2018. The 8kg seizure of mephedrone in Pozna last year and other recent seizures across the country indicate a strong market for the drug, which is probably the result of how easy it is to synthesize, said the Social Drug Policy Initiatives Jerzy Afanasjew.

On the Polish drug market, mephedrone is more of a brand than a specific substance, says Afanasjew. What survived the blanket ban on new psychoactive substances are mostly mephedrone analogues, like 4-CMC, but nobody really knows, because users simply refer to the new analogues as crystal. Nobody cares if it's mephedrone if it works like a speedy euphoric party drug.

Eastern Europes affair with cathinones is not all-encompassing. For example, drug prevalence data shows Czechs and Slovaks, who neighbor Poland to the north, have not taken to them. Up until recently, despite the rise of cathinones in Russia, Ukraine has resisted cathinones. However, experts in Ukraine said that mephedrone has seen a steady growth due to its low cost and strong euphoric effect, and word of mouth increases its popularity every month.

While the epicenter of global synthetic cathinone use appears to be on Europes eastern fringes, these drugs have also been taken up in other parts of the world. Synthetic cathinone abuse is the fastest-growing drug problem in the small east Asian country of Taiwan, according to the latest statistics from the countrys Food and Drug Administration.

Little is known on cathinone use in Taiwan, although most users are young men. The drugs have been linked to an alarming rise in fatal ODs. Mephedrone, produced in nearby China, is the most detected cathinone in Taiwan, followed by methylone, while new derivatives have recently been added to the controlled illicit substances list. Cathinones are sold online as cute products such as Rainbow Little Devil and Hello Kitty and often advertised as containing "organic ingredients." Police have seized the drugs packaged as coffee, candy, cookies or chocolate.

In 2012, mephedrone took off in India, where it was branded poor mans cocaine. At the same time, what were called loophole drugsa name for legal highs containing mainly synthetic cathinones and synthetic cannabinoidswere being widely distributed and abused in Japan. In both countries, these drugs were responsible for a high number of arrests and admissions into psychiatric hospitals. But since new legislation and heavy police crackdowns, cathinones are no longer so cheap and readily available. However, the quantity of mephedrone seized and reported by the Indian Narcotics Control Bureau in recent years, for example a 50g haul in Mumbai earlier this month, indicates that its still a common drug.

Synthetic cathinones are not just being used around the world to substitute recreational drugs, but as alternatives to heroin. Anya Sarang, President of the Andrey Rylkov Foundation for Health and Social Justice in Moscow, said alpha-PVP is popular among injecting users in Russia because it is more cost-effective than other drugs. In Russia, using alpha-PVP is not a matter of choice or personal preferences but rather a marker of poverty, she said.

A similar scenario has likely occurred in Georgia. Natia Natenadze, a Master of Addiction Studies, says web bought alpha-PVP is now more on the Georgian drug market than heroin.

In Poland, drug injectors are mainlining cathinones despite the blanket ban and crackdown on legal high shops. According to Bartosz Michalewski, who works with drug users on a daily basis at the Monar clinic in Krakow, "100 percent of them are shooting cathinones." He said they are usually people who are living on the streets who are injecting cathinones because heroin is harder to get hold of in the city.

In both Hungary and Romania, shortages in the availability of heroin in 2010 and 2011, along with the increased availability of cathinones sold as "legal highs" in headshops and online shops, meant that cathinones have now largely replaced traditional drugs among injecting users.

The switch to cheap cathinones was most notable within poor, segregated Roma communities in the two countries, where people are severely disadvantaged on every levelhousing, education, employment, and health. Cathinones like pentedrone (a more MDMA-like, liver-toxic drug than mephedrone) and lesser-known cathinone analogues are common here. They are often sold in branded packets, usually in combination with other drugs, yet few people know exactly what's in them, as the government rarely tests them.

Unlike heroin or amphetamines, whose effects are longer-lasting, users of cathinones need repeated hits, so often shoot up three to ten times per day. Alina Dumitriu, a drug outreach worker at ARAS (the Romanian Anti-AIDS Association) in Bucharest, Romania told VICE that the more chaotic use of cathinones have increased needle sharing, making users even more vulnerable to infections such as HIV, hepatitis and tuberculosis. In addition, the consequences of injecting cathinoneslike skin erosion and large holes at overused injecting sitespredisposes users to cellulitis and other potentially serious bacterial infections.

Harm reduction services in Hungary are also facing similar problems, which have been exacerbated by a lack of financial resources, according to Peter Sarosi, a human rights activist and drug policy expert. NGOs that provide harm reduction programs in some of the most impoverished parts of Budapest, which are home to many Roma people who live in deep poverty, have had funding and support from Hungarys right wing government cut to shreds. Since closing down the two largest harm reduction programs, thousands of high-risk drug users have become invisible to the treatment system, so it is impossible to keep track of infection rates such as an HIV outbreak.

Estimates of cathinone use across the world, especially in countries that do not routinely test seized drugs or new psychoactive substances, are highly likely to be the tip of the iceberg.

In many countries, data on synthetic cathinone use is either lacking or entirely absent. In addition, drug-detection dogs and routine urine drug screens do not detect synthetic cathinones, meaning the scale of their global use may be largely underestimated. The United Nations Office on Drugs and Crime have identified close to 170 synthetic cathinones on their drug markets since 2009. However, only a handful of these are well known.

The law, it seems, is being played for a fool. Strict narco-policy has not only failed to stem the flow of these drugs in Eastern Europe and Taiwan, it is the reason new and dangerous cathinones are being introduced on the black market. As most countries continue to wage a war on drugs, the question is not whether cathinones will continue to spread, but which ones, and where they will take hold.

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