Cannabis is the most widely consumed illicit drug worldwide, with an estimated global use by 2.9– 4.3% of the population aged 16–64. A growing number of clinical and preclinical studies have found concurrent use of psychostimulants and cannabis. After surveying more than 10,000 college students in the United States, researchers reported a prevalence of 40% to 60% for such a combination. Moreover, urine samples collected from 852 mephedrone users in the UK between 2020 and 2021 revealed the presence of the metabolite of the main psychoactive compound ∆9-tetrahydrocannabinol (∆9-THC), 11-nor-9-carboxy-THC.
In Europe, the prevalence of combined use of mephedrone and cannabis ranges from 20% to 30% in different countries, and the rate is as high as 90% among regular male cannabis users than among female and occasional cannabis users. Because of its low cost, wide availability, and high abuse potential, mephedrone is the third most commonly used recreational psychostimulant and euphoretic among adolescents.
Why do they like to be used together?
The high percentage of simultaneous use of ∆9-THC and mephedrone can be explained by several psychosocial and functional reasons. Cannabis is often considered a “pathway drug” and its use may predict a significantly higher risk of subsequent heavy illicit drug use, such as ALS. However, numerous reports have not supported this theory, and other studies point to social, environmental and genetic factors explaining the cause of cannabis and other drug use.
Mephedrone is a psychostimulant that causes euphoria, increased sociability and empathy, while cannabis induces relaxation and feelings of happiness. One of the main reasons for using cannabis in conjunction with mephedrone is that the combination of the two drugs enhances the subjective effects of the drug and counteracts the dysphoric symptoms of “coming down” from meth.
Indeed, mephedrone users often use cannabis immediately after meth as symptomatic relief from the negative physiological and emotional states (e.g., anhedonia, depression) that follow the “high” of mephedrone. Many meth users also report taking cannabis during the initial acute phase of mephedrone to “improve” and “alleviate” the feelings and anxiety that often occur when too much of a dose is taken.
Anecdotal evidence suggests that marijuana can offset some of the unpleasant subjective effects of mephedrone use, such as anxiety and paranoia. Some studies demonstrate that both drugs increase vulnerability to schizophrenia in young vulnerable individuals, raising the possibility that their simultaneous ingestion may have a synergistic effect on the development of psychotic manifestations.
In addition, the combination of the two substances may affect their subjective effects and exacerbate the propensity to abuse them. Although current data on the neurobiological interaction between cannabis and mephedrone remain largely elusive, initial studies in animal models suggest that the cannabinoid system may play an important role in the motivational and addictive properties of mephedrone; in addition, cannabinoids may modify behavioral effects and even mitigate some adverse long-term effects of meth.
Mixing different types of drugs makes it possible to increase the euphoric sensations, to make them qualitatively different, and sometimes to minimize unwanted symptoms. Mephedrone and marijuana (mephedrone and alcohol) have different effects on the body. Often addicts smoke cannabis to reduce the excessive activity caused by the excess stimulant. Conversely, mephedrone is used after smoking marijuana to increase performance and eliminate drowsiness. When mixing or consecutively using two drugs of different types, it is impossible to accurately predict the subsequent effects: the risk of overdose, paradoxical reactions of the body, and complications increases.
Mechanism of drug action
Mephedrone is a synthetic central nervous system psychostimulant and euphoretic. It increases the release of dopamine, norepinephrine and serotonin – neurotransmitters that speed up the nerve transmission in certain centers of the brain (mephedrone effects on the brain). Under the influence of the drug, mental and physical activity increases at the expense of the body’s reserve stores of catecholamines. When intoxication passes, there is a decline of strength, apathy, depression (mephedrone toxicity).
Marijuana, hashish and hash oil are derivatives of cannabis. They are plant-based drugs made from plants of the cannabis family. Once in the body, they act on cannabinoid receptors in the central nervous system. The highest concentrations of these receptors are found in the hippocampus, cortex, cerebellum and spinal cord. When marijuana or hashish is used, coordination of movements is impaired, memory and learning ability are reduced, and relaxation occurs. Activity caused by excess dopamine is inhibited and serotonin production is increased.
In contrast to basic research, human studies examining the acute and long-term effects of cannabis + mephedrone use are limited and often contradictory. In acute use, cannabis can enhance the subjective effects of mephedrone and counteract the additional effects of MEPH, such as fatigue, insomnia, decreased appetite, irritability, panic attacks, visual delusions, and paranoid delusions that occur when “coming off” mephedrone.
Both drugs, when taken separately, can have deleterious effects on memory and cognition, and when taken together can determine neurocognitive impairment in several areas. Notably, while mephedrone enhances oxidative stress in animal studies, cannabinoids have antioxidant and anti-inflammatory properties, which supports the idea that cannabinoids may also have neuroprotective effects against mephedrone-induced neurotoxicity in humans.
Literature data on the long-term effects of each substance and/or their combination on cognitive function, memory, mood, and impulsivity are inconsistent. Indeed, several reports have shown that deficits in memory, learning or fluency, and self-reported psychopathological problems such as depression, anxiety, paranoid thoughts, and obsessive-compulsive behavior are mostly associated with cannabis use rather than mephedrone use.
Regarding the potential neuroprotective effects of cannabis on mephedrone users, cannabis + MEPH users have been found to have fewer psychobiological problems (i.e., lower levels of anger, hostility, depression, and negative symptoms) than non-cannabis users. Moreover, mephedrone users have been found to have changes in brain activation and low performance, and the concomitant use of cannabis is thought to improve mephedrone-induced changes. Notably, the combined use of the two drugs did not exacerbate the cognitive impairment caused by either drug.
Mixing mephedrone and cannabis
The main reason people choose to use these substances together for recreational purposes is that cannabis provides a smoother “descent” after the effects of mephedrone have already been suppressed. This is best accomplished with the sedative strains of Indica, because the excitable Sativa strains produce relatively similar effects to mephedrone at least in terms of energy. If the user decides to consume both of these substances at the same time, the combined effects vary greatly from person to person (like when they use mephedrone chemsex).
MEPH and cannabis often produce a strong sense of euphoria when consumed at the same time, as well as causing an increase in blood pressure and heart rate. Mixing these substances is not recommended for those who suffer from heart disease. As with large amounts of THC, the combination of pot and mephedrone can also cause anxiety and paranoia. Some users have also experienced shortness of breath and breathing problems, and we will discuss this side effect further in a follow-up article.
What are the effects of mixing mephedrone and cannabis?
The answer to this question depends on 3 factors:
How much mephedrone you took
What kind of weed you use
When each substance was consumed
The effects of mephedrone are consistent with the dosage you use. Naturally, the higher the dosage, the more likely you are to develop side effects and the greater the likelihood of unwanted consequences.
The type of cannabis consumed also plays a vital role in a person’s experience with these substances in combination. If a person is using the sedative Indica strain, this type of cannabis is likely to reduce the energizing and psychostimulant effects of mephedrone. If one is using the stimulant Sativa strain, this type of weed will add to the energetic effects of mephedrone.
The third and final factor is time. Many recreational mephedrone users enjoy using these substances at the same time because they combine the stimulating and euphoric effects of mephedrone with the relaxing properties of cannabis.
This is the worst possible way to use them, as it often leads to those negative side effects we’ve already mentioned: anxiety and paranoia, increased blood pressure and heart rate, and sometimes even serious breathing problems and shortness of breath.
Why do I feel like I can’t breathe when I use this combination?
This is a relatively common side effect of the simultaneous use of mephedrone and cannabis. Since there are no scientific studies that have observed and analyzed the combination of these substances, it is very difficult to determine how harmful this effect really is.
As mentioned earlier, mephedrone increases levels of dopamine and noradrenaline, and this activates our sympathetic nervous system, which dilates the vascular system and pumps blood from the periphery to our vital organs, including the heart.
This increases our overall alertness and concentration, but it also causes our heart to beat more frequently (and sometimes even causes irregular heartbeats, called palpitations).
The increase in heart rate and blood pressure makes it difficult to breathe. Interestingly, high levels of THC also increase heart rate and blood pressure, especially in the first couple of minutes after use.
When mephedrone and high THC cannabis are combined, it can definitely make it very difficult to breathe. This is more than enough to scare anyone, and it can be especially frightening if you are prone to anxiety.
In short, if this keeps happening to you, it’s best to just stop using them together.
Mephedrone refers to psychostimulants/euphoretics: it increases the activity of neurotransmitters of arousal, which manifests as increased physical and mental activity. Cannabinoids – marijuana, hashish, hash oil – have a sedative effect, i.e. cause lethargy, relaxation, change in perception.
Because these drugs act in opposite ways, when they are used together, some symptoms are suppressed by others. As a rule, the effects of mephedrone appear first, but are then “muted” by marijuana/hashish.
Many individual cases prove that using cannabis after using mephedrone can mitigate the negative side effects of the drug. However, we have pointed out situations where it would be wise to refrain from mixing mephedrone with pot.
Thus, when mixing these psychoactive substances together, it is best to follow our safe use guidelines, use low doses of the substance, and only use cannabis “off” of mephedrone, preferably 1 hour after the euphoria is gone and 2 hours after.