Substance Abuse:
Designer Drugs

Meperidine Analogs

Meperidine, was the very first synthetic narcotic ever produced and is known by the trade name of Demerol. Demerol is a narcotic controlled under Schedule II of the CSA (meaning that it has a high potential for abuse as well as recognized medical use).

Chemically unlike morphine, it does resemble the opium extract in its analgesic potency. Meperidine is available in pure form and in products containing other medications. It is administered orally or by injection. Tolerance and dependence occur with long-term use, and large doses can result in convulsions. Over the past decade, the illicit use of meperidine has increased during periods when heroin was scarce. Two meperidine analogs that have appeared on the streets include: (1) MPPP--(1-methyl-4-phenyl-4-propionoxypiperidine), and (2) PEPAP--(1-[2-phenylethyl]-4-acetyloxypiperdine)

They often are marketed as "new heroin," "China White," or "synthetic Demerol." MPPP is popular among drug users because when it is injected, it produces a euphoria similar to that produced by heroin.

An impurity formed during the clandestine manufacture of MPPP, called MPTP (1-methyl-4-phenyl-1,2,3,6,-tetrahydro-pyridine), has been shown to be a potent neurotoxin and has caused irreversible brain damage in several individuals. The damage is manifested in a syndrome resembling a very severe parkinsonism, which results in increased muscle tone, difficulty in moving and speaking, drooling, and cogwheel rigidity of the upper extremities. Tremor in such patients characteristically involves the proximal muscles and is more pronounced than the typical involuntary rest tremor occurring in idiopathic parkinsonism. MPTP was identified primarily in California, in the early 1980's.

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