Year(s) and type of review / ECDD meetings
Drug Class
Technical information (most recent pre-review / critical review report)
ECDD Recommendation
Inclusion in Schedule II of the 1971 Convention on Psychotropic Substances
Recommendation (from TRS)

Substance identification
4-CMC (4-chloromethcathinone; 1-(4-chlorophenyl)-2-methylamino)propan- 1-one) is a synthetic cathinone also known as clephedrone. It is found in powder or crystalline form.

WHO review history
4-CMC has not been reviewed previously. A critical review was proposed on the basis of information brought to WHO’s attention that 4-CMC is manufactured clandestinely, poses a risk to public health and society and has no therapeutic use recognized by any Party.

Similarity to known substances and effects on the central nervous system
4-CMC increases extracellular neurotransmitter levels, most notably dopamine, noradrenaline and serotonin. Its molecular mechanisms and functional properties are similar to those of other psychostimulants that are listed in Schedule II of the Convention on Psychotropic Substances of 1971.

In humans, the reported effects of 4-CMC include increased concentration, increased self-confidence and increased sociability. Adverse effects associated with the use of 4-CMC include hypertension, chest pain, tachycardia, agitation, fear, aggression, psychoses, hallucinations and sleeplessness. These adverse effects are similar to those of other psychostimulants such as amphetamine and 3,4-methylenedioxy-methamphetamine (MDMA), as well as other cathinones.

Dependence potential
No controlled experimental studies of the dependence potential of 4-CMC in animals or humans were available. In view of its action in the central nervous system, however, 4-CMC would be expected to produce a state of dependence similar to that of amphetamine and other psychostimulants.

Actual abuse and/or evidence of likelihood of abuse
4-CMC caused time- and dose-dependent increase in locomotor activity in mice. In drug discrimination assays in animals predictive of subjective effects in humans, its effects were similar to those of MDMA, cocaine and methamphetamine. 4-CMC also showed rewarding effects in a brain stimulation model that is predictive of abuse potential.

4-CMC has been analytically confirmed in biological fluids from cases of non-fatal and fatal intoxication. In most of these cases, other substances were also reported.

This compound has been detected in seized materials and in biological samples in countries in various regions, including in cases of impaired driving. It has also been identified in used syringes. Seized materials containing both 4-CMC and MDMA have also been identified. One non-fatal case of intoxication with 4-CMC alone was reported.

Therapeutic usefulness
4-CMC is not known to have any therapeutic use.

4-CMC (4-chloromethcathinone) is a synthetic cathinone with effects similar to those of other synthetic cathinones listed as Schedule II substances in the Convention on Psychotropic Substances of 1971. Its mode of action and effects are consistent with those of other cathinones, indicating that it has the potential for dependence and the likelihood of abuse. There is evidence of use of 4-CMC in a number of countries in various regions, and its use has resulted in fatal and non-fatal intoxications. The substance causes substantial harm and has no therapeutic use.

■ Recommendation: The Committee recommended that 4-CMC (1-(4-chlorophenyl)-2-methylamino)propan-1-one) be added to Schedule II of the 1971 Convention on Psychotropic Substances.