MDMB-CHMICA

IUPAC Name

methyl 2-[[1-(cyclohexylmethyl)indole-3-carbonyl]amino]-3,3-dimethylbutanoate

Year(s) and type of review / ECDD meetings
Drug Class

Recommendation (from TRS)

Substance identification
Chemically, MDMB-CHMICA is methyl N-{[1-(cyclohexylmethyl)-1H-indol-3- yl]carbonyl}-3-methyl-L-valinate. MDMB-CHMICA has a chiral carbon in the butanoic chain. Therefore, two stereoisomers exist: (S)-MDMB-CHMICA and (R)-MDMB-CHMICA.

Previous review
MDMB-CHMICA has not been previously pre-reviewed or critically reviewed. A direct critical review was proposed based on information brought to the attention of WHO that MDMB-CHMICA is clandestinely manufactured, poses a serious risk to public health and society, and has no recognized therapeutic use by any Party.

Similarity to known substances and effects on the central nervous system
MDMB-CHMICA belongs to the group of synthetic cannabinoid receptor agonists (SCRAs). MDMB-CHMICA has been shown to activate CB1 and CB2 cannabinoid receptors with preference for CB1 receptors over CB2 receptors. MDMB-CHMICA is a highly efficacious compound with full agonist properties at the CB1 receptor of the endocannabinoid system and with a greater potency than delta-9-tetrahydrocannabinol (THC). Few reports of pharmacodynamic studies in laboratory animals or humans are available that describe the pharmacology of MDMB-CHMICA. Case reports and user reports indicate that MDMB- CHMICA can induce acute toxicity and serious adverse events including nausea, confusion, agitation, hallucinations, loss of consciousness, emesis, bradycardia or tachycardia, spontaneous urination and defecation, respiratory insufficiency and acidosis, hypothermia, mydriasis, hypoglycaemia and seizures including tonic–clonic seizures. MDMB-CHMICA has been associated with 53 analytically confirmed cases of serious adverse events in Europe and at least 28 deaths. While in most instances other drugs (typically other SCRAs) were also present, MDMB- CHMICA was the sole substance detected in some cases.

Dependence potential
No controlled studies in humans or laboratory animals regarding the potential physical dependence or tolerance effects of MDMB-CHMICA have been reported. Withdrawal-like symptoms associated with abstinence from MDMB- CHMICA such as numbing of skin, cravings, mental fog, depressed mood, nausea and abdominal pain have been reported by poison information centres and on user websites. However, information on duration of use, pattern and amount consumed over time was not available.

Actual abuse and/or evidence of likelihood of abuse
There are no available reports of controlled studies involving the dependence potential or abuse potential of MDMB-CHMICA in laboratory animals or human subjects. Epidemiological reports of the incidence and prevalence of MDMB-CHMICA use are also apparently unavailable. MDMB-CHMICA is easily purchased on the Internet. It is sold online as a commercially branded legal high or as a research chemical in various countries in different regions. More than 3600 seizures or reports of detection of MDMB-CHMICA in 21 European countries were reported in February 2016. In addition to the non-fatal and fatal intoxications, analytically confirmed MDMB-CHMICA use has been related to DUID and violent public behaviour. A number of countries in different regions have placed MDMB-CHMICA under some level of national control.

Therapeutic usefulness
There are no known approved therapeutic applications for MDMB-CHMICA.

Recommendation
The Committee considered that the degree of risk to public health and society associated with the abuse of MDMB-CHMICA (methyl N-{[1-(cyclohexylmethyl)- 1H-indol-3-yl]carbonyl}-3-methyl-L-valinate) is substantial. Therapeutic usefulness has not been recorded. It recognized that MDMB-CHMICA has similar abuse and similar ill-effects to substances in Schedule II of the UN Convention on Psychotropic Substances of 1971. The Committee considered that there is sufficient evidence that MDMB-CHMICA is being or is likely to be abused so as to constitute a public health and social problem warranting the placing of the substance under international control. As per the Guidance on the WHO review of psychoactive substances for international control (2), higher regard was accorded to the substantial public health risk than to the lack of therapeutic usefulness. The Committee recommended that MDMB-CHMICA be placed in Schedule II under the UN Convention on Psychotropic Substances of 1971.

ECDD Recommendation

Inclusion in Schedule II of the 1971 Convention on Psychotropic Substances