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PMMA/PMA

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Also known as

red mitsubishi, killer, death, pink ecstasy, pink mcdonalds, mitsubishi turbo, dr death, double stacked, chicken yellow, chicken fever, yellow rockstar, green rolex, chicken powder

Classification

Entactogen, stimulant

Overview

PMA/PMMA looks like, and is sold as ecstasy, but is more toxic, and in some cases fatal [1]. Para-methoxymethamphetamine (PMMA) is an analogue of para-methoxyamphetamine (PMA). Both are strong psychedelic/stimulants that are very similar to MDMA, MDA, MDEA and mescaline and likely to cause very strong, dangerous over-heating of the body. PMA has been available on the streets in the US since the 1970's, whereas PMMA has appeared on the streets more recently. They are usually found in ecstasy pills, or sold as ecstasy/MDMA pills with or without other amphetamines.

There have been a number of deaths caused by PMMA/PMA over the last few decades. The exact numbers are not clear, but the deaths seem to be rising.

The predominant symptom of the fatalities has been hyperthermia and the causes of death since around 2010 have been related to either PMA or PMMA.

Most recently,there haev been four deaths in the UK where PM(M)A was thought to be the cause [1].

PMA is similar to MDMA (the chemical in ecstasy). It can make you feel alert, alive and full of energy. Its similarity means that PMA is actually sometimes sold as ecstasy. However, PMA is more poisonous and can kill at lower doses than MDMA. Also like MDMA, it can cause a fatal rise in body temperature.

The effects of PMA also take longer than MDMA to begin to be felt - so some users have overdosed by mistakenly taking pill after pill thinking nothing is happening, which can also be fatal.

In recent years there have been a number of deaths and hospitalisations that have been linked to PMA and/or PMMA. It appears that those affected thought they were taking ecstasy pills containing MDMA and did not know that the pills contained PMA and/or PMMA. As with any drug you can never be sure what it is your buying and how it might affect you.

As PMA is often sold as ecstasy pills rather than sold by its own name, a lot of the street names associated with PMA are actually street names for ecstasy pills. Sometimes PMA and/or PMMA containing pills even look like regular ecstasy pills [2].

What does it look like?

It is usually found in pill form, a white-ish colour, but can also be pink or yellow.

Several PMA pills have been found to have a Mitsubishi stamp imprinted on them [1].

PMA is sold as a pill but the pills can be lots of different colours and can have different marks on them. It is relatively easy to grind down pills to re-colour and re-brand them with a new logo or design, so a pink heart-shaped pill can be made into a green round pill or a yellow square pill.

As with any pill you can never be sure what it contains or how this might affect you.

PMA has been found in ecstasy pills and these come in a variety of colours and shapes [2].

Why take it?

Sought after effects

Effects are similar to those experienced with other stimulants including ecstasy and other amphetamines -

  • increase in energy,
  • minor visuals [1].

Undesired effects

Symptoms with a higher dose include -

  • hallucinations,
  • convulsions,
  • respiratory distress [1].

Dosage

Abuse

  • threshold - ? mg,
  • light - 20 - 40 mg,
  • common - 40 - 60 mg,
  • strong - Higher dosages can result in serious hyperthermia and eventually death [3].

Pharmacology

PMA strongly acts as a selective serotonin releasing agent (SSRA) and very weakly on dopamine and norepinephrine (noradrenaline) systems in the brain and nervous system. However, it is not as potent in directly releasing serotonin in the same way as MDMA, and consequently is not particularly euphoric. Studies show that rodents do not seem to self-administer it in the same way as they do amphetamine and MDMA.

The other great difference between PMA/PMMA and other amphetamine-type substances is its inhibitory effect on the enzyme monoamine oxidase (MAO). It is 20 times more potent on this enzyme (specifically the 'A' variant) than amphetamine. MAO acts to breakdown compounds such as serotonin, dopamine, norepinephrine and epinephrine in the liver. This prevents toxic and potentially lethal levels of these 'monoamines' from building up in the blood. Although not fully understood, it is thought that the reason PMA and PMMA are fatal is due to a combination of this inhibitory effect on the MAO-A enzyme in preventing the metabolism of monoamines as well as an increase in serotonin centrally that causes the body to overheat [1].

PMA acts as a selective serotonin releasing agent (SSRA) with weak effects on dopamine and norepinephrine transporters. However, relative to MDMA, it is considerably less effective as a releaser of serotonin with properties more akin to a reuptake inhibitor in comparison. It evokes robust hyperthermia while producing only modest hyperactivity and serotonergic neurotoxicity, substantially lower than that caused by MDMA. Anecdotal reports suggest it is not particularly euphoric at all, perhaps even dysphoric in contrast. PMA has also been shown to act as a potent, reversible inhibitor of the enzyme MAO-A with no significant effects on MAO-B, and the combination of this property and serotonin release is likely responsible for its high lethality potential.

It appears that PMA elevates body temperatures dramatically; the cause of this property is suspected to be related to its ability to inhibit MAO-A and at the same time releasing large amounts of serotonin, effectively causing serotonin syndrome. It appears that PMA activates the hypothalamus much more strongly than MDMA and other drugs like ephedrine, thereby causing rapid increases in body temperature (which is the major cause of death in PMA mortalities) [3].

How is it taken?

  • Swallowed - pills are swallowed (ingested) [1]. Like ecstasy, PMA is swallowed [2].

Signs of usage

  • increased breathing,
  • increased body temperature,
  • increased pulse rate and blood pressure,
  • erratic eye movements,
  • muscle spasms,
  • nausea,
  • heightened visual stimulation [4].

Effects

PMA is similar to MDMA (the active substance in ecstasy) but can kill at lower doses as it is more poisonous [2].

PMA effects include -

  • giving people an energy buzz that makes them feel alert and alive,
  • feeling in tune with surroundings,
  • sounds and colours are more intense,
  • feelings of great love for friends and strangers [2].

Physical effects

  • pupil dilation,
  • stimulation,
  • appetite suppression,
  • abnormal heartbeat,
  • dehydration,
  • dizziness,
  • increased blood pressure,
  • increased heart rate,
  • increased perspiration,
  • nausea,
  • seizure,
  • teeth grinding,
  • temporary erectile dysfunction,
  • vasoconstriction [3].

Cognitive effects

  • anxiety,
  • cognitive dysphoria,
  • cognitive euphoria,
  • time distortion,
  • wakefulness,
  • anxiety suppression,
  • dream suppression [3].

Visual effects

  • drifting,
  • tracers,
  • double vision,
  • vibrating vision [3].

Overdose

  • kidney failure,
  • extremely high body temperature,
  • vomiting,
  • convulsions and seizures,
  • coma,
  • death [5], [6].

Risks

The effects of PMA can a take a while to kick-in so there's a risk of the user double-dosing to compensate, risking a fatal overdose. Other risks include -

  • As little as a quarter of a tablet (60mg) is enough to significantly increase blood pressure, body temperature and pulse rates.
  • Anyone with a heart condition, blood pressure problems, epilepsy or asthma can have a very dangerous reaction to the drug.
  • Anyone using too much can get paranoid and depressed.
  • PMA can cause muscle spasms and lots of people feel very sick after taking it.
  • PMA affects the body's temperature control and the risk of overheating may be greater than ecstasy, as it is more poisonous. People can get so out of control that they don't realise they're in danger of overheating and dehydration. Users should take regular breaks to cool down and should keep hydrated. If you feel your temperature soaring on the dance floor seek help immediately.
  • Be a little careful not to overdo it when drinking fluid to avoid dehydration and overheating - as drinking too much water can also be dangerous or even fatal. Just remember to sip no more than a pint of non-alcoholic fluid every hour. This is important because drugs like PMA and MDMA (ecstasy) can cause the body to release a hormone which suppresses the production of urine. So, if a user drinks a few pints of liquid too quickly, water builds up in the body and interferes with the body's salt balance. This excess of water in the body can directly harm brain function; and this can be as deadly as not drinking enough water.
  • The long term risks associated with PMA have yet to be studied but many are likely to be similar to ecstasy [2].

Purity

Not enough is known about the purity of PMA but if it's being sold as ecstasy it's likely the pills have been cut with other ingredients like amphetamine (i.e. speed), caffeine and starch [2].

Addiction

Can you get addicted

As with ecstasy, it's possible to build up a tolerance [2].

Dependence

Psychological dependence may also develop (with an increased desire to keep taking the drug despite the risks) [7].

Interactions

Dangerous

  • αMT,
  • Tramadol - Tramadol and stimulants both increase the risk of seizures.
  • MAOIs - MAO-B inhibitors can increase the potency and duration of phenethylamines unpredictably. MAO-A inhibitors with amphetamine can lead to hypertensive crises [8].

Unsafe

  • DOx - The combined stimulating effects of the two can lead to an uncomfortable body-load, while the focusing effects of amphetamine can easily lead to thought loops. Coming down from amphetamines while the DOx is still active can be quite anxiogenic.
  • NBOMes - Amphetamines and NBOMes both provide considerable stimulation. When combined they can result in tachycardia, hypertension, vasoconstriction and in extreme cases heart failure. The anxiogenic and focusing effects of stimulants are also not good in combination with psychedelics as they can lead to unpleasant thought loops. NBOMes are known to cause seizures and stimulants can increase this risk.
  • 2C-T-x - Stimulants increase anxiety levels and the risk of thought loops which can lead to negative experiences. In extreme cases, they can result in severe vasoconstriction, tachycardia, hypertension, and in extreme cases heart failure.
  • 5-MeO-xxT - The anxiogenic and focusing effects of stimulants increase the chance of unpleasant thought loops. The combination is generally unnecessary because of the stimulating effects of psychedelics.
  • DXM - Both substances raise heart rate, in extreme cases, panic attacks caused by these drugs have led to more serious heart issues.
  • PCP - This combination can easily lead to hypermanic states [8].

Withdrawal

There have been no clear physical withdrawals reported with PMA but, as with ecstasy, users may feel lethargic or low for some days after having used [7].

Drug testing

How long does PMA stay in the urine?

Shows up in urine tests for 3 - 8 days. (The length of time depends on the test used, the amount you take, if you have other medical conditions and your own metabolism. Please use this figure as a guide only) [7].

Legality

  • PMA is a Class A drug which means that it's illegal to have for yourself, give away or sell.
  • Possession can get you up to seven years in prison and/or an unlimited fine.
  • Supplying someone else, even your friends, can get you a life sentence and/or an unlimited fine [2].

Did you know?

  • A conviction for a drug-related offence could have a serious impact. It can stop you visiting certain countries - for example the United States - and limit the types of jobs you can apply for.
  • Like drinking and driving, driving while impaired by PMA is illegal - you can get a heavy fine, be disqualified from driving or even go to prison.
  • Allowing other people to supply drugs in your house or any other premises is illegal. If the police catch people supplying illegal drugs in a club they can potentially prosecute the landlord, club owner or any person concerned in the management of the premises [2].

Mixing with other drugs

Mixing PMA with alcohol can have serious consequences - the effects of PMA are increased, making it more likely to experience its negative effects [2].

Taking PMA or PMMA with other drugs such as alcohol, cocaine, amphetamines, cannabis and some prescription medications such as anti-depressants (SSRIs and MAOIs) can be potentially fatal [5], [6].

Harm reduction

Drug potency

This is very hard to estimate with tablets, but here are a few things to consider -

  • What are the markings on tablets that are being offered around? Make sure you can see what you are taking.
  • 'Ramps' or marks on tabs are no guarantee of content, but they can help guide you.
  • Colour and size or texture can help to identify a tablet, but producers rely on a type of brand recognition that can work on a number of levels.
  • Just because one type of pill say a 'white dove', for example, was good a couple of months ago, doesn't mean you can rely on it now.
  • Check the websites that offer information. These days, 'smartphones' offers an extra level of self-protection that was not available to people at clubs previously. But the same advice applies, perhaps the best way to look at it is - you are looking for reports of bad pills, not necessarily endorsements of good ones.
  • If you can, get your pills tested before taking them. If they include PMA/PMMA do not take the pills [1].

Tips on staying safe

Remember that if you don't feel any effect from one pill (at the most) after 45 minutes, it is possible that you have not taken MDMA. Taking more of the same will not help. If it is PMA/PMMA you are taking a significant risk.

The possible interaction with other substances particularly alcohol and alcohol/energy drink mixes; if you are doing pills these should be avoided.

Setting - This means the environment that you are in. While you are out to have a good time, don't get too lost in the moment. It is particularly important to be aware that your body will be more likely to overheat if you are dancing in a packed club and you should make sure you top up on liquids, particularly water or an 'isotonic' beverage. The recommended guidelines are sipping 500ml/hour (when dancing) or 250ml/hour (when inactive) of water. However, be cautious of consuming over this amount as it can lead to overhydration which can be fatal.

Overheating is a cause for concern as one of the symptoms of PMA/PMMA at dangerous doses is hyperthermia. If you are in a club, do not try to counter-balance this by going out immediately to cool down, a sudden drastic change in environment can be risky. You will want to get somewhere more temperate, but overheating with PMA/PMMA does not only occur in clubs, it is an internal physical reaction. If you are worried and you begin to overheat, call an ambulance.

Stay together with your mates for at least an hour if you do take any pills.

Make sure you know where your trusted friends are if you are at a big rave, and if you get separated, have a meet-up point. If you are in other social settings (i.e. not raves or nightclubs) and you or someone who know shows signs of overheating, it is advisable to be cautious that you have taken PMA/PMMA and you should seek medical help [1].

History

PMA has been present in history since 1970, where it was first available on the black markets around the world. The first deaths reported by the U.S. due to the substance being mis-sold as MDA, were in 1972. The first known, and reported death in the UK due to PMA was Jeremy Andrew Shaw, who died in 1975. Around this time (1975), the substance was being sold as a recreational psychoactive under the name "chicken powder" and "chicken yellow".

The substance then began to drop in circulation from the market in the 1980's, with only a few deaths being reported between the late 1970's and the very early 1990's. However, in the early 1990's there was a rise in deaths again as the substance began to reappear in Australia. Since then, the pill has been dropping in use, and resurfacing in the illicit market every so often. In 2000 - 2001 there were nearly 20 deaths across the world due to PMA/PMMA being mis-sold as ecstasy pills.

In late 2010, over a course of 6 months there were 12 deaths in Norway that were found to be caused by PMMA. This first brought PMMA into mainstream media attention.

In 2013 we have seen a drastic rise in PMA/PMMA deaths occurring in the UK due to the same reason. Between June and July there have been just under 30 deaths because of the substance being mis-sold as ecstasy/MDMA across England, Scotland and Northern Ireland, and the death toll still seems to be rising [1].


References