Synthetic cathinones are becoming increasingly popular and available as legal highs on the internet smartshop. Since July 2012, all synthetic drugs from the cathinones family have been banned and listed as narcotic in France but remain used.

To describe the clinical presentation and alert the health care community about the abuse identification and risk assessment problems of these compounds.

We retrospectively reviewed cases of cathinone derivatives abuse notified to our Parisian centre during a two-year period (2011-2012).

Twenty cases of cathinones abuse were identified. Users were mostly men (19/20), with mean age of 38 years, showing occasional cathinones abuse in sexual gay party (12/20). The synthetic cathinones were most commonly administered by intravenous injection (75%): an increasingly popular practice among Parisian men who have sex with men (MSM). This practice is called “slam”. This is an especially worrisome trend since the prevalence of HIV infection in our cases were 70% (14/20) with frequent co-infection HIV/Hepatitis C (40%). Thirteen cases presented psychiatric disorders: psychotic symptoms (58%), agitation (37%), anxiety (37%), suicidal ideas (28%) or attempt (2/20), acute satyriasis (2/20). Seven patients presented a cathinones dependence with DSM 4 criteria. Two patients had forensic problems. Somatic complications were described in ten cases with various pattern of symptoms as headache or rhabdomyolysis with renal failure.

Cathinones cause fast dependence syndrome with strong craving and prolonged psychiatric symptoms. We discuss the relation between sex and drugs in our sample. Cathinones could have a specific effect on sexual drives.