New “Lethal highs”: A case of a deadly cocktail of GHB and Mephedrone

Drug scenes within several countries have changed in recent years to incorporate a range of licit psychoactive products collectively known as “legal highs”: these in combination with substances already in use can cause major health problems and even death. Consumption of Gamma-hydroxybutyric acid (GHB) spread from 1980s to 2000s, when several nations have enacted laws that have made it illegal. Cases of GHB-caused or related deaths are often described in association with alcohol or traditional drugs (heroin, cocaine, amphetamine); few cases of acute lethal toxicity due to Mephedrone have been recently reported; we describe the first case of fatality due to concomitant consumption of GHB and Mephedrone. A 43 years old man died during a drugs-based party: the two substances were not detected at toxicological screening, but were identified by further analysis on the basis of circumstantial data reported by a survivor. Through our work we aim to bring to the attention in the emerging role of new drugs of abuse, and highlight problems in identifying these drugs with immunoassay screening test commonly used.