The Narcotics Division of the Security Bureau in Hong Kong is planning to put three substances under the regulation of the First Schedule of the Dangerous Drugs Ordinance (Cap. 134). These substances are MT-45, 4,4’-DMAR (4,4’-Dimethylaminorex) and phenazepam. The amendment is scheduled to be submitted within the legislative year of 2016-2017.

For their potential risk of being used as illicit drugs, said substances had earlier been included in the international control by the United Nations Commission on Narcotic Drugs. MT-45 is regulated under Schedule 1 of the Single Convention of Narcotic Drugs of 1961, 4,4’-DMAR in Schedule II and phenazepam in Schedule IV of the Convention of Psychotropic Substances of 1971. Being part of the United Nations, Hong Kong partakes in the amendment.

MT-45 - a synthetic opioid that exerts similar effects as morphine


MT-45 is a synthetic opioid that exerts effects similar of a classical opioid such as morphine. Its analgesic potency is comparable of morphine’s, with similar magnitude of respiratory depression. It shows high affinity to all three opioid receptors, inducing euphoric effect upon consumption.

Acute toxicity of MT-45 can lead to respiratory distress, permanent loss of hearing, coma and even death. Between year 2013 and 2014, there were 28 deaths associated with the use of MT-45 in Sweden and one death in United States of America.

4,4’-DMAR – a new psychoactive substance which produce rewarding properties via the dopamine system


4,4’-DMAR is a new psychoactive substance with stimulant properties. It became available on the European Union drug market since November 2012.7 According to the World Health Organisation, 4,4’-DMAR does not have any therapeutic or legitimate purposes.

Additionally, 4,4’-DMAR has been found to produce rewarding properties via the dopamine system, imitating amphetamine-like abuse. It is often sold as ecstasy and amphetamines on the illicit market. Intoxication of 4,4’-DMAR can lead to agitation, seizures and hyperthermia prior to death. A total of 27 deaths associated with 4,4’-DMAR were reported between year 2013 and 2014, with eight from Hungary and 19 from the United Kingdom.

As both MT-45 and 4,4’-DMAR possess no therapeutic value, Hong Kong does not register any product containing any of the 2 substances. However, these substances are not regulated in Hong Kong and there is no record of law enforcement agencies seizing such substances.

Phenazepam – high dose intake can induce suppression of central nervous system


Legal status of phenazepam differs across the world. In Hong Kong, phenazepam is regulated under the control of the Pharmacy and Poisons Ordinance (Cap. 138), although there are no registered pharmaceutical products containing phenazepam on the market.

The Hong Kong law enforcement agencies have seized 19,426 pieces of phenazepam in 2013, 4934 in 2014, 133 in 2015 and 1252 from the first 3 quarters of 2016. Belonging to the group of benzodiazepines, phenazepam is being used as a tranquilizer to treat neurotic disorders, alcohol abuse disorder, epilepsy, sleep disorder, anxiety and schizophrenia.

Phenazepam was developed in the former Soviet Union, and is easily available via online purchase. In 2011, attention grew as phenazepam was found to be associated with at least 9 death cases in the United Kingdom. High doses of phenazepam consumption induce suppression of central nervous system, leading to muscle weakness, respiratory distress, coma and death.

With the increasing numbers of severe adverse events and deaths associated with emerging synthetic opioids and phenazepam reported globally, it is time to impose stricter control on the said substances. MIMS

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http://www.unodc.org/documents/commissions/CND/CND_Sessions/CND_59/Decision_59_2.pdf
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http://www.emcdda.europa.eu/attachements.cfm/att_229825_EN_TDAS14006ENN.pdf (p. 7 &12)
http://www.who.int/medicines/access/controlled-substances/5.5_44_DMAR_CRev.pdf
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