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Hexen (Drug): Is There a Risk of Addiction or Abuse?

Hexen, or HexEn (N-Ethylhexedrone), is a synthetic drug that is classified as a synthetic cathinone. Its psychoactive effects are often compared to those of cocaine, including crack cocaine or substances such as MVP that occur in various designer drugs. Hexen may be a substance that is referred to by various media sources as bath salts as well. The drug appears to have been available since 2015 through various sources as a research chemical.

Cathinones are stimulants that produce:

  • Euphoria
  • Stimulation
  • Extreme talkativeness and sociability
  • Accelerated thought processes
  • Loss of inhibitions

These drugs are believed to affect the reuptake of the neurotransmitters norepinephrine and dopamine, although in the case of Hexen, this has yet to be scientifically studied. There is very little empirical evidence on Hexen.

Although many synthetic cathinones are listed as Schedule I controlled substances, the actual legal status of Hexen is uncertain. It is not listed as controlled substance by the United States Drug Enforcement Administration (DEA) at the time of this writing. However, it could be banned under the Federal Drug Analog Act. The drug is typically purchased online as a designer drug or research drug, and it is available as a white powder or in the form of crystals.

Anecdotal Evidence

As mentioned above, little empirically validated information is available about Hexen. Most of the information regarding its recreational use comes from anecdotal evidence from individuals who have used the drug. These anecdotal reports indicate that the drug does produce euphoria and stimulation.

  • The drug is commonly snorted, smoked, or injected by recreational users with snorting and smoking the drug being more popular forms of use.
  • Its effects are extremely short-lived. It appears that the euphoria associated with its use lasts 30-60 minutes.
  • Users often reuse the drug quickly (keep taking the drug) to get and maintain its euphoric effects.
  • The euphoric effects only appear to occur with one or two more doses after the initial dose has been taken. After that, hyperactivity and other effects predominate.
  • The drug is associated with an extremely high probability of a very severe crash once it is discontinued. The crash consists of severe apathy, feelings of hopelessness, depression, lethargy, and increased appetite
  • Individuals who engage in multiple doses or in bingeing are typically trying to avoid the crash as the euphoric effects are no longer experienced.

The drug is notorious on online sources as a drug that results in a significant desire to continue reusing it, leading to potential bingeing on the drug. Continuing to use the drug after it no longer produces euphoria often results in anxiety, psychosis (particularly paranoid delusions and hallucinations), jitteriness, hyperactivity, nervousness, appetite loss, and insomnia.

It appears that the drug has similarities to amphetamines and cocaine regarding its diminishing euphoric effects and the tendency toward reuse of the drug to produce more negative effects than positive effects. Abuse of substances with stimulant qualities at high doses (e.g., as a result of continued bingeing of Hexen) is known to be associated with the development of psychosis.

For some individuals, the psychosis occurring as a result of stimulant abuse may not fully resolve even with treatment. Estimates range from 5 percent to 15 percent of users who develop psychosis may not see this issue fully resolve after long-term abstinence. These individuals may need long-term treatment with antipsychotic medications that can lead to further complications.

In addition, stimulants are commonly abused with central nervous system depressants, such as alcohol. This combination can lead to serious issues with potential overdoses, an increased potential for seizures, which can be fatal, and long-term polysubstance abuse issues that can lead to significant health problems and problems with social functioning.

 The drug is notorious on online sources as a drug that results in a significant desire to continue reusing it, leading to potential bingeing on the drug.

Abuse and Addiction Potential

There is little research regarding the specific abuse potential of Hexen, although given that it is classified as a synthetic cathinone and that the anecdotal evidence indicates it is associated with compulsive bingeing, potential psychosis similar to amphetamine or cocaine psychosis, a short duration of effects, and initial euphoric effects that may lead to attempts to reuse the substance very quickly, it can be surmised that the drug does have a potential for abuse. Many of the drugs related to Hexen produce a form of physical dependence when chronically abused, although the symptoms of withdrawal associated with these drugs are most often emotional or psychological in nature as opposed to physical symptoms like nausea, vomiting, etc.
 A person diagnosed with a substance use disorder as a result of abusing Hexen would most likely qualify for a diagnosis of a stimulant use disorder based on the diagnostic criteria for substance use disorders put forth by the American Psychiatric Association (APA).
This diagnosis would be associated with:

  • Dysfunction or significant distress occurring as a result of use of the drug
  • Issues with controlling use of the drug that could occur across numerous contexts
  • Continuing to use the drug in spite of issues with functioning normally, physical health, or psychological/emotional health.
  • Frequent urges to use the drug
  • The development of tolerance to the drug
  • The development of withdrawal symptoms associated with discontinuing the drug

According to the diagnostic criteria for withdrawal from stimulants from APA, the person could be diagnosed with physical dependence on Hexen if they demonstrate two or more of the following symptoms after discontinuing its use:

  • Extreme lethargy or fatigue
  • Increased appetite
  • An increased need for sleep (hypersomnia) or an inability to sleep (insomnia)
  • Very vivid dreams that are unpleasant or disturbing
  • Problems with motor functioning, such as psychomotor retardation (slow movements or difficulty moving) or psychomotor agitation (extreme issues with irritability, restlessness, etc.)

Other symptoms often occur but are not diagnostic. Some of these include:

  • Depression or mood swings
  • Accelerated heart rate, elevated temperature, or chills
  • Sweating
  • Psychotic symptoms
  • Extreme cravings for the drug
Conclusions

Hexen is a stimulant compound similar to the cathinones that appears to have a moderate level of popularity, according to information gather from the Internet. There is very little empirical research evidence regarding the effects, both short-term and long-term, of use of Hexen; however, it appears that the drug has similarities to comparable drugs of abuse, such as cocaine, and should be considered to have a serious potential for abuse. Given the anecdotal information available about the drug online, it should be treated as a drug of serious concern and its use should be avoided.