What is mephedrone, and is it in South Africa?

In short

• Mephedrone (4-MMC, meow meow) is a synthetic stimulant whose high lasts about an hour. That is why a session runs for hours rather than one dose. In South Africa it sits in Schedule 7 of SAHPRA’s Consolidated Schedules, the same schedule as heroin and methamphetamine.
• In one survey of people who use it, 30% met the criteria for dependence. Almost half, 47%, had used it for two or more days in a row, according to Winstock et al., Addiction, 2011. Yet the word mephedrone does not appear once in South Africa’s national treatment data for January to June 2025.
• At Renewed Life Center in Lakeside, Cape Town, the addiction and what sits under it are treated on one plan. Medication is used only where a doctor decides it is needed. Admission can be immediate, typically within three days of first contact.

Worried about your own mephedrone use, or someone else’s? Book a free, confidential call. Twenty to forty minutes, no obligation, and we reply the same day.

Most people who ask about mephedrone are not asking out of curiosity. They know someone whose sessions run two or three days, or they have found it themselves and cannot work out why stopping is so much harder than it looks.

What is mephedrone, and is CAT the same drug in South Africa?

Mephedrone (4-methylmethcathinone, 4-MMC), also called meow meow or M-CAT, is a synthetic cathinone: a man-made stimulant related to the compound in the khat plant. It is sold as a white or yellowish powder, crystals, capsules or pills. In South Africa, CAT usually means methcathinone, a close chemical relative, and on the street the two names get used for each other.

The high fades after about an hour, which is what sets mephedrone apart from cocaine or MDMA: timing, not strength. Almost nobody uses it for one dose and one evening. Users redose roughly every hour to keep it going, and a session commonly runs two to three days with barely any sleep.

Methcathinone has circulated in South Africa since the 1990s, and mephedrone is a close relative, one methyl group away. SACENDU, the surveillance network the South African Medical Research Council has run since 1996, tracks methcathinone and khat under one merged heading: “CAT and KHAT are often used interchangeably during reporting which makes distinguishing between the two … difficult during analysis.” So someone treated after a mephedrone binge may be logged as a CAT/KHAT admission, and the figures cannot say which drug they actually used.

What are the effects of mephedrone, and why do people switch to it?

People switch to mephedrone from cocaine and MDMA mainly because it is cheaper and, for a while, was legal, not because it works better. Like other stimulants, it raises heart rate and blood pressure, narrows blood vessels, and is harsh on the nose when snorted, with real risks if someone injects it instead.

The pattern showed up in the Netherlands, where researchers found the share of “ecstasy” tablets containing any MDMA at all fell by more than 50% in 2009, replaced in many tablets by mephedrone, dosed at 96 to 155 mg without the buyer being told. In the same research, 70 regular ecstasy users found the effects pleasant and close to other amphetamine-type stimulants, but most reported strong craving on mephedrone, which MDMA typically does not cause, and that turns a substitute into something harder to put down.

Injecting it instead carries the same risks as injecting any drug: damaged veins, and a higher chance of HIV and hepatitis C where equipment is shared. Then comes the drop. An observational study of 46 regular users found those who took mephedrone reported worse mood, more physical complaints and more fatigue afterwards than those who abstained.

Is mephedrone addictive, and why do other drugs stop working?

Yes. In one survey of 100 users, 30% met the criteria for dependence and 47% had used it two or more days in a row, because a high that fades within the hour pushes constant redosing. Stimulants also flood the brain with dopamine, so ordinary pleasures, and other drugs, eventually stop registering the same way.

That craving is not a willpower problem. The brain’s reward system turns its own sensitivity down, and it does not stay selective about which pleasures it dulls: food, music and company can all start to feel flat, and going back to cocaine or MDMA often does not do much either.

Pharmacologically, mephedrone behaves differently from MDMA rather than acting as a cheaper version of it, part of why the swap rarely runs in reverse. Sensitivity recovers with sustained abstinence, but slowly, which is why aftercare that outlasts the residential stay matters as much as the stay itself.

Dr Ruby Weber, who leads the psychological side of treatment at Renewed Life Center, has worked in the addictions field for more than two decades with both South African and international clients, across chemical and process addictions.

If mephedrone sessions have stopped feeling optional, that is worth talking through properly. Book a free, confidential call. Twenty to forty minutes, and we reply the same day.

Why does mephedrone affect sex, and why does that stop people asking for help?

Mephedrone strongly increases sex drive and strips away inhibition, and for a lot of users that is a large part of the appeal. It is also why people wait months or years before telling anyone what has actually been going on.

A qualitative study of 22 mephedrone users documented disinhibition as a common pattern: compulsive sexual behaviour, propositioning strangers, multiple casual partners, marathon sessions combining the drug and sex, and unprotected sex. Heterosexual users also reported acting on attraction they said they would not otherwise have acted on.

The medical risk is straightforward: disinhibition, multiple partners and no protection raise the chance of HIV, hepatitis C and other infections. The harder risk to treat is shame. This is pharmacology acting on the systems that govern restraint, not a character flaw, and people who behaved in ways that do not match who they are tend to carry that quietly rather than say it out loud, including to a doctor. Nobody at Renewed Life Center is surprised by it, or treats it as a moral failing.

How does mephedrone compare with cocaine, MDMA and tik?

The differences that matter for spotting a problem are less about strength and more about rhythm.

For Cape Town readers, a stimulant problem running in tight hourly cycles rather than long runs is probably not tik.

What happened when mephedrone reached the UK?

By 2009, mephedrone was sold openly in Britain as plant food or bath salts, labelled not for human consumption, and still legal. It was cheaper than cocaine and, unlike an ecstasy market flooded with weak tablets, consistent in what buyers actually got.

It became a Class B substance under the UK’s Misuse of Drugs Act from 16 April 2010. The next year’s national crime survey found mephedrone had reached 4.4% of British 16 to 24 year olds, the same share as powder cocaine in that age group. That survey came after the wave had crested, so it confirmed a wave rather than warned about one, and mephedrone never fully disappeared afterwards.

Is mephedrone in South Africa today, and why is the country exposed?

Not in measurable numbers yet. Mephedrone is banned under SAHPRA’s Schedule 7, alongside heroin, but the word does not appear once in South Africa’s national treatment data for January to June 2025. Cape Town is exposed regardless: an established tik market to undercut and the Western Cape’s high rate of polysubstance use leave room for a new stimulant.

Alongside heroin, mephedrone’s Schedule 7 listing, shared with methcathinone, also covers LSD, MDMA and methamphetamine. SACENDU covered 7,975 treatment admissions across 84 centres between January and June 2025. Mephedrone is not even on the list of substances the network has asked members to watch, which runs to fentanyl, vaping, cannabis use among adolescents, methaqualone and hookah pipes.

Treatment statistics are the slowest signal drug surveillance produces, and Britain’s own survey only confirmed its wave after the numbers had peaked: an empty line in a mid-2025 report is what the early stage of a wave looks like from the inside, not proof there is not one.

The Western Cape has lived with methamphetamine, known locally as tik, for two decades, and tik was the primary substance for 30% of people admitted to treatment in the province, against 17% nationally, the highest rate anywhere in the country. Mephedrone would only need to undercut that existing market, the way it undercut cocaine in Britain.

The environment also absorbs new substances rather than resisting them: polysubstance use was reported by 60% of people admitted to treatment in the Western Cape, against 48% nationally, the highest figure in the country. A new drug entering that picture does not have to replace anything, it gets added on top. Two markers are worth watching: the CAT/KHAT line rising with no matching rise in khat use, and the average age at admission for CAT/KHAT, currently 31 nationally and 37 in the Western Cape, starting to fall.

What are the signs someone close to you might be using mephedrone?

A mephedrone binge does not look like what most people picture when they think of drug use. What is visible from outside usually includes:

None of these alone proves anything. Together, and repeating, they are worth a conversation. If you recognise this in someone you love, read our guide on starting that conversation, or write to us.

How is mephedrone addiction treated?

Treatment for stimulant dependence is mostly psychological and structured. The drug comes out safely, then sleep and routine get rebuilt while whatever it was standing in for gets treated alongside it.

At Renewed Life Center, that starts with a medical and psychiatric assessment, since anxiety, depression, PTSD and burnout often sit underneath heavy stimulant use and need treating on the same plan, not afterwards. Individual therapy typically runs three sessions a week in the first phase, alongside five or more group sessions, with medication used only where a doctor decides it is clinically indicated. Where appropriate, stabilisation runs under 24-hour nursing supervision, and the mental health side is treated in the same place, on one plan. Craig Duke, an addiction counsellor and recovery coach with more than twenty years of his own recovery and a background working in the UK and Switzerland, carries that work day to day.

Talk it through before it gets worse. Book a free, confidential call, twenty to forty minutes, no obligation.

Why do families choose Renewed Life Center, and how do you start treatment?

Families choose Renewed Life Center because the medical side and the therapy happen in the same house, with named specialists and nursing staff on site 24 hours a day, and because payment is direct, so the clinical picture decides how long someone stays. Treatment starts with a free twenty to forty minute call, and admission can follow within three days.

The part that is hardest to say out loud gets heard by people who have heard it before. Dr Ruby Weber and Craig Duke, named above, lead the psychological and counselling side of treatment. Dr John Wulz, our resident GP, examines every arrival.

Family therapy runs on Wednesday evenings, in person or by video, and airport transfers at Cape Town International are included both ways. The house sits in Lakeside, in Cape Town’s Southern Suburbs, with a mountain ridge behind the property and Muizenberg beach about two kilometres away.

We do not publish a fixed fee for mephedrone treatment in a blog article, because it depends on the phase, the room and whether stabilisation is part of the first days. Write to us and we will send the exact figure in writing after that first call, usually the same day. For the general range private rehab in the city runs at, see what rehab costs in Cape Town. International flights are booked separately.

Book a free, confidential call, or send us a message if you would rather write first.

Questions people ask

This article is general information, not medical advice.

Sources

1. SAHPRA, Consolidated Schedules, 1 August 2025
2. SACENDU Research Brief, South African Medical Research Council, volume 29(1), 2026
3. The Misuse of Drugs Act 1971 (Amendment) Order 2010
4. Home Office, Drug Misuse Declared: Findings from the 2010/11 British Crime Survey
5. Brunt et al., Instability of the ecstasy market and a new kid on the block, Journal of Psychopharmacology, 2011
6. Winstock et al., Mephedrone: use, subjective effects and health risks, Addiction, 2011
7. Green et al., The preclinical pharmacology of mephedrone, British Journal of Pharmacology, 2014
8. Homman et al., Sub-acute effects of mephedrone on mood, cognition and sleep, Psychopharmacology, 2018
9. Van Hout and Brennan, “Bump and grind”: mephedrone users’ perceptions of sexuality and sexual risk, Drugs and Alcohol Today, 2011
10. Alcohol and Drug Foundation, Mephedrone drug facts
11. South African national emergency numbers