Brandt, SD (2019) Critical Review Report: DOC (4-Chloro-2,5-dimethoxyamfetamine). World Health Organisation, Geneva, Switzerland.

Abstract

Executive Summary Substance identification: DOC (4-chloro-2,5-dimethoxyamfetamine) (IUPAC name: 1-(4-chloro-2,5dimethoxyphenyl)propan-2-amine) is the chloro analogue of DOB (4-bromo-2,5dimethoxyamfetamine) and DOM (2,5-dimethoxy-4-methylamfetamine) which are both listed in Schedule I of the Convention on Psychotropic Substances of 1971. Information obtained from seizures and collections suggests that it has been encountered in powdered and liquid form but that it is predominantly found in the form of LSD-like blotter papers. WHO Review History: DOC has not been previously pre-reviewed or critically reviewed. Chemistry: There is no specific information available about the routes of synthesis employed for seized DOC products circulating on the drug market but straightforward methods for its preparation exist without requiring access to precursors that are controlled internationally. The presence of an asymmetric carbon atom gives rise to the (R)- and (S)-enantiomer and it seems likely for DOC to be most commonly available in the racemic form. Ease of convertibility into controlled substances: A conversion of DOC into another substance currently listed in any of the international drug conventions might be chemically feasible but specific information is not available. Similarity to known substances / Effects on the central nervous system: DOC can be considered a classical (serotonergic) hallucinogen and its effects and potency are comparable to the hallucinogenic amfetamines DOB, DOM and DOI (4-iodo-2,5dimethoxyamfetamine) and to some extent similar to LSD, psilocybin, mescaline and N,N-dimethyltryptamine. General pharmacology: DOC is a potent 5-HT2A receptor agonist with high affinity, a key element in mediating hallucinogenic effects in humans. The available data available so far also indicates that it also binds with high affinity to and activates 5-HT2B/2C receptors. Self-experiments suggested DOC to be active in the 1.5–3.0 mg range with duration of effects estimated to range between 12–24 h. A long duration of effects is also shared by the other hallucinogenic amfetamines DOI, DOB and DOM. DOC is most commonly administered orally and/or sublingually when encountered in the form of blotters. The discriminative stimulus effects of DOC in the drug discrimination paradigm were similar to those of other hallucinogens DOM and N,N-dimethyltryptamine but not methamfetamine. Data collected from in vitro metabolism studies showed that DOC is transformed into the two O-demethylated (2- and 5-position) metabolites. The parent molecule is the preferred analytical target in clinical casework. Toxicology: Information could not be identified. Adverse reactions in humans: The total number of cases reported in the scientific literature is very small and the detection of other drugs in published cases has also been reported. Clinical features associated with DOC intoxication included agitation, aggressive behaviour, hallucinations, tachycardia, rhabdomyolysis, seizures, and hyperthermia. In one case, some clinical features were observed to persist for up to 33 h. Dependence potential: Dependence potential in humans or animals has not been demonstrated. Abuse potential: Studies specifically linked to DOC could not be identified. Therapeutic applications / usefulness: DOC is not known to have any therapeutic uses. Listing on WHO Model List of Essential Medicines: DOC is not listed. Marketing authorizations: DOC is not known to have any marketing authorisations. Industrial use: DOC is not known to have any agricultural, industrial or cosmetic uses. Non-medical use: The mode of use may involve the combinational use (intentionally or unintentionally) of other drugs and users may be unaware of the exact dose or compound being ingested (by whatever route). Household or subpopulation surveys that specifically probe for prevalence of DOC could not be identified. Use of DOC is presumably limited to people who use hallucinogenic drugs in recreational settings (e.g. home environments, outdoors, discotheques/nightclubs and outdoor music festivals) rather than the general population. Nature and magnitude of public health problems: The information currently available suggests that DOC is most commonly found in the form of blotter papers and that it has also been misrepresented as LSD, which adds to health risks to people who use these substances where information about the identity and/or the dose are unavailable. Some Internet retailers also offer DOC for sale as a research chemical. Information from acute intoxications suggests that some people have obtained access to the powdered form which can increase the risk of overdose and untoward effects. Licit production, consumption, and international trade: DOC is available as standard reference material and produced for scientific research by commercial suppliers. Other uses could not be identified. Illicit manufacture and traffic: DOC has been formally notified in Europe in 2004 but its first published synthesis dates back to 1973. In Europe, DOC was encountered in seizures and collected specimens in several countries and notified between 2004–2016. The majority of notifications described the detection of DOC in blotters although powders and liquid samples were also reported. In the period between 2006 and 2009, a number of DOC identifications obtained from seizures (mostly blotters but also some powdered and liquid material) have been published in the forensic literature the United States of America. According to UNODC, a total number of 77 countries have so far reported the detection of DOC. Current international controls and their impact: DOC is not controlled under the 1961, 1971 or 1988 United Nations Conventions. Current and past national controls: DOC is controlled in some UN Member States.

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