Exploring the New Phenomena of Home-Made Extraction and Injection of Ephedra Plant Product in Georgia.

Background: Since the end of 2015, reports by service providers have indicated a new trend in kitchen (homemade) production of an injection drug prepared from an ephedrine-containing conifer bush that is indigenous to the region.

Objective: The aim of this report is to describe an emerging new homemade psychoactive drug synthesized from the ephedra plant, and the drug consumption methods associated with its' use in the Eurasia.

Methods: Focus groups conducted with 16 people, self-identified as injection drug users (IDU's) who reported at least one incidence of ephedra preparation injection during the previous 30-days.

Results: Participants were male, mean age of 43 and mean length of drug use of 22.2 years. Participants identified "conifer vint" as the most frequently injected drug during the 30-day period preceding the focus group. The source plant of the drug identified, as "conifer vint" is plant-based ephedra extracted from a common conifer bush that grows wild and is pervasive in the region. The process of synthesis resembles the production of "vint" (conversion of ephedrine to methamphetamine by reduction) and involves several legal and widely available chemical precursors. The final product of the synthesis is a strong injectable CNS stimulant solution. Conclusions/Importance: The production and use of raw ephedra from a pervasive indigenous plant reflect a new trend in psychoactive drug preparation and use that warrants international attention and has global implications for emerging trends in drug use.