N-Ethylhexedrone, better known as Hexen, is a lesser-known synthetic cathinone that was developed as a precursor to methylenedioxypyrovalerone (MDPV), the main ingredient in the designer drug known as bath salts.

Cathinones are a stimulant derived from a plant called khat, while synthetic cathinones are a combination of these stimulants and other chemicals, typically producing effects most similar to Ecstasy or amphetamines.

Although its development was first documented as far back as the 1960s, it is only since about the mid-2010s that Hexen has come to prominence as a designer drug. It is frequently sold online as an alternative to cocaine or methamphetamine.

Like other synthetic drugs, much of Hexen’s current popularity is due to the legal gray area that it inhabits. It is often classified as a research chemical and, therefore, not legislated in the same way that illicit drugs like cocaine are.

Hexen’s unstable chemical makeup also allows it to exploit a legal loophole where its chemical structure is just different enough to avoid identification and classification as a cathinone analog, which would make it illegal to possess.

Because of this, Hexen may also frequently contain a random assortment of different chemicals to ensure that it is unique enough to stay ahead of drug laws and restrictions. This makes it difficult to learn more about the substance, and it also makes it more dangerous, as there is almost no way to know what you’re going to get from dose to dose in terms of not only potency but also what’s even in it.

There are multiple ways that someone can take Hexen, but the most common and fast-acting methods are snorting it or smoking it. While there is still much about Hexen use that remains unknown, the serious and adverse health effects of both smoking and snorting it are well-documented.

How Does Hexen Work?

As a synthetic cathinone like bath salts or flakka, Hexen’s chemical makeup can vary, resulting in unpredictable and often dangerous effects. Like many stimulants, Hexen abuse can cause euphoria and an increase in energy and alertness, as well as elevated blood pressure and heart rate, and hyperactivity.

While Hexen’s pharmacology is still largely unknown, based on its effects, it can be assumed that Hexen primarily impacts the brain chemicals dopamine, serotonin, and norephedrine, which are responsible for regulating mood, emotions, energy, cognition, and how we process feelings of pleasure, among other things.

Hexen and other cathinone analogs will block the brain from being able to reabsorb these chemicals, causing them to build up in the brain so that their effects are felt more strongly and for a longer period than otherwise. This is also how the brain becomes addicted to substances as it grows dependent on Hexen to provide this boost in brain chemicals and the feelings of pleasure that come with it.

However, the high from Hexen is very brief, usually only lasting between 30 minutes to an hour. Because of this, it’s common for users to string multiple doses together, although their ability to achieve the same euphoric effect diminishes with each dose as they quickly build up a tolerance. This can cause extremely unpleasant as well as dangerous side effects, along with a high risk of overdose.

What Happens When You Snort or Smoke Hexen?

Again, much like cocaine or methamphetamine, Hexen can be snorted and smoked, with these two forms of administration having many of the same side effects as other illicit stimulants. Specifically, snorting Hexen can lead to intense intranasal pain and runny nose, along with:

  • Obstructed breathing
  • Nosebleeds
  • Chronic sinus problems
  • Loss of sense of smell
  • Severe tissue damage
  • Total nasal cavity collapse

Because smoking Hexen allows it to bypass the blood vessels and instead travel directly through the lungs to the heart and up into the brain, it causes the user to feel its effects even more rapidly than snorting, sometimes in as little as two minutes. However, it is not any safer than snorting, in fact, someone who smokes Hexen is even more likely to become addicted to it than someone who either snorts or injects it.

Side effects such as chemical burns inside the mouth and throat have been widely reported by users who have smoked Hexen, along with other serious health consequences associated with stimulant inhalation, including:

  • Tooth decay
  • Gum disease
  • Mouth sores
  • Increased risk of lung infection
  • Increased risk of pulmonary injury

Can Smoking or Snorting Hexen Kill Me?

In short, yes.

There is no such thing as “safe” drug abuse, and Hexen was never meant for human recreational use. It doesn’t matter if someone snorts or smokes Hexen, neither option is safe to do, and both can easily prove deadly.

Adverse side effects that can result from either snorting or smoking Hexen include:

  • Paranoia
  • Insomnia
  • Excessive sweating
  • Jaw clenching
  • Heart palpitations

The comedown from Hexen is usually short-lived will result in emotions, including  irritability, depression, restlessness, dysphoria, and has been described as extremely unpleasant. As previously mentioned, this usually leads to heavier use to prevent the symptoms associated with comedown and withdrawal, which can not only cause an overdose but also what is known as stimulant psychosis, which is a mental health problem induced by the excessive use of a stimulant drug.

Person snorting hexen

Stimulant psychosis is triggered by heavy Hexen use within a short period, usually in combination with a lack of sleep. Snorting or smoking Hexen can bring on stimulant psychosis, the symptoms of which include delusions, auditory or visual hallucinations, severe panic attacks, disassociation, and even a total psychotic breakdown.

Smoking or snorting Hexen can also increase cardiovascular stress, which, in turn, increases the risk of abnormal heart rate, arrhythmia, heart attack, and stroke. Hexen also makes users more susceptible to potentially deadly seizures, especially for people who have epilepsy or are otherwise already predisposed to seizures.

And all these dangers only cover what little is known about how Hexen works and what it can do. There is much more to be discovered about Hexen which is more concerning especially for those individuals who choose to use this substance unaware of potential risks to their mental health and physiological welfare.

As a result, emergency medical personnel are placed at a disadvantage in providing appropriate medical services due to a lack of empirical and experiential studies obtained pertaining to the adverse effects of this drug. This increases the risk of a misdiagnosis, which can end up causing even more complications and can ultimately prove fatal.

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