The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade

Fenethylline (street name, captagon) is a synthetic amphetamine-type stimulant that is emerging as a significant public health and security concern, particularly in the Middle East. This systematic review synthesizes original research articles, epidemiological studies, systematic reviews, policy ana...

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Main Authors: Matthew Chidozie Ogwu, Matěj Malík, Pavel Tlustoš, Jiří Patočka
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Drug and Alcohol Dependence Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S277272462500006X
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author Matthew Chidozie Ogwu
Matěj Malík
Pavel Tlustoš
Jiří Patočka
author_facet Matthew Chidozie Ogwu
Matěj Malík
Pavel Tlustoš
Jiří Patočka
author_sort Matthew Chidozie Ogwu
collection DOAJ
description Fenethylline (street name, captagon) is a synthetic amphetamine-type stimulant that is emerging as a significant public health and security concern, particularly in the Middle East. This systematic review synthesizes original research articles, epidemiological studies, systematic reviews, policy analyses, and case reports to provide a comprehensive analysis of fenethylline’s health impacts, addiction potential, and dynamics of illicit trade. Initially developed for therapeutic use, fenethylline illicit production and use have escalated, raising concern about its physiological, psychological, and socio-economic impacts. This stimulant profoundly affects the central nervous system, enhancing wakefulness, concentration, and physical stamina while inducing euphoria. These effects come at the cost of serious adverse health outcomes, particularly with prolonged or heavy use, including cardiovascular complications, neurological damage, and addiction. The dependence-forming nature of captagon contributes to escalating substance use disorders, impacting healthcare systems. Beyond its biomedical implications, fenethylline trafficking has become a global issue, with supply chains deeply intertwined with politically unstable regions where illicit economies thrive. The geopolitical dimensions of captagon’s trade amplify its global security threat, influencing international relations and regional stability. This paper underscores the urgent need for systematic data collection and coordinated efforts to regulate illicit fenethylline production and distribution. Strategies such as improved surveillance, public health interventions, and international cooperation are essential to mitigate its escalating risks. Addressing this issue requires a multidisciplinary approach, integrating public health, law enforcement, and policy development to curb its impact on global health and security.
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spelling doaj-art-a01475d62a8e4ece9d47e4b1ef6e17a72025-08-20T02:02:51ZengElsevierDrug and Alcohol Dependence Reports2772-72462025-06-011510032310.1016/j.dadr.2025.100323The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit tradeMatthew Chidozie Ogwu0Matěj Malík1Pavel Tlustoš2Jiří Patočka3Goodnight Family Department of Sustainable Development, Appalachian State University, 212 Living Learning Center, 305 Bodenheimer Drive, Boone, NC 28608, United States; Corresponding author.Department of Agroenvironmental Chemistry and Plant Nutrition, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Kamýcká 129, Suchdol, Praha 165 00, Czech RepublicDepartment of Agroenvironmental Chemistry and Plant Nutrition, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences Prague, Kamýcká 129, Suchdol, Praha 165 00, Czech RepublicDepartment of Radiology, Toxicology and Civil Protection, Faculty of Health and Social Studies, University of South Bohemia, J. Boreckého 1167/27, České Budějovice 370 11, Czech RepublicFenethylline (street name, captagon) is a synthetic amphetamine-type stimulant that is emerging as a significant public health and security concern, particularly in the Middle East. This systematic review synthesizes original research articles, epidemiological studies, systematic reviews, policy analyses, and case reports to provide a comprehensive analysis of fenethylline’s health impacts, addiction potential, and dynamics of illicit trade. Initially developed for therapeutic use, fenethylline illicit production and use have escalated, raising concern about its physiological, psychological, and socio-economic impacts. This stimulant profoundly affects the central nervous system, enhancing wakefulness, concentration, and physical stamina while inducing euphoria. These effects come at the cost of serious adverse health outcomes, particularly with prolonged or heavy use, including cardiovascular complications, neurological damage, and addiction. The dependence-forming nature of captagon contributes to escalating substance use disorders, impacting healthcare systems. Beyond its biomedical implications, fenethylline trafficking has become a global issue, with supply chains deeply intertwined with politically unstable regions where illicit economies thrive. The geopolitical dimensions of captagon’s trade amplify its global security threat, influencing international relations and regional stability. This paper underscores the urgent need for systematic data collection and coordinated efforts to regulate illicit fenethylline production and distribution. Strategies such as improved surveillance, public health interventions, and international cooperation are essential to mitigate its escalating risks. Addressing this issue requires a multidisciplinary approach, integrating public health, law enforcement, and policy development to curb its impact on global health and security.http://www.sciencedirect.com/science/article/pii/S277272462500006XPsychostimulantAddictionWithdrawal symptomsIllicit tradeGlobal traffickingPublic health
spellingShingle Matthew Chidozie Ogwu
Matěj Malík
Pavel Tlustoš
Jiří Patočka
The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade
Drug and Alcohol Dependence Reports
Psychostimulant
Addiction
Withdrawal symptoms
Illicit trade
Global trafficking
Public health
title The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade
title_full The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade
title_fullStr The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade
title_full_unstemmed The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade
title_short The psychostimulant drug, fenethylline (captagon): Health risks, addiction and the global impact of illicit trade
title_sort psychostimulant drug fenethylline captagon health risks addiction and the global impact of illicit trade
topic Psychostimulant
Addiction
Withdrawal symptoms
Illicit trade
Global trafficking
Public health
url http://www.sciencedirect.com/science/article/pii/S277272462500006X
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