Synthetic cathinones first appeared on the European drug market in 2004. Since then, they have been sold as replacements for controlled stimulants such as amphetamines, cocaine and MDMA. They are also mis-sold as these controlled stimulants to unsuspecting consumers.

Typically, they are found as powders and, to a lesser degree, tablets. In the latter case, these may be mis-sold as or used to adulterate MDMA (ecstasy) tablets. Other physical forms are reported to a much smaller degree.

The cathinones are used recreationally, but they are also used by high-risk drug users in some countries, including by people who inject stimulants and opioids. This also includes in the context of chemsex. In some cases, changes in patterns of use, such as an increase in injecting frequency with cathinones, have been linked to HIV and HCV outbreaks.

There are some indications that certain cathinones, such as 4-MMC (mephedrone), 4-CMC (clephedrone) and 3-CMC (clophedrone), may be becoming more established in Europe, in part due to domestic production that takes place mainly in the Netherlands and Poland...