July 30, 2012
Bath Salts: Dangers of a New Synthetic Drug
Until recently, most Americans hearing the phrase bath saltsprobably conjured an image of a relaxing, therapeutic soak in the tub.
But that was before a spate of bizarre incidents involving people often likened to zombies. Like the Georgia man, 21, who rambled incoherently about eating people and, when he did not blink at the pepper-spray police blasted in his eyes, was Tasered 14 times before police could subdue him. Or a 35-year-old central New York woman, who, growling and barking like a dog, rampaged naked through her town before police subdued her with a Taser, witnesses said. She later died of an apparent cardiac arrest.
Police Allege Face-Biting Attack in Louisiana
Police and many drug experts believe events like these have been fueled by the synthetic drug called “bath salts.” And while every bath-salts experience is not ending up in the news, it is causing “an alarming number of ER visits across the country” and thousands of calls to poison control centers, says the National Institute on Drug Abuse (NIDA).
Until quite recently, they were entirely legal.
What Are Bath Salts?
Despite its name, the drug bath salts is not at all the same thing as the innocent minerals and salts used for healing and relaxation. It is a powerful stimulant that produces a high mimicking the effects of cocaine, methamphetamine, and Ecstasy, according to the U.S. Drug Enforcement Agency.
Imported from abroad or crafted in home labs in the United States, bath salts’ main ingredient is the powerful man-made stimulant methylenedioxypyrovalerone (MDPV). MDPV is a derivative of the appetite suppressant and anti-fatigue drug pyrovalerone, which was first synthesized in the late 1960s and is still prescribed under the drug trade names Centroton and Thymergix.
In addition to MDPV, bath salts also often contain mephedrone and/or methylone, also stimulants. All three substances are members of the cathinone family, which NIDA describes as “amphetamine-like chemicals.” Along with these stimulants, bath salts are “cut” with a variety of other substances as fillers, some harmful (ingredients aren’t listed on the packaging).
Usually sold as a white or light-tan powder, in 200- to 500-milligram packs roughly the size of tea bags, or in small plastic canisters, bath salts cost between $25 and $50 and are sold through online retailers as well as in smoke shops and gas stations in states where they’re still legal. And although the packaging is often marked “Not for Human Consumption” to further obscure its intended use, bath salts are most often snorted, but sometimes smoked or injected.
Bath Salts’ Effect on the Body: Mental and Physical Danger
Once taken, bath salts produce a state of “excited delirium,” writes Thomas Penders, MD, in the April 2012 edition of the Journal of Family Practice. (A professor of psychiatry at Brody Medical School at East Carolina State University, Penders also co-authored an oft-cited 2011 study on MDPV.) This excited state, Penders writes, is a result of both mental and physical changes in the body brought on by the drug.
Put simply, MDPV, mephedrone, and methylone work to increase the amount of the “feel-good neurotransmitter” dopamine in the brain, this leads to an elated feeling. But when dopamine is artificially elevated, the brain may produce less of it, requiring the bath salts user to take larger doses of the drug to keep the euphoric feeling going.
As the drugs in bath salts are also stimulants, they excite the central nervous system in the extreme, increasing heart rate and raising blood pressure, elevating body temperature to dangerous levels (the reason, experts say, people who’ve overdosed on bath salts often strip off their clothes), and sometimes to psychotic-like breaks with reality.
Taking too much bath salts is a near surefire way to end up in grave medical trouble, according to medical professionals. Bath salts overdose cases “are just very difficult to manage,” says Karen Simone, Pharm.D, director and chief toxicologist of the Northern New England Poison Center, headquartered in Portland, Maine. “Users are seeing things that aren’t there, they’re paranoid, they’re frightened, and sometimes they’re quite violent.”
“It can take up to five times the normal dosage to get [overdose cases] sedated,” says Tom Gutwein, MD, emergency department medical director at Parkview Hospital in Fort Wayne, Ind, which has seen a rise in bath salts cases over the past several months. Poison control centers nationwide have seen bath-salts related calls increase 20 times, from just 304 in 2010, to 6,138 calls this year, according to figures from the American Association of Poison Control Centers.
Why Would Anyone Take Bath Salts?
Unlike methamphetamine, cocaine, or crack cocaine, bath salts are a cheap and easy way to get a speedy high. “The wrinkle with bath salts is if you are doing crack cocaine every day, all day long for a week, that’s going to cost you between $3,000 and $4,000 to get high like that,” says Richard Taite, founder and CEO of Cliffside Malibu, a California drug rehab center that’s treated more than 10 young people for problems with bath salts. “To get high like that off bath salts, it’s going to cost you between $60 and $100.”
And there’s another enticing benefit to the bath salts high, says Taite. “On crack, for example, you become very sexual, you want it so badly, but you just can’t get there,” Taite explains. In contrast, he says, the stimulant effect in bath salts doesn’t inhibit sexual function — it enhances it.
‘Brutal:’ One Addict’s Story
Former bath salts user Brooks, 27, a musician from Duluth, Minn., didn’t take the drug for sex but as a way to offset the effects of sedatives — specifically benzodiazepines, legal depressants prescribed as sleep aids and for anxiety and muscle spasms. (To protect his anonymity, he asked that his last name be withheld.) “I was frustrated by how often I would zone out and pass out,” Brooks says. “In my mind I needed to use speed to even things out.” Brooks says he first purchased pure MDPV via the Internet in early 2011, but then switched to purchasing a bath salt called Eclipse at a local smoke shop.
What started as taking only “a little to stay awake” quickly ballooned into a debilitating chase for, as Brooks puts it, “a high that I never found.” He describes the bath salts high as “speedy, briefly euphoric, prolonged, and paranoid.” His sleep, he says, went from excessive on the depressants to “nonexistent” while using bath salts. “I’d function on zero to two hours of sleep a night,” he says. “Many times I would be awake for three days in a row.” He says he also developed a nasty case of paranoia, believing that computer hackers, police, or the DEA were spying on him. He boiled the physical and mental effects of bath salts down to one word: “brutal.” Eventually feeling the need to quit, Brooks says he simply couldn’t.
Finally, last July the law intervened. Brooks says Minnesota’s July 1, 2011, ban on bath salts motivated him to give up his habit. When he went to buy his usual stash of Eclipse, a smoke shop employee told him bath salts would no longer be sold there because of the state ban. “This was the shove I needed to finally break free,” he says, and adds, “I have not used MDPV a single time since the day I went in and couldn’t buy it at the store.”
The Fight Against Bath Salts Heats Up
To date 38 states have joined Minnesota in enacting legislative bans on the chemicals commonly used to make bath salts, according to a listing of state laws on the National Conference of State Legislatures’ Web site. Last October, amid growing concern about the dangers of bath salts abuse, the U.S. Drug Enforcement Agency (DEA) issued a temporary emergency ban on MDPV, mephedrone, and methylone.
Congress is also considering a federal ban. The Synthetic Drug Control Act was passed by the House of Representatives last December and was introduced in the Senate and referred to committee on May 16. The act would amend the federal Controlled Substances Act, adding synthetic drugs (bath salts as well as synthetic marijuana, often sold as Spice and K2) to the list of Schedule I controlled substances, alongside drugs like Ecstasy, cocaine, and mescaline. And on July 9, President Obama signed into law the Food and Drug Administration Safety and Innovation Act, which contains a provision that permanently bans MDPV and mephedrone from use in bath salts.
But the federal and state bans aren’t keeping bath salts producers from getting their product to market. Many have simply changed their formulas, substituting other, still legal, stimulants. “What’s happening now is we have a lot of drug analogues popping up, and people are hoping to get around the laws by coming up with slightly altered chemical formulas,” says Bruce Talbot, a former Illinois police officer who has studied and taught fellow first responders about emerging drug trends for 20 years. Talbot says from what he sees on the front lines, “I don’t think this is going away anytime soon.”
Today Bath Salts, Tomorrow Some Other Drug?
As vexed as Talbot is about getting control of the bath salts problem, he cautions against focusing on any one drug as the nation’s Enemy Substance No. 1.
“We tend to run in this country from crisis to crisis to crisis,” he says, citing previous scares high-profile about PCP, crack, and methamphetamine. “All substance abuse, including alcohol, can be dangerous and deadly,” Talbot says. “Alcohol kills more Americans than bath salts. We have more young people who are placing themselves in harm’s way on Vicodin and prescription drugs than we do bath salts. What we need to do is not focus in like a laser beam on one particular drug du jour, but rather we need to start talking about all substance abuse and the harm it produces.”
