Bath Salts: A scary new epidemic?

There have been numerous cases of deaths and severe side effects after the use of a new drug on the market called "bath salts".  In one way, it's kind of ingenious that these people created this designer drug, labelled and sold it in various places as "bath salts" with the line of "not for human consumption" on the label, thus they were overlooked by the federal drug and food enforcement agencies...they skirted under the radar. It became an underground phenomena that the use of the drug (which is not actually a salt that you would put into your bath to relax after a rough day), sold mostly in head shops and tobacco stores, was through word of mouth.  Bath salts were banned in Louisiana, New Jersey, Florida, and a few other states after numerous violent homicides and/or deaths from the drug. Although, as of September 7, 2011 the DEA has deemed these drugs illegal (in an emergency status) and a few arrests have been made for the creation, distribution, and use of bath salts.  Honestly, why anyone would actually want to try this drug, I am not sure, but the state of the adolescents and young adults that have used this drug coming into the Emergency Department is enough to scare me straight!

What are bath salts?
They are a synthetic stimulants such as methylenedioxypyrovalerone (MDPV).  MDPV is a drug that first started circulating in 2004 in the US and it was called "super coke" as it is approximately 4 times the strength of most street cocaine or prescription Ritalin.   It is known on the street as either bath salts, ivory wave, purple wave, vanilla sky, bliss, bonsai grow, plant food, pixie dust, white lightening, along with TONS of other names, and it looks almost like powdered sugar but tends to be more yellowish on its own and the color can obviously be changed with various additives.  The scary thing is that there is no test for MDPV and not all bath salts are the same drug, they are created at various different place by different "chemists" and you never really know what drug you are ingesting.

How is it taken?
People are pretty inventive and it depends on length of use and the person, but the main routes of ingestion are snorting into your nose, injecting into a vein, smoking (or free basing), and mixing the drug into food and or drinks to consume it. Depending on how fast the user wants to feel the high or just plain choice of favorite route!

What are the side effects?
Euphoria
Tachycardia (fast heart rate)
Hypertension (high blood pressure)
Increased alertness/awareness
Vasoconstriction (narrowing of blood vessels)
Increased body temperature
Increased energy
Increased sexual stimulation
Seizures
Confusion
Agitation
Stroke
Insomnia
Psychosis (paranoia, delusions thoughts)
Suicidal ideation (wanting to kill oneself)

The primary effects (initial "high") last around 3 to 4 hours and the user has usually come down by 6 to 8 hours after use.  The interesting thing with this drug though is that the user feels extreme urges to "re-dose" or take another hit, before they have finished their high, and even if they have had horrible side effects (paranoia, chest pains, etc). The drug is so highly addictive that even upon first use the urge to use again is so strong that people cannot stop and will go for days with using the drug, only making the "come down" that much worse.   Also, a huge number of users report feeling suicidal for up to three and four days post usage of the drug (even a one time use) and there were a rash of suicides after the use of bath salts, which is what lead to Louisiana banning the sale and use of bath salts.

What happens with an overdose?
Many times people come in overdosing and as HCP's we do not know what is causing it, especially because most of our simple toxicology screens will be negative because we do not test for MDPV, so we need someone to tell us what the overdose is on, so we can treat the patient with anti-anxiety and anti-seizure medication to help prevent strokes, heart attacks, seizures, and ease the effects of the drug. At this time, we do not have an antidote specifically for MDPV. In some cases, patients overdosing on bath salts have had to be put into medical induced comas to prevent further damage to their brain and heart.  In all honesty, there are a LARGE number of people who take the drug and overdose die before they even make it to the hospital.

If you have done bath salts, please don't do it again.  If you know someone who has taken them and appears to not be feeling well or is becoming aggressive and agitated or confused, please call 9-1-1 or your local emergency number and get them to an Emergency Department for treatment ASAP and tell the HCP's what was ingested and how much, it can help us save lives and treat the patient appropriately. And, if someone is suicidal or homicidal, that is an emergency that also needs immediate treatment. If you or someone you know has taken bath salts and feels suicidal afterwards, talk to your HCP or someone you trust to get immediate help, or call a suicide hotline for support 800-273-8255.

Obviously my advise is that bath salts are not worth even trying; you never truly know what you are ingesting in your body and overdosing is too risky and tough for HCPs to treat.  Any drug that is being banned by states, and adding states each week from bad effects, isn't worth it!  The choice is up to you, and you are informed of the mal effects, I hope you choose to be healthy.


Yours in Good Health
B