Bath Salts Linked to More than 20,000 Emergency Room Visits in 2011

A new report released by the Substance Abuse and Mental Health Services Administration (SAMHSA) has identified the group of drugs known as "bath salts" in more than twenty thousand emergency room visits in 2011 alone.    With properties similar to amphetamines,  bath salts are designer drugs chemically similar to cathinone,  a monamine alkaloid derived from the khat plant which has long been used as a recreational stimulant  in parts of Africa and the Middle East.   Though synthetic cathinones such as mephedrone were first developed in 1910, it was largely ignored until being rediscovered by underground chemists in the early 21st century.   Legal in many jurisdictions, bath salts are usually sold as a white or brown powder under names such as "Zoom" and "Cloud Nine".    Their popularity is linked to the legal "high" provided, including euphoria and increased sociability, as well as being undetectable by standard urinalysis or drug detection dogs.   

According to the Drug Abuse Warning Network (DAWN), bath salts were named in 22,904 emergency ward visits in 2011.    Thirty-three percent of those visits involved bath salts only while the remainder involved bath salts in combination with other substances.     People requiring medical attention after taking bath salts often show "excited delirium" which can include dehydration, breakdown of muscle tissue, and kidney failure.   In addition to the dangers linked to bath salts themselves,  products labeled as bath salts can also contain other unknown ingredients which can cause additional harmful effects.

Bath salts gained their name from attempts to conceal their psychoactive properties by marketing them as common household products which can be purchased in head shops and gas stations.    Products that have been used to disguise the designer drugs include "plant food", "jewelry cleaner", and "phone screen cleaner."   In recent years, drug enforcement agencies have begun cracking down on the sale and distribution of bath salts following the rising number of cases referred to poison control centres and hospital emergency wards.  

The synthetic cathinones found in bath salts are chemically similar to drugs such as MDMA (ecstasy) and can boost dopamine levels in the brain, especially in areas controlling reward and movement.    The hallucinatory effects of bath salts also suggest that they can boost serotonin levels as well.  Potential adverse effects include heart and circulatory problems, depression, suicidal thoughts, violent behaviour, and even death.    Bath salt users also report problems with physical addiction.   This can involve intense cravings, drug tolerance, physical dependence, and strong withdrawal effects.   Users range in age from fifteen to fifty-five with an average age of twenty-eight.

Already identified as the fourth most popular recreational drug in countries such as the United Kingdom,  their popularity in the United States has led to bath salts being made illegal in 41 states with pending legislation in others.   In October 2011, the U.S. Drug Enforcement Administration placed three synthetic cathinones under emergency ban and in July of last year, President Obama signed legislation banning mephedrone and MDPV, two of the most common bath salts ingredients.    Synthetic cathinones have also been made illegal in Canada and the United Kingdom.

As new cases of bath salt intoxication continue to be reported, the social costs involved are just beginning to be understood.   It still remains to be seen attempts at curbing the sale and distribution of bath salts will make a real difference in future.

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