Bath salts (drug) explained

Bath salts (also called psychoactive bath salts, PABS[1] [2]) are a group of recreational designer drugs.[3] [4] The name derives from instances in which the drugs were disguised as bath salts.[5] [6] [7] The white powder, granules, or crystals often resemble Epsom salts, but differ chemically. The drugs' packaging often states "not for human consumption" in an attempt to circumvent drug prohibition laws. Additionally, they may be described as "plant food", "powdered cleaner", or other products.

Drugs

Bath salts usually contain cathinones, typically methylenedioxypyrovalerone (MDPV, also known as monkey dust[8]), methylone or mephedrone; however, the chemical composition varies widely and products labeled with the same name may also contain derivatives of pyrovalerone or pipradrol. In Europe the main synthetic cathinone is mephedrone, whereas in the US MDPV is more common.

Pharmacology

Pharmacologically, very little is known about how bath salts interact with the brain and how they are metabolized by the body. Scientists are inclined to believe that bath salts have a powerful addictive potential and can increase users' tolerance.[9] They are similar to amphetamines in that they cause stimulant effects by increasing the concentration of monoamines such as dopamine, serotonin, and norepinephrine in synapses.[10] They are generally less able to cross the blood brain barrier than amphetamines due to the presence of a beta-keto group that increases the compound's polarity.

Usage

Bath salts can be ingested orally, snorted, smoked, plugged or injected. Bath salts can be detrimental to human health and can potentially cause erratic behavior, hallucinations, and delusions.[11] This is often due to their wakefulness-promoting effect, leading to insomnia.

Interaction with alcohol

Bath salts are often consumed concurrently with alcohol. A 2015 study[12] has investigated the interrelation between mephedrone and alcohol, focusing on psychostimulant and rewarding effects. It showed that alcohol, at low (non-stimulant) doses, significantly enhances the psychostimulant effects of mephedrone. This effect is mediated by an increase in synaptic dopamine, as haloperidol, but not ketanserin, was capable of blocking the potentiation by alcohol.

Subjective effects

Bath salts or monkey dust come in a powdered or crystallised form which can be swallowed, smoked, injected or snorted. Subjective effects are similar to MDMA or cocaine[13] but with a duration of 5–6 hours. Both substances cause a rapid onset of action in the central nervous system,[14] and stimulant toxicity.

Adverse effects

Bath salt/monkey dust users have reported symptoms that include headache, heart palpitations, nausea, cold fingers, hallucinations, paranoia, and panic attacks. Furthermore, there is evidence to support the claim that a psychoactive compound could catalyze psychosis in a person who is already susceptible to psychotic disorders.

Visual symptoms similar to those of stimulant overdoses include mydriasis, dyskinesia, tachycardia, and hypertension.[15] [16]

In larger doses this class of substances can cause effects similar to those seen in cases of serotonin syndrome.[17] Due to their rapid onset, synthetic cathinones are powerful reward/reinforcers, with high addiction potential.[18] "Monkey dust", "bath salts" or "plant food" are often used at the same time as classical psychoactive drugs. Users who have overdosed often display symptoms of agitation, delirium, hallucinations, seizures, tachycardia, hypertension, and/or hyperthermia.[19]

Detection

MDPV and other synthetic cathinones cannot be smelled by detection dogs and are not detected by typical urinalysis,[20] though they can be detected in urine and hair using gas chromatography-mass spectrometry or liquid chromatography-mass spectrometry.[21] [22] Distributors may disguise the drug as everyday substances such as fertilizer or insect repellent.[23]

Prevalence

Little is known about how many people use bath salts. In the UK, mephedrone, commonly known as MCAT, is the fourth most commonly used illicit drug among nightclub goers after cannabis, MDMA and cocaine. Based on reports to the American Association of Poison Control Centers, use of bath salts in the US is thought to have increased significantly between 2010 and 2012. The increase in use is thought to result from their widespread availability, undetectability on many drug tests, and sensationalist media coverage.[24]

User's age tends to range from 15 to 55, with the average age being 28.

Legal status

The drug policy of Canada since fall 2012 categorizes methylenedioxypyrovalerone (MDPV) as a schedule I substance under the Controlled Drugs and Substances Act, placing it in the same category as heroin and MDMA. Mephedrone and methylone are already illegal in Canada and most of the United States.

In the United Kingdom, all substituted cathinones were made illegal in April 2010,[25] [26] under the Misuse of Drugs Act 1971, but other designer drugs such as naphyrone appeared soon after[27] and some products described as legal contained illegal compounds.[28] To avoid being controlled by the Medicines Act, designer drugs such as mephedrone have been described as "bath salts", or other misnomers such as "plant food" despite the compounds having no history of being used for these purposes.[29] [30] [31]

In July 2012, US federal drug policy was amended to ban the drugs commonly found in bath salts.[32] Prior to that, bath salts were legal in at least 41 states.[33] Prior to the compounds being made illegal, mephedrone, methylone, and MDPV were marketed as bath salts. The "bath salt" name and labels that say "not for human consumption" are an attempt to skirt the Federal Analog Act, which forbids selling drugs that are substantially similar to drugs already classified for human use.[34] [35] [36]

Society and the media

Use of bath salts or monkey dust has spread through social media.[37] Anecdotal reports of the drug increasing its users' pain thresholds while simultaneously giving them increased strength can largely be attributed to the emergency services and frontline NHS staff. Such reports have been picked up, and sensationalised by the regional and tabloid press.[38] [39] In 2018, in the city Stoke-on-Trent,[40] Monkey dust was reported to be an entirely new compound, when in fact preparations of MDPV and MDPHP or "bath salts" have been available since the early 2000s.[41] The print press and broadcast media have often used textual framing techniques to report on synthetic cathinone use among society's most vulnerable. Terms like "epidemic", "zombie attack" and more recently "incredible hulk" are often used when describing users.[42] In August 2018, Staffordshire police said they were receiving around ten calls per day regarding monkey dust. However, it was not clear whether the incidents actually involved monkey dust, or a combination of substances.[43]

Contrary to popular belief, during the investigation of the 2012 Miami cannibal attack toxicologists found no trace of the components in bath salts during the autopsy of the attacker.[44] But some scientists doubt the claim that no bath salts were involved in the ordeal and say that due to the meager testing capabilities a bath salt could have gone undetected.[45]

Bath salts or monkey dust were originally a research chemical or legal highs. Users would purchase the chemicals off the internet, ingest them and blog about the effects.[46]

History

Synthetic cathinones such as mephedrone, which are chemically similar to the cathinone naturally found in the plant Catha edulis (khat), were first synthesised in the 1920s. They remained obscure until the first decade of the 21st century when underground chemists rediscovered them and began to use them in designer drugs, as the compounds were legal in many jurisdictions.[47] In 2009 and 2010 there was a significant rise in the use of synthetic cathinones, initially in the United Kingdom and the rest of Europe, and subsequently in the United States. Drugs marketed as "bath salts" first came to the attention of authorities in the US in 2010 after reports were made to US poison centers. In Europe, the drugs were predominantly purchased from websites, but in the US they were mainly sold in small independent stores such as gas stations and head shops. In the US, this often made them easier to obtain than cigarettes and alcohol. Bath salts have also been sold online in small packets.[48]

Hundreds of other designer drugs or "legal highs" have been reported, including artificial chemicals such as synthetic cannabis and semi-synthetic substances such as methylhexaneamine. These drugs are primarily developed to avoid being controlled by laws against illegal drugs, thus giving them the label designer drugs.[49]

In the US, the number of calls to poison centers concerning "bath salts" rose from 304 in 2010 to 6,138 in 2011, according to the American Association of Poison Control Centers. Calls related to bath salts then began to decrease; by 2015, the number had declined to 522.[50]

See also

Notes and References

  1. Gray. Bobbe Ann. Holland. Cindra. Implications of Psychoactive 'Bath Salts' Use During Pregnancy. Nursing for Women's Health. June 2014. 18. 3. 220–30. 10.1111/1751-486X.12123. 24939199.
  2. Ross. Edward A.. Watson. Mary. Goldberger. Bruce. "Bath Salts" Intoxication. New England Journal of Medicine. 8 September 2011. 365. 10. 967–8. 10.1056/NEJMc1107097. 21899474. free.
  3. Web site: DEA: Chemicals Used in "Bath Salts" Now Under Federal Control and Regulation . 28 December 2013 . 25 April 2014 . https://web.archive.org/web/20140425083923/http://www.justice.gov/dea/divisions/hq/2011/hq102111.shtml . dead .
  4. Web site: Situation Report. Synthetic Cathinones (Bath Salts): An Emerging Domestic Threat . United States Department of Justice: National Drug Intelligence Center . 1 June 2013 .
  5. News: What are 'bath salts'? A look at Canada's newest illegal drug . 25 June 2012 . Black . Matthew . . . 28 December 2013.
  6. Spiller HA, Ryan ML, Weston RG, Jansen J . Clinical experience with and analytical confirmation of "bath salts" and "legal highs" (synthetic cathinones) in the United States . 10.3109/15563650.2011.590812 . Clinical Toxicology . 49 . 6 . 499–505 . 2011 . 21824061. 33364692 .
  7. Coppola M, Mondola R. 10.1016/j.toxlet.2012.03.009 . Synthetic cathinones: Chemistry, pharmacology and toxicology of a new class of designer drugs of abuse marketed as "bath salts" or "plant food" . Toxicology Letters . 211 . 2 . 144–149 . 2012 . 22459606.
  8. News: Monkey dust "epidemic" causing drug users to experience violent hallucinations . 17 August 2018 . Newsweek . 10 August 2018 . en.
  9. Ross . EA . Watson . M . Goldberger . B . "Bath Salts" Intoxication . 365 . 10 . 967–968 . The New England Journal of Medicine . 8 September 2011 . 10.1056/NEJMc1107097 . 21899474 . free .
  10. Kehr . J. . Ichinose . F. . Yoshitake . S. . Goiny . M. . Sievertsson . T. . Nyberg . F. . Yoshitake . T. . Mephedrone, compared to MDMA (ecstasy) and amphetamine, rapidly increases both dopamine and serotonin levels in nucleus accumbens of awake rats . British Journal of Pharmacology . April 2011 . 10.1111/j.1476-5381.2011.01499.x . 21615721 . 3246659 . 1949–58 . 164 . 8.
  11. Web site: Europol–EMCDDA Joint Report on a new psychoactive substance: 4-methylmethcathinone (mephedrone) . https://web.archive.org/web/20110408215242/http://www.emcdda.europa.eu/attachements.cfm/att_102496_EN_Europol-EMCDDA_Joint_Report_Mephedrone.pdf . 8 April 2011 . European Monitoring Centre for Drugs and Drug Addiction . 27 May 2010 .
  12. Ciudad-Roberts. Andrés. Camarasa. Jorge. Ciudad. Carlos J.. Pubill. David. Escubedo. Elena. 2015. Alcohol enhances the psychostimulant and conditioning effects of mephedrone in adolescent mice; postulation of unique roles of D receptors and BDNF in place preference acquisition. British Journal of Pharmacology. 172. 20. 4970–4984. 10.1111/bph.13266. 26228024. 4621996.
  13. Web site: Products - Bath Salts, Plant Food, etc (also Bath Salts; Plant Food; Fertilizer) Erowid experience vaults. 2020-08-08. erowid.org.
  14. Penders . Thomas M. . Gestring . Richard . 2011-09-01 . Hallucinatory delirium following use of MDPV: 'Bath Salts' . General Hospital Psychiatry . 33 . 5 . 525–526 . 10.1016/j.genhosppsych.2011.05.014 . 21762997 . 0163-8343.
  15. Web site: Miller, Michael C. . Ask the Doctor: Bath salts—a new way to get high? . Harvard Mental Health Letter . September 2011 .
    Q. I heard a news story about people using bath salts to get high. How is that possible? My husband and I have two teenagers. Should we talk with them about this?

    A. The "bath salts" you've heard about have nothing to do with the type that people add to water and use while soaking in a tub. These newer bath salts are designer drugs that circumvent the laws governing controlled or illegal substances, but can be used to get high.

    The active chemicals in these salts—mephedrone, pyrovalerone, or methylenedioxypyrovalerone (MDPV)—all have stimulant properties. They are ... . 18 December 2013 . 17 January 2021 . https://web.archive.org/web/20210117155507/https://www.health.harvard.edu/newsletters/harvard_mental_health_letter/2011/september . dead .
  16. Sivagnanam G. . News and Views: 'Drug abuse' of a different 'wave' length . Journal of Pharmacology and Pharmacotherapeutics . 3 February 2012 . 3 . 1 . 85–86 . 10.4103/0976-500x.92493 . 15 March 2024 . free .
  17. Mugele . Josh . Nañagas . Kristine A. . Tormoehlen . Laura M. . July 2012 . Serotonin Syndrome Associated with MDPV Use: A Case Report. Annals of Emergency Medicine . en . 60 . 1 . 100–102 . 10.1016/j.annemergmed.2011.11.033 . 22237165 . 0196-0644.
  18. Aarde. S. M.. Huang. P. K. . Dickerson. T. J. . Taffe. M. A. . 2015-06-01. Binge-like acquisition of 3,4-methylenedioxypyrovalerone (MDPV) self-administration and wheel activity in rats . Psychopharmacology . en . 232 . 11 . 1867–1877 . 10.1007/s00213-014-3819-4 . 1432-2072 . 4426253 . 25424056.
  19. Olof . Beck . Matilda . Bäckberg . Patrick . Signell . Anders . Helander . 2017. Intoxications in the STRIDA project involving a panorama of psychostimulant pyrovalerone derivatives, MDPV copycats. Clinical Toxicology. 56. 4. 256–263. 10.1080/15563650.2017.1370097 . free . 28895757 .
  20. Winder . G. S.. Stern . N.. Hosanagar . A.. Are "Bath Salts" the next generation of stimulant abuse?. J Subst Abuse Treat. 44. 1. 42–45. March 2012 . 22445773. 10.1016/j.jsat.2012.02.003.
  21. Book: Baselt, R. . Disposition of Toxic Drugs and Chemicals in Man . 11th . Biomedical Publications . Seal Beach, CA . 2017 . 1280–1282 . 29 June 2012 . https://web.archive.org/web/20120425083904/http://www.biomedicalpublications.com/mephedrone.pdf . 25 April 2012 . dead.
  22. Rust KY, Baumgartner MR, Dally AM, Kraemer T. Prevalence of new psychoactive substances: A retrospective study in hair . 10.1002/dta.1338 . Drug Testing and Analysis . 4 . 6 . 402–408 . 2012 . 22522922.
  23. News: 'Bath salts,' synthetic drugs targeted in Schneiderman lawsuits . Long Island Newsday . 10 July 2012 . 18 December 2013 . https://web.archive.org/web/20131228075413/http://www.newsday.com/news/new-york/bath-salts-synthetic-drugs-targeted-in-schneiderman-lawsuits-1.3829630 . 28 December 2013 . live . .
  24. Prosser JM, Nelson LS . 10.1007/s13181-011-0193-z . The Toxicology of Bath Salts: A Review of Synthetic Cathinones . Journal of Medical Toxicology . 8 . 1 . 33–42 . 2011 . 22108839. 3550219.
  25. News: BBC – Democracy Live – MPs move to ban mephedrone . BBC News . 7 April 2010 . 28 December 2013.
  26. News: The Misuse of Drugs (Amendment) (England, Wales and Scotland) Regulations 2010 No. 1144 . Office of Public Sector Information . 16 April 2010 . https://web.archive.org/web/20110105053256/http://www.legislation.gov.uk/uksi/2010/1144/made . 5 January 2011 . dead .
  27. News: NRG-1 'legal high' drug is banned . BBC News . 12 July 2010 . 28 December 2013.
  28. Brandt . SD . Sumnall . HR . Measham . F . Cole . J . Second generation mephedrone: The confusing case of NRG-1 . British Medical Journal . 341 . c3564 . July 2010 . 20605894 . 10.1136/bmj.c3564. 20354123 .
  29. News: Reed . Jim . Clubbers are 'turning to new legal high mephedrone' . BBC News . 13 January 2010 . 4 July 2010.
  30. Web site: Consideration of the Cathinones . http://webarchive.nationalarchives.gov.uk/20100402214933/http%3A//drugs.homeoffice.gov.uk/publication%2Dsearch/acmd/ACMD%2Dcathinones%2Dreport.pdf . dead . 2 April 2010 . 31 March 2010 . Advisory Council on the Misuse of Drugs . 25 . 1 April 2010 .
  31. News: Police warning over 'bubble' drug . 20 November 2009 . BBC News . 28 December 2013.
  32. Obama Signs Federal Ban on 'Bath Salt' Drugs . Patience . Haggin . Newsfeed . . 10 July 2012 . 28 December 2013.
  33. News: Synthetic Drug Threats . . National Conference of State Legislatures . 28 November 2012 . 28 December 2013.
  34. News: An Alarming New Stimulant, Legal in Many States . The New York Times. Abby . Goodnough . Katie . Zezima . 16 July 2011 . 15 January 2012.
  35. News: Synthetic form of cocaine and methamphetamine being packaged as bath salts . The Huntsville Times. Victoria . Cumbow . 6 February 2011 . 10 February 2011.
  36. Web site: Reports: Miami 'zombie' attacker may have been using 'bath salts' . CNN . 29 May 2012 . 28 December 2013 . 25 March 2021 . https://web.archive.org/web/20210325054706/https://news.blogs.cnn.com/2012/05/29/reports-miami-zombie-attacker-may-have-been-using-bath-salts/ . dead .
  37. News: Surge in monkey dust drug use linked to social media, police say. Marsh. Sarah. 2018-08-17. The Guardian. 2019-02-08. en-GB. 0261-3077.
  38. Web site: The Truth About 'Monkey Dust', UK Media's Latest Drug Obsession. Daly. Max. Clifton. Jamie. 2018-08-16. Vice. en-UK. 2019-02-08.
  39. News: Monkey dust warning as police say increasingly popular drug is leading to people jumping off buildings. Johnson. Jamie. 2018-08-15. The Telegraph. 2019-02-08. en-GB. 0307-1235.
  40. Web site: Monkey dust couple's warning before setting their house on fire. Davies. Ruby. 2018-11-20. stokesentinel. 2019-02-08.
  41. Baumann. Michael H.. Bukhari. Mohammad O.. Lehner. Kurt R.. Anizan. Sebastien. Rice. Kenner C.. Concheiro. Marta. Huestis. Marilyn A.. 2017. Neuropharmacology of 3,4-Methylenedioxypyrovalerone (MDPV), Its Metabolites, and Related Analogs. Current Topics in Behavioral Neurosciences. 32. 93–117. 10.1007/7854_2016_53. 1866-3370. 5392131. 27830575. 978-3-319-52442-9.
  42. Book: How Broadcast Media Discuss New Drug "Epidemics": Integrating Neuroscience With Communication Studies Through Textual Framing - SAGE Research Methods. methods.sagepub.com. 2017 . 10.4135/9781526409508 . en. 2019-02-08 . Swalve . Natashia . Defoster . Ruth . 9781526409508 .
  43. Web site: Monkey Dust mayhem: the English city reportedly at the centre of a drug-fuelled 'epidemic'. Page. Sarah. The Conversation. 6 September 2018 . en. 2019-02-08.
  44. Web site: Laboy. Suzette. 27 June 2012. Tests find only marijuana in face-chewer's system. The Boston Globe. Associated Press.
  45. Web site: 2012-08-20 . Causeway Cannibal: Toxicology reports say Rudy Eugene was not on bath salts, but not everyone believes them . 2022-01-25 . . Fort Lauderdale, Florida . https://web.archive.org/web/20120820120733/http://articles.sun-sentinel.com/2012-07-06/news/fl-bath-salts-tests-20120706_1_bath-salts-synthetic-marijuana-clandestine-labs . 20 August 2012 . dead.
  46. News: Boseley. Sarah. 2014-07-04. Psychonauts explore unknown world of legal highs—with themselves as lab rats. The Guardian. 2019-02-08 . en-GB. 0261-3077.
  47. News: Hamilton's Pharmacopeia. Mephedrone: the phantom menace . https://web.archive.org/web/20111030023436/http://www.vice.com/read/hamilton-s-pharmacopeia-455-v17n6 . 30 October 2011 . Morris . H. . Vice Magazine . 5 April 2010 . live.
  48. News: Dolak . Kevin . 'Bath Salts': Use of Dangerous Drug Increasing Across U.S. . ABC News: Good Morning America . 5 June 2012 . 28 December 2013.
  49. McElrath, K . O'Neill, C . Experiences with mephedrone pre- and post-legislative controls: perceptions of safety and sources of supply . The International Journal on Drug Policy . 22 . 2 . 120–7 . March 2011 . 21242082 . 10.1016/j.drugpo.2010.11.001.
  50. Web site: Bath Salts . 18 January 2017 . American Association of Poison Control Centers . In 2012, poison centers took 2,697 calls about exposures to bath salts with the number reducing to 998 in 2013. In 2014, there were 587 exposure calls with the number reducing to 522 in 2015. . https://web.archive.org/web/20170119053143/http://www.aapcc.org/alerts/bath-salts/ . 19 January 2017 . dead.

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