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Bath Salts

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What are bath salts?

Bath salts are a designer drug of abuse with reports of dangerous intoxication from emergency departments across the US. “Bath salts” are not a hygiene product used for bathing, as the name might imply, but are dangerous synthetic cathinones. These mind-altering drugs are strong central nervous system stimulants that inhibit the dopamine-norepinephrine reuptake system (neurotransmitters in the brain). They can lead to serious, and even fatal adverse reactions. The drug effect is a high or “rush” that is similar to methamphetamine (speed). They are often sold on the street as cheap substitutes for other stimulants such as methamphetamine and cocaine.

What is in bath salts?

The most commonly reported ingredient is methylenedioxypyrovalerone (MDPV), although other stimulants may be present, such as mephedrone and pyrovalerone.1 MDPV is of the phenethylamine class and is structurally similar to cathinone, an alkaloid similar in structure and effects to amphetamine and found in the khat plant. Khat is a shrub found in East Africa and southern Arabia. Mephedrone has been reported to have a high potential for overdose.

MDVP is structurally related to methylenedioxymethamphetamine (MDMA) and cathinone derivatives. MDMA is a schedule I hallucinogenic substance and cathinone derivatives (cathinone, methcathinone) are listed as schedule I stimulants. Animals studies have demonstrated elevated levels of extracellular dopamine 60 minutes after administration of MDVP.3

Are bath salts illegal in the U.S.?

The US Drug Enforcement Agency (DEA) announced emergency scheduling in 2011 to control MDPV, mephedrone and methylone, all chemicals found in bath salts. In 2012, U.S. President Barack Obama signed into law a ban on mephedrone, methylone and MDVP by placing them on the Schedule I controlled substances list.

Schedule I controlled substances cannot be sold under any circumstances and cannot be prescribed for medical purposes. The law also bans any future designer chemical compounds meant to mimic the effects of bath salts. Having possession or selling these chemicals or any product that contains them is illegal in the US.1,12

How do people use bath salts?

Users usually snort the drug up the nose, but it can also been injected, smoked, swallowed or used rectally. Toxic doses for the newer synthetic cathinones such as bath salts have not yet been determined9, and doses can be variable due to the illegal nature of the drug. There is a great risk for overdose because retail packages may contain up to 500 milligrams. If ingested orally, absorption is rapid with a peak “rush” at 1.5 hours, the effect lasting 3 to 4 hours, then a hard “crash”. The total experience may last upwards of 8 hours or longer.1 Snorting and injecting the drug can be especially hazardous.