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Published: Sunday, October 23, 2011 at 3:15 a.m. last Modified: Monday, October 24, 2011 at 12:28 a.m.
After recent headlines about synthetic drugs called “bath salts,” some might question why people would use substances that can produce mind-altering effects that seem nightmarish or lead to bizarre behavior.
Emergency room admissions for bath salts are up, but a lot about the drugs remains unknown.
These are not the bath salts poured into tubs for soaking and relaxation. Instead, they stimulate the central nervous system. They are chemical derivatives of cathinone, a chemical naturally found in the khat plant. Synthetic cathinones in most bath salts are mephedrone and MDPV, which is 3-4 methylene-dioxypyrovalerone.
Earlier this month, Pacolet police said a North Carolina woman under the influence of bath salts tried to steal a police car. in another incident, a “hysterical” woman flagged down a Spartanburg Sheriff’s deputy early one morning and told the officer her live-in boyfriend had smoked bath salts all evening and forced her out of their Mayo residence at gunpoint.
A Chesnee man was arrested after Spartanburg County deputies say he fired a rifle at an imaginary intruder while under the influence of bath salts. Another incident included Spartanburg County deputies arresting a woman who told them she was high on bath salts after she was accused of trespassing at a Chesnee home five times.
“six months ago, bath salts were not much of a phenomenon. Now, however, most, if not all, of the emergency room physicians have encountered a patient who has taken them. Because it’s early in the development of the drug, it’s very difficult for physicians to know for sure if someone is actually under the influence of bath salts, unless they specifically admit to taking them. They are certainly harmful and can be fatal,” a Spartanburg Regional Healthcare Center spokesman said in a written statement.
Dr. Chris Lombardozzi, a physician in Spartanburg Regional’s emergency room, said this “big issue” is getting bigger.
“It has really exploded,” he said.
Lombardozzi said the drugs are injected, snorted, and he’s even seen a report of users placing the drugs in their rectum. Bath salts also are smoked and orally consumed.
Emergency room admissions here began increasing this past spring, Lombardozzi said.
He estimates one or two people are hospitalized each week for possible bath salt ingestion. but there’s no test to screen for the drug.
Lombardozzi said the drug can produce “very drastic behavioral changes.” the stimulants rev up the central nervous system and cause the heart rate to speed up. That increase can cause heart attacks and strokes.
Other effects on the body can include sweating, chest pain, nosebleeds, nausea and vomiting, according to the Drug Enforcement Administration. then, there’s the effects on users’ minds.
They can become agitated, angry and hallucinate, Lombardozzi said.
There are no antidotes for bath salts, he said.
Health care workers mostly provide supportive care. They may give patients benzodiazepine to calm them. the patient waits for the effects of the drug to wear off, and they might have to be protected from themselves.
Many users combine bath salts with other drugs, such as methamphetamine or cocaine to “double the effects, so to speak,” Lombardozzi said.
Users don’t know what they’re getting with bath salts, he said.
Dr. Keith Borg is an associate professor at the Medical University of South Carolina. his specialties include pediatric and adult emergency medicine, clinical research and medical education.
Like Lombardozzi, Borg pointed out that bath salts are labeled not for human consumption.
There can be impurities in the drugs, which are being created in bath tubs and industrial spaces, Borg said.
“Law enforcement officials believe that the stimulant chemicals contained in these products are manufactured in China and India, and packaged for wholesale distribution in Eastern Europe,” according to the DEA’S website.
Officials have moved forward to ban the synthetic drugs.
The DEA took emergency action Friday and reportedly banned mephedrone, MDPV and methylone.
Spartanburg County Council passed first reading of an ordinance to outlaw bath salts, synthetic marijuana and certain other synthetic drugs at its last meeting.
When injected, the drug goes straight to the heart, Borg said.
That might damage the heart and brain, and the use of needles increases risk of infection.
He’s seen patients suffer heart attacks. He’s also seen them injured in car accidents.
If users don’t provide information about using bath salts, health care workers might not know the cause of their medical emergency. are they confused or violent because of head injury? Is the chest pain a heart attack or the effect of drug use?
Cynthia M. Kuhn is professor of pharmacology and cancer biology and professor in psychiatry and behavioral sciences at Duke University Medical Center. she also co-authored a book titled, “Buzzed,” that provides an overview of various drugs.
Kuhn said there is “nothing exotic or incredibly unusual” about these drugs.
“They work biochemically the way other stimulants do,” she said, with “core effects” similar to cocaine or amphetamine.
The drugs increase three neurotransmitters — norepinephrine, dopamine and serotonin, Kuhn said.
Users feel “buzzed,” “euphoric” and “full of energy.”
With high doses, users can lose “track of reality,” she said.
They might appear psychotic when admitted to the hospital, and their behavior returns to normal as the drug leaves their bodies.
“It’s not that the drug turns you psychotic and you’re psychotic forever. but the drug causes that kind of perceptual change because it’s present in your brain,” Kuhn said.
Bizarre behavior is one danger.
A small minority of people who have used bath salts are hospitalized for psychiatric symptoms and have been treated with anti-psychotic medication. Kuhn said there’s no proven medical treatment yet because of limited experience with these synthetic drugs.
She said bath salts “potentially” could be addictive, but added there is not a lot of information available on it, yet.
“as happens, people are doing the experiment for us,” Kuhn said.
It’s not really known whether these drugs permanently alter the brain.
“we know the chemical structures. we know chemically what they do. we do not really have any idea what the long-term consequences are going to be toward human health,” Kuhn said.
Bath salts is one of the latest in a never-ending game in which people find ways to get high and experience the effects of illegal drugs without suffering legal consequences, Kuhn said.
Cocaine was used for centuries. It was even an ingredient in tonics in the late 19th and early 20th century until the Harrison Narcotic Act of 1914 severely restricted the distribution of cocaine and opium products, according to the book, “Buzzed.”
There is a small group of pharmacologists who develop and produce alternative chemical structures with the same range of effects but are not specifically mentioned in law and aren’t, strictly speaking, illegal, Kuhn said. yet, as officials ban the most common ingredients in bath salts, someone with the know-how potentially could create a variation of these drugs, restructured on a molecular level, to make yet another drug that has similar effects. That is, until people realize the drugs are intoxicating and dangerous and in turn make the new drugs illegal, Kuhn said.
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