Balth Salts: A Public Health Concern for Youth

An urgent call is made to Poison Control Center for advice from an emergency department concerning an 18 year old male who has ingested an unknown substance. The patient is acting anxious and paranoid and is sweating, vomiting, and hallucinating. His heart rate is racing and his blood pressure is elevated. He is complaining of chest pain. He has decreased ability to think clearly and wants to commit suicide. The poison control physician is worried that this patient has been exposed to bath salts.

Calls similar to this one are frequently received by poison control centers in the United States. According to the American Association of Poison Control Centers, the number of calls due to bath salt exposure has increased more than 20 times in 2011. For example, in 2010 there were 304 calls whereas in 2011 there were 6,138 calls.

What are bath salts? They are synthetic (man-made) central nervous system stimulants similar to cocaine and amphetamines. Bath salts are technically called substituted cathinones. The chemicals in bath salts are most often methylenedioxpyrovalerone (MDPV), mephedrone, and methylone. They resemble bathing salts such as Epsom salts and Calgon in the way they look, but they are not this kind of bath salt rather they are very different. They can be ingested by snorting, swallowed, smoked, or injected into veins.

Why do people use bath salts? Youth use bath salts to get high or energy. They are cheap, easy to obtain, and undetectable on a typical urine drug screen. Using bath salts may lead to serious conditions such as heart attacks and strokes. These drugs are very dangerous and have unpredictable effects. Bath salts place youth at high risk of overdose and can even cause death. Unfortunately, there are no known antidotes.

Bath salts are sold in small plastic or foil packages with street names such as Cloud Nine, Bliss, Ivory Wave, Zoom, Purple Wave, Red Dove, Blue Silk, Red Dove, Meow Meow, Bloom, Ocean Burst, Lunar Wave, Vanilla Sky, Drone, Energy-1, White Lightning, Hurricane Charlie, Snow Leopard, Stardust and others. They can also be sold as plant feeder or insect repellent. They can be bought online and in convenience stores. Bath salts often have a warning “not intended for human consumption.” These designer drugs are developed to avoid being controlled by laws such that minor changes are made to the drugs in order to prevent the drugs from being regulated.

The Drug Enforcement Agency has taken emergency action to make bath salts illegal. As a result, bath salts are designated as Schedule 1 substances under the Controlled Substance Act which is reserved for substances with a high potential for abuse. Bath Salts are illegal in at least 42 states. Currently, Vermont has not banned bath salts.

If you want more information go to: www.drugfree.org/drug-guide/bath-salts. For parents, teachers, and other influencers, there is a drug guide just published this year Synthetic (K-2 Spice & Bath Salts) Drug Guide For Parents (PDF).

Dr. Jane L. Uva, MPH is an emergency department physician with Dartmouth-Hitchcock Putnam Physicians and also cares for patients in the occupational health department at Southwestern Vermont Medical Center (SVMC). To learn more about how SVMC and Dartmouth-Hitchcock are working together for a healthier community, visit www.svhealthcare.org. “Health Matters” is a weekly column meant to educate readers about their personal health, public matters and public policy as it affects health care.