Overview of Bath Salts Use and Abuse
- Bath salts are synthetic drugs that chemically resemble amphetamines.
- They are sold online or in drug paraphernalia shops as “jewelry cleaner” or “plant food” to avoid drug laws.
- Bath salts effects include increased energy, euphoria, increased sex drive and increased sociability.
- Users can experience dangerous side effects, including hallucinations, seizures, violent behavior, chest pain and hyperthermia.
- Reports have linked the drugs to a rise in emergency room visits, deaths and poison control center calls.
What Are Bath Salts?
If you’re concerned about your use of bath salts, or a loved one’s use of bath salts, call 1-888-319-2606
Who Answers? to speak with a treatment support representative about rehabilitation programs in your area.
Bath salts are typically distributed as a white or brown powder or in the form of a crystal or liquid. But they are sometimes available in tablet or capsule form.2
They are advertised as a “legal high” or “legal cocaine” and even sold online as actual bath salts (hence the name), jewelry cleaner, plant food or phone screen cleaner.3 Sellers label the product “not for human consumption” to sidestep drug laws.
How They Affect the Brain
Bath salts increase the activity of 3 neurotransmitters: dopamine, serotonin and norepinephrine.
Because bath salts are manufactured illegally, their chemical make-up is constantly changing. Still, the most common bath salts produce similar effects to many other stimulants by increasing the activity of 3 neurotransmitters, which are the chemical messengers of the central nervous system:
- Plays an important role in movement, memory, pleasurable reward, attention, sleep, mood, learning and behavior.
- Plays an important role in regulating mood, social behavior, appetite, digestion, sleep, memory and sexual desire and function.
- Responsible for “fight or flight” response.
- Increases heart rate, blood pressure and blood flow to skeletal muscle.
Bath salts are typically sold online or in drug paraphernalia stores (“head shops”) under the following brand names:
- Blue Silk.
- Charge Plus.
- Cloud Nine.
- Hurricane Charlie.
- Lunar Wave.
- Meow Meow.
- Ocean Burst.
- Ocean Snow.
- Pure Ivory.
- Purple Rave.
- Purple Wave.
- Red Dove.
- Snow Leopard.
- Vanilla Sky.
- White Dove.
- White Knight.
- White Lightning.
Banning of Bath Salts Chemicals
In September 2011, the U.S. Drug Enforcement Administration (DEA) placed 3 common synthetic cathinones under emergency ban pending further investigation:
- Methylenedioxypyrovalerone (MDPV).
In July 2012, the DEA classified mephedrone and MDPV as Schedule I substances under the Controlled Substances Act. This means they have no accepted medical use and a high potential for abuse. They are illegal to possess, use or distribute. Enforcement of the laws is difficult, however, because street chemists continually tweak formulas to evade the DEA.
Treatment Costs and Rehab Options
- Find programs without insurance. If you are looking for recovery programs that help people without insurance, call the Substance Abuse and Mental Health Services Administration’s helpline.
- Find programs if you have insurance. If you need more information on what your insurance will cover and what your treatment options are, call 1-888-319-2606 Who Answers? .
Not all programs cost the same. Factors that affect cost include:
- Insurance coverage.
- The length of time you stay in the program.
- The program’s features.
- Whether the program is residential, outpatient or 12-step.
Bath Salts Addiction Treatments
- Outpatient rehabilitation programs. You attend a treatment facility or hospital several times a week to receive group and individual therapy. These programs also may offer detoxification.
- Inpatient or residential rehabilitation programs. You reside at the treatment center while undergoing a structured program. Many inpatient rehab programs include detox, therapy, psychoeducation and 12-step meetings.
- 12-step programs. You work through a set of recovery steps with a sponsor. The 12-step program focuses on admitting powerlessness over your addiction and repairing relationships.
In addition to selecting the type of bath salts recovery center, you will want to look at other factors in a program such as cost, location and the expertise of the staff.
Bath Salts Effects
Bath salts can be taken orally, smoked, snorted or injected.
- When taken orally. The drug is absorbed into the body slowly, so the user may not experience the peak rush for 1.5 hours. These effects may then last anywhere from 3 to 4 hours after ingestion and are followed by the post-high crash.1
- When smoked snorted or injected. These methods speed up onset of the high. Generally, effects with these methods of administration can be felt within 15 minutes and may last 6-8 hours.2 The worst outcomes of bath salts are associated with snorting or injecting.4
Use of bath salts can be extremely dangerous and life-threatening. In the last decade, the number of emergency room and poison control center visits associated with their consumption has dramatically increased.
The short-term effects of bath salts vary from person to person. But common short-term effects may include:
- Increased energy.
- Increased sociability.
- Increased sex drive.
A number of dangerous effects
are associated with bath salt use:
- Dilated pupils (mydriasis).
- Violent behavior.
- Panic attacks.
- Suicidal thoughts.
- Increased body temperature (hyperthermia).
- Rhabdomyolysis (destruction of muscle fibers).
- Increased heart rate (tachycardia).
- Increased blood pressure (hypertension).
- Heart palpitations.
- Chest pain.
The long-term effects of bath salts remain largely unknown. Little research has been conducted into how bath salts interact with alcohol and other prescription or illicit drugs, or the outcome of mixing several synthetic cathinones, or bath salts.
Each dose may have different chemical properties. But most bath salts are similar to amphetamines, so the long-term effects are likely similar. Some of the long-term effects of amphetamine abuse are as follows:
- Weight loss.
- Financial, marital, familial, personal and relationship problems.
- Social isolation.
- Sexual dysfunction.
- Aggressive behavior.
- Chaotic behavior. 15
- Loss of coordination and physical collapse.12
- Muscle aches.
- Muscle tissue damage.
- Kidney damage or failure.
- Convulsions, coma and death.12
- Intranasal users. 15
- Perforated nasal septum.
- Bleeding nose.
- Intravenous users.
- Collapsed veins.
- Track lines.
- Abscesses on arms or legs.
- HIV or hepatitis. 15
- Necrotizing fasciitis, a skin infection that kills the body’s tissue. 14
- Tolerance (needing to consume more of the drug to feel the same effects).
- Withdrawal symptoms and intense cravings.
Signs and Symptoms of Addiction
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Who Answers? for help finding a rehabilitation center for you or a loved one.
- Bath salts are consumed in larger amounts or over a longer period than planned.
- Inability to cut down or quit bath salts use.
- Large amounts of time spent acquiring bath salts, using bath salts or recovering from the effects of bath salts.
- An extremely strong desire or urge to use bath salts.
- Regular use of bath salts resulting in negligence of responsibilities at work, home or school.
- Social and interpersonal problems are aggravated by abuse of bath salts yet the individual continues to use them anyway.
- Significant social, occupational or recreational activities are neglected in favor of bath salts use.
- Repeated bath salts use in physically dangerous situations.
- Ongoing use of bath salts despite knowledge of having a physical or psychological problem likely caused or worsened by bath salts use.
- Tolerance:a need for larger amounts of bath salts to achieve intoxication or desired effect or a lesser effect with continued use of the same amount of bath salts.
- Withdrawal symptoms, which can be relieved by taking more bath salts.
How Many People Abuse Them?
The extent of bath salt abuse is difficult to measure. Online user surveys provide most of the available abuse data.2
Abuse in the U.S.
In 2010, bath salts rapidly emerged as a new drug of abuse in the United States. A study published in 2014 from an online survey characterized users as mostly male, 18-24 years old, and Caucasian with some college education.
Abuse in Europe
In 2009 and 2010, a significant rise in the abuse of bath salts was reported in Western Europe.1,2 In late 2010, a survey reported that bath salts were the fourth-most commonly used drug in the United Kingdom[/link] (UK) behind cannabis, ecstasy and cocaine.15
An online survey of club-goers in the UK reported that 41% of those surveyed had used mephedrone.7
Moreover, a third of those surveyed reported that they had used methedrone in the last month, while 10% reported that they used the drug weekly.
Findings from this same survey indicated that 10% of the sample reported using methylone.7
Bath salts have a high risk of overdose. One of the most profound results of an overdose is an incredibly long duration of some of the more severe mental effects—especially delirium and psychosis—which can last for days or weeks.14
If you suspect a bath salts overdose call 911 or visit the nearest emergency room.
- Panic attacks.
- Extreme psychosis.
- Violent behavior.
- Suicidal thoughts.
- Tachycardia (very rapid heart rate).
- High blood pressure.
- Fever or hyperthermia (high body temperature).
- Cardiac arrhythmia (irregular heartbeat).
- Heart attack.
- Intracerebral hemorrhage.14
Recent Increase in Overdoses
Bath salts were linked to 23,000 ER visits in 2011.
Bath salts pose an increasing risk to public health, with reports of overdoses and deaths skyrocketing along with calls to poison control centers in the United States. 4
A report by Substance Abuse and Mental Health Services Administration links bath salts to nearly 23,000 emergency room visits in 2011.11 Approximately 66% of the emergency room visits involved bath salts in combination with other drugs.
According to the American Association of Poison Control Centers, poison control centers received reports of 587 exposures to bath salts in 2014.
Teen Bath Salts Abuse
In the United Kingdom, a 2010 survey of high school and college students revealed 20% had used bath salts at least once in their lives and 4% reported daily use.7 All of the respondents that reported daily use were under the age of 21. In the United States, the 2014 annual Monitoring the Future Study reported 0.5% of 8th graders and 0.9% of 10th and 12th graders admitted to using bath salts at least once in their lives.6
Finding Treatment for Bath Salts Addiction
. Coppola M, Mondola R. (2012). Synthetic cathinones: chemistry,, pharmacology, and toxicology of a new class of designer drugs of abuse marketed as “bath salts” or “plant food.” Toxicol Lett 211 (2): 144-149.
. Prosser JM, Nelson LS. (2012). The toxicology of bath salts: a review of synthetic cathinones. J Med Toxicol 8(1): 33-42.
. Ramsey J, Dargan PI, Smyllie M, et al. (2010). Buying ‘legal’ recreational drugs does not mean that you are not breaking the law. QJM 103(10):777-783.
. Spiller HA, Ryan ML, Weston RG, Jansen J. (2011). Clinical experience with and analytical confirmation of “bath salts” and “legal highs” (synthetic cathinones) in the United States. Clin Toxicol 49 (6): 499-505.
. Sivagnanam G. (2012). “Drug abuse” of a different “wave” length. J Pharmacol Pharmacother 3 (1): 85-86.
. Miech, R. A., Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2015). Monitoring the Future national survey results on drug use, 1975-2014: Volume I, Secondary school students. Ann Arbor: Institute for Social Research, The University of Michigan, 599 pp.
. Winstock AR et al. (2011). Mephedrone, new kid for the chop? Addiction 106 (1): 154-161.
. Olives TD, Orozco BS, Stellpflug SJ. (2012). Bath salts: the ivory wave of trouble. West J Emerg Med 13 (1): 58-62.
. James D et al. (2011). Clinical characteristics of mephedrone toxicity reported to the UK National Poisons Information Service. Emerg Med J 28: 686-689.
. Watterson LR, Olive MF. (2014). Synthetic cathinones and their rewarding and reinforcing effects in rodents. Adv Neurosci 2014: 209875.
. Substance Abuse and Mental Health Services Administration (SAMSHA). “Bath salts” drugs were involved in nearly 23,000 emergency department visits in one year. SAMSHA [Press Release] September 17, 2013.
. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). Washington, D.C.: American Psychiatric Association.
. University of Maryland Center for Substance Abuse Research. (2013). Amphetamines | CESAR. (2013). Retrieved October 7, 2015, from http://www.cesar.umd.edu/cesar/drugs/amphetamines.asp
. Ross EA, Reisfield GM, Watson MC, Chronister CW, Goldberger BA. (2012). Psychoactive “bath salts” intoxication with methylenedioxypyrovalerone. Am J Med. 125(9):854-8. Retrieved October 30, 2015 from http://www.ncbi.nlm.nih.gov/pubmed/22682791
. Synthetic cathinones drug profile. (n.d.). Retrieved October 14, 2015, from http://www.emcdda.europa.eu/publications/drug-profiles/synthetic-cathinones
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