Although some progress has been made in stemming the “bath salts” designer drug epidemic, a new report shows that more work must be done to control the use of these dangerous stimulants in the U.S.
A paper published in this month's issue of the Journal of Addiction Medicine calls for more medical research and coordinated public health efforts to curb the use of cathinone, a synthetic stimulant commonly marketed as bath salts.
“No one is looking at this in formal research studies,” Dr. Erik W. Gunderson of the University of Virginia said in an interview with Healthline. ”Human laboratory studies would be an important place to start.”
Gunderson and his colleagues concluded that medical professionals don't have enough information regarding the epidemiology, behavioral pharmacology, clinical effects, and management of the drug. In theory, bath salts have been illegal for several years under the Federal Analogue Act addition to the Controlled Substances Act of 1970. However, that law only applies to products intended for human consumption.
People now are buying the drug packaged as a household good and labeled “not for human consumption.” The label is code for a product used to get high, Gunderson said. The substances are readily available on the Internet, and in some parts of the country they even can be purchased at convenience stores and smoke shops.
A Frightening Case in Point
In a case study related to the published paper, Gunderson described the effects of cathinone on a patient who had been on a three-week bath salts binge. He had underlying mental health issues and had also smoked synthetic marijuana, or “K2,” another designer drug. He used Benadryl to “come down” from the drug after experiencing insomnia for several days.
The patient sent his doctor pictures of people he thought he saw outside a window. He also climbed onto a roof with a crossbow and shot arrows at those who he said would not “identify themselves.”
Synthetic drug abuse is most common among male teens and young adults. Every incident in which designer drugs like cathinone have been used is different, Gunderson stressed. However, symptoms often include an elevated heart rate, agitation, paranoia, and delusions.
Progress on the State Level
The American Association of Poison Control Centers, which keeps timely data on calls to poison control centers around the country, noted that calls concerning bath salts rose from none in 2009 to a peak of 6,036 in 2011. However, that number has ebbed to only 431 calls as of May 31 of this year.
Dr. Michael Wahl, who oversees the Poison Control Center in Chicago, Ill., told Healthline that this is due to efforts made in communities around the country to combat the problem. “Some states have done a better job of reducing the retail sales of [bath salts] than others. In Illinois, we have removed open retail sales everywhere in the state, and our calls are among the lowest in the nation,” he said.
Gunderson said that ground zero in the battle against cathinone occurred in Marquette County, Mich., in February 2011. That's when Fred Benzie, health officer for the county, declared a public health emergency there. Michigan gives county health officers broad powers when it comes to protecting public health.
The declaration halted the sale of the product at a local smoke shop. The county also launched an aggressive public education campaign that became a model for other communities in the state. Although tests for cathinone are not widely available, reports from hospitals and other healthcare providers of symptoms usually seen from ingesting the substance sharply declined in Marquette County.
“We were passionate enough about this as a community that we weren't going to stand for it,” Benzie told Healthline. “Sometimes, people trained in law enforcement are not passionate about public health.”
Such success stories remain few and far between, Gunderson said.
A year ago, Congress passed and President Obama signed into law legislation that made bath salts illegal. However, manufacturers have gotten around that law by tweaking the drug's chemical composition.
New designer drugs are being manufactured and brought to the market at a rapid pace, Gunderson said, making it difficult for healthcare professionals and lawmakers to keep up.
And these substances are not clinically tested or regulated to ensure their safety. “Anybody who puts this into their bodies is a research experiment at this point," Wahl said. "It's not like the drugs you get at the pharmacy that have undergone clinical trials for safety.”