Tuesday, May 31, 2011

'Bath Salts' Aren't What They Used To Be

Remember when bath salts were what you put in hot water before you lowered yourself into a bath so you could have a wonderful soak? Well I suppose you can still get these, but sales of another form of 'bath salts' are reaching new records -- and bringing grave health hazards. While news of their popularity (and risk) has circulated for some time, there is very disturbing information just out.

The Centers for Disease Control and Prevention (The CDC) has released the first report on 35 patients who appeared in Michigan Emergency Departments (EDs) from mid-November 2010 until the end of March 2011. One of the people who ingested the 'bath salts' was already dead upon arrival at the ED. The others suffered from severe agitation, rapid heart rate, high blood pressure, paranoia and other psychotic symptoms including hallucinations and delusions (ideas contrary to reality and not responsive to efforts to correct them with reality). Some of these patients were violent. Half of those who came to the EDs required hospitalization, half of those were admitted to the intensive care unit. Sixteen of the cases had pre-existing mental health or substance abuse problems.

'Bath Salts' are stimulants, cooked up in underground labs. They are sold on the internet, at head shops, convenience stores and even some gas stations. The packages typically contain methylenedioxypyrovalerone (MPDV), mephedrone and pyrovalerone, all amphetamine-like in their action. The drugs are taken by mouth and sometimes inhaled or even injected. Needless to say, the last two routes of administration are associated with the worst reactions. While stimulants are controlled drugs, the labs often produce variations of existing drugs to avoid regulation.

Bags of 'bath salt' sometimes have written on them "Not Intended for Human Consumption." New York State's Health Commissioner, Dr. Nirav Shah, banned their distribution. Several states have proposed legislation, as has happened federally, to prohibit these substances, but the law is a slow tool in a rapidly moving market. These substances are also marketed as 'plant food' and 'pond water cleaner', and in many other ways to elude detection and control. In other words, it will be the same word of mouth that has driven their consumption that is needed to control it.

Speak to your friends. Talk to your children. Doctors, mental health and addiction counselors warn your patients. Let them know: The bath you take with 'bath salts' is dangerous and at the deep end of the toxic pool.

The opinions expressed herein are solely my own as a psychiatrist and public health advocate.

Dr. Sederer receives no support from any pharmaceutical or device company.

Visit Dr. Sederer's website for questions you want answered, reviews and stories.


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