“Bath salts” are a new family of drugs containing one or more manmade chemicals related to cathinone, an amphetamine-like stimulant found naturally in the khat plant.
There have been reports of severe intoxication and dangerous health effects from using bath salts. These reports have made the drugs a serious and growing public health and safety issue. The synthetic cathinones in bath salts can produce feelings of joy and increased sociability and sex drive. But some people who abuse bath salts experience paranoia, agitation, and hallucinations; some even lose contact with reality and act violently. Deaths have been reported in several cases.
The synthetic cathinone products sold as “bath salts” should not be confused with products like Epsom salts that are sold to improve the experience of bathing. Epsom salts have no drug-like properties.
Bath salts are usually white or brown crystalline powder and are sold in small plastic or foil packages labeled “not for human consumption.” Sometimes labeled as “plant food”—or, more recently, as “jewelry cleaner” or “phone screen cleaner”—they are sold online and in drug product stores under a variety of brand names, such as “Bloom,” “Cloud Nine,” “Vanilla Sky,” “White Lightning,” and “Scarface.”
Bath salts are typically swallowed, inhaled, or injected, with the worst dangers being associated with snorting or needle injection.
Common manmade cathinones found in bath salts include 3,4-methylenedioxypyrovalerone (MDPV), mephedrone (“Drone,” “Meph,” or “Meow Meow”), and methylone, but there are many others. There is a lot we still don’t know about how these substances affect the human brain, and each one may have somewhat different properties. Chemically, they are similar to amphetamines (such as methamphetamine) and to MDMA (Ecstasy).
The energizing and often agitating effects reported in people who have taken bath salts are similar to the effects of other drugs like amphetamines and cocaine. These drugs raise the level of the neurotransmitter dopamine in brain circuits that control reward and movement. Dopamine is the main neurotransmitter that makes people feel good when they do something they enjoy. A rush of dopamine in these circuits causes feelings of joy and increased activity and can also raise heart rate and blood pressure. Learn more about how neurotransmitters work in the section “How Does the Brain Communicate?”.
Bath salts have been marketed as cheap (and until recently, legal—see Box) substitutes for stimulants like amphetamines and cocaine. A recent study found that MDPV—the most common manmade cathinone found in the blood and urine of patients admitted to emergency departments after taking bath salts—raises brain dopamine in the same way as cocaine but is at least 10 times stronger.
The hallucinatory effects often reported in users of bath salts are similar to the effects caused by other drugs such as MDMA or LSD. These drugs raise levels of another neurotransmitter, serotonin, in a way that is similar to MDMA.
Bath salts have been linked to a high number of visits to emergency departments and Poison Control Centers across the country. Reports show bath salts users have needed medical attention for heart problems (such as racing heart, high blood pressure, and chest pains) and symptoms like paranoia, hallucinations, and panic attacks.
Patients with the syndrome known as “excited delirium” from taking bath salts also may have dehydration, breakdown of skeletal muscle tissue, and kidney failure. Intoxication from several synthetic cathinones including MDPV, mephedrone, methedrone, and butylone has caused death in several instances.
Synthetic cathinones appear to have a high abuse and addiction potential. Rats in an experiment administered themselves the drug and increased the amount they took in a pattern identical to the way they took methamphetamine. Bath salts users have reported that the drugs cause an intense urge to use the drug again and that they are highly addictive. Frequent use may cause tolerance, dependence, and strong withdrawal symptoms when not taking the drug.
The dangers of bath salts are even more complicated when you consider that these products may contain other, unknown ingredients that may have their own harmful effects.
Also, people who believe they are purchasing other drugs such as Ecstasy may be in danger of receiving synthetic cathinones instead. For example, mephedrone has been found commonly substituted for MDMA in pills sold as Ecstasy in the Netherlands.
When bath salts emerged at the end of the last decade, they rapidly gained popularity in the United States and Europe as “legal highs.” In October 2011, the Drug Enforcement Administration placed three common synthetic cathinones under emergency ban pending further investigation, and in July 2012, President Obama signed legislation permanently making two of them—mephedrone and MDPV—illegal along with several other synthetic drugs often sold as marijuana substitutes (“Spice”).
Although the new law also prohibits chemically similar “analogues” of the named drugs, manufacturers are expected to respond by creating new drugs different enough from the banned substances to evade legal restriction. After mephedrone was banned in the United Kingdom in 2010, for example, a chemical called naphyrone quickly replaced it, and is now being sold as “jewelry cleaner” under the brand name “Cosmic Blast.”