According to the National Institute on Drug Abuse (NIDA), the term bath salts refers to a number of different designer drugs that are potentially dangerous. These drugs are produced in laboratories overseas, such as in China. They are then sent to the United States and marketed to individuals who attempt to use them for their psychoactive properties.
The most common of these substances is referred to as MDPV (3, 4 methylenedioxypyrovalerone), which is a synthetic cathinone. Cathinones are stimulant substances that are found in a number of plants, such as the khat plant that grows in portions of the Middle East and Africa. Individuals indigenous to these areas have long used the drug for its stimulant properties. Users chew the leaves of the khat plant or make the leaves and stems into a tea they drink.
Synthetic cathinones produce much more powerful stimulant effects than naturally occurring cathinones, and both drugs are considered to be potentially dangerous. Other drugs that are in bath salts include the stimulant drugs pyrovalerone and mephedrone.
All of these substances have been designated as Schedule I drugs by the United States Drug Enforcement Administration (DEA). This classification means that the substances are without any significant medicinal uses and have significant dangers associated with their use, such as the potential development of physical dependence and substance use disorder.
Bath salts were typically sold in local businesses, such as liquor stores, gas stations, head shops, etc., and they can still be found for sale on the Internet where the substances are often referred to as “legal cocaine” or “legal meth.” They go by a number of street or common names, including flakka, vanilla sky, and white lightning. These drugs are most often available in a powder form that is typically snorted but can be smoked, injected, or taken orally.
Effects of Bath Salts
The psychoactive effects of bath salts are similar to the effects of methamphetamine (crystal meth) and include feelings of euphoria, feelings of invulnerability, an increased rush of energy, hyperactivity, overheating, and excessive sweating. These drugs produce elevated levels of the neurotransmitters norepinephrine and dopamine in the brain, and this leads to a number of other potential side effects.
An article published in the New England Journal of Medicine in 2011 listed the effects attributed to bath salts:
- Hyperthermia (increased body temperature)
- Rapid or irregular heartbeat
- Increased blood pressure
- Increased perspiration
- Pupil dilation
- Difficulty sleeping
- Muscle spasms
- Muscle tremors
- Issues with breathing
- Irritability and increased potential for aggressive behavior
- Depression (particularly when one has stopped using the drug)
- A tendency toward self-mutilation or suicidal thoughts
- Increased potential to have a heart attack
- Increased potential for stroke
- Potential brain swelling
- The development of psychosis (experiencing hallucinations and/or delusions, particularly of a paranoid nature)
- Increased potential to develop seizures
- The development of delirium
- Cognitive issues, such as problems with concentration, memory, and problem-solving
Delirium is a complicated state that consists of severe confusion (often to the point of an individual not knowing what the day is, where they are, recognizing familiar people, etc.), hallucinations, and hyperactivity or hypoactivity. A number of the above potential side effects can lead to permanent changes in the brain that can affect behavior and functioning. For example, brain swelling is a serious condition that can result in lasting brain damage. Seizures can also lead to brain damage. Both brain swelling and seizures can be fatal. There are documented fatalities associated with the use of bath salts.
The Development of a Substance Use Disorder and Physical Dependence
Other potential side effects associated with use of bath salts include developing a substance use disorder and tolerance to them. Research suggests that there might be a withdrawal syndrome associated with discontinuing bath salts; however, the symptoms of withdrawal appear to be mostly psychological in nature, and it is not certain whether they meet the criteria as being symptoms that are usually associated with the development of physical dependence. A number of animal studies have determined that rodents will abuse bath salts in the same manner that they abuse other drugs of abuse like cocaine. Studies of individuals who have abused bath salts indicate that users develop strong cravings for the drugs.
If someone has developed a substance use disorder as a result of abusing bath salts, they would demonstrate at least two of the following symptoms over a 12-month period:
- Issues with controlling use of bath salts, such as:
- Frequently using more of the drug than intended
- Spending significant amounts of time trying to get bath salts, using them, or recovering from using them
- Issues with work, important relationships, school, or other issues as a result of bath salt use
- Developing emotional problems or potentially damaging physical symptoms as a result of bath salt use and still continuing to use them
- Giving up important activities in favor of using bath salts
- Experiencing frequent cravings for bath salts
- Using bath salts in situations where it is dangerous to do so, such as using them in conjunction with other drugs of abuse, while driving, when caring for others, etc.
- Developing tolerance to any of the substances
- The development of withdrawal symptoms
- Using the substance to avoid withdrawal symptoms that occur when one has not used them
The symptoms that are associated with withdrawal from bath salts mentioned in the above studies include:
- Issues with insomnia
- Mood swings, including anxiety and depression
- Tremors, particularly in the hands
- In rare cases, hallucinations and/or delusions
- Severe cravings
Part of the issue with determining whether the use of bath salts results in physical dependence is that these drugs actually represent a number of different drugs as mentioned above. There is no consistency in the type of substance being sold even when these drugs are marketed under the same label.
The development of a substance use disorder as a result of abusing bath salts represents a significant long-term issue. A substance use disorder is a serious mental health disorder that requires long-term and intensive treatment. Many individuals find that they encounter a number of ups and downs in their recovery process. It is imperative that these individuals seek treatment and remain involved in it for a sufficient length of time. In addition, individuals who have suffered physical damage to their central nervous system (the brain and spinal cord) or other important body systems may require lifelong medical treatment.