Bath salts are swallowed, snorted, or injected for the experience of a drug-induced high. These bath salts often contain the compounds MDPV (3,4-methylenedioxypryrovalerone) and/or mephedrone, known as synthetic cathinones. In appearance, they are an odorless, powdery substance, often white, tan, or brown, although they can also be a crystal, liquid, or tablet.

Bath salts abuse is a rapidly evolving and escalating public health problem: in 2009 there were no poison control center calls; in 2010, poison control centers logged 304 calls about bath salts; in 2011, these calls jumped to 6,138. Although dozens of different illegal synthetic cathinones have already been developed, new ones can and will be synthesized as commercial drug tests are developed that screen and identify the original compounds.

• Some of the many common names for these drugs are “Ivory Wave,” “Red Dove,” “Blue Silk,” “Zoom,” “Vanilla Sky,” “Pure Ivory,” “Ocean Burst,” and “Purple Wave.” Bath salts have also been marketed as plant food and herbal incense.
• These psychoactive drugs are central nervous system stimulants and have effects similar to cocaine, methamphetamine, or MDMA (“ecstasy”). Bath salts can trigger powerful cravings and can lead to binges lasting multiple days. Effects from a single dose can last from 3 hours to as long as 8 hours, depending on how much the user ingests.
• The compounds in bath salts – MDPV and mephedrone – act on the brain’s dopamine transport system. Dopamine is an important neurotransmitter involved in the brain’s pleasure and reward center. Although these two compounds affect dopamine differently, they synergistically combine to produce dangerous effects on the brain and and behavior.

In July 2012, President Obama signed a bill to ban several compounds contained in both synthetic marijuana (“Spice,” “K2”) and bath salts. These drugs are now in the FDA category of substances that cannot be sold under any circumstances and cannot be prescribed for any medical purposes. This new law’s unique strength is that it prohibits not just MDPV and mephedrone, but bans a total of 31 compounds, outlawing the most popular synthetic drugs currently used.

On August 7, 2012, New York State Governor Andrew M. Cuomo announced that the NYS Department of Health was issuing new state regulations to significantly expand the list of prohibited compounds to make synthetic drugs (http://www.governor.ny.gov/press/08072012-bath-salts-illegal). These regulations will help ensure that distributors can no longer avoid the law by modifying bath salt ingredients. To support NYS law enforcement, criminal penalties for selling or possessing these bath salt drugs have increased – fines to up to $500 and up to 15 days in jail. With these new regulations, local law enforcement officials can pursue perpetrators under state laws and refer violators to local District Attorneys for prosecution.

New York State has initiated a toll-free hotline: 1-888-99SALTS (1-888-997-2587). Individuals with information about illegal distribution in New York State of bath salts or synthetic drugs are encouraged to call this hotline.

Routine drug screens do not detect bath salts, although specialized drug testing is becoming available. The risk of overdose on these compounds is high, especially when bath salts are taken orally, as these drugs are rapidly absorbed. In emergency room settings, patients presenting with bath salts overdose may need care and monitoring in the ICU; physical restraints and sedatives may be needed to prevent self-harm and harm to others.

www.whitehouse.gov/ondcp/ondcp-fact-sheets/synthetic-drugs-k2-spice-bath-salts

www.niaaa.nih.gov/alcohol-health

www.drugabuse.gov/drugs-abuse/emerging-drugs

www.aapcc.org/dnn/Portals/0/Bath%20Salts%206.2012.pdf