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In recent years, “bath salts” have emerged as frequently used and highly addictive substance that can be obtained legally in some areas as well as on online. Although they have nothing to do with the bath additives, “bath salts” is an informal name for synthetic cathinones—a central nervous system stimulant taken to produce effects similar to cocaine, methamphetamine, or MDMA (ecstasy or Molly).1
A recreational dose of bath salts reportedly enhances mood and increase alertness. In higher doses, it can lead to dangerous neurologic and cardiovascular complications requiring emergency medical care.1
Bath salts are usually found as a white or brown crystal-like powder that’s sold in small plastic or foil packages labeled “not for human consumption.” They may also be labeled as “bath salts,” “jewelry cleaner,” or “plant food.”2 Other street names for bath salts are flakka, cloud nine, vanilla sky, or white lightning. Sometimes, the drugs can be seen in tablet or capsule form, but this is less common.3
Bath salts are usually self-administered by insufflation (“snorting”) but may be swallowed, smoked or injected. The intoxication lasts 6 to 8 hours and bath salts have a high addictive potential.1
The psychoactive ingredient in bath salts, typically psychoactive “designer drug” methylenedioxypyrovalerone (MDPV) are a human-made derivative of a chemical related to cathinone, a stimulant found in the khat plant—a shrub grown in East Africa and southern Arabia.1,3 Khat leaves are sometimes chewed for their mild stimulant effects.4 Man-made versions of cathinones are generally stronger and more dangerous.2
In 2011, the U.S. Drug Enforcement Agency (as well as agencies from other countries) banned MDPV and two of the other main chemicals that were prevalent in bath salts, mephedrone and methylone.5 But new cathinone derivatives that only slightly modify the original can be created fairly easily by chemists and have quickly replaced the drugs that are subject to regulatory control.1
Small amounts of synthetic cathinones can enhance mood and increase alertness, friendliness and sex drive.1,2
Mild side effects may include:1,2
Severe, life-threatening side effects are experienced with larger doses and can lead to death. Physical effects that might be experienced when taking large doses of bath salts include:1,2
High doses of bath salts can also induce a state of excited delirium, where the user becomes extremely paranoid and agitated, resulting in violent and aggressive behavior.2 Suicidal ideation and self-mutilation may also occur.1
In short, the answer is “yes.” Synthetic cathinones can be addictive. In animal studies, rats would self-administer the drugs, and individuals have reported strong cravings in association with synthetic cathinone use. Individuals may develop a tolerance, meaning that they require an increased dose of the drug to achieve the desired effect. With tolerance comes strong withdrawal symptoms that include:2
Individuals wishing to recover from abuse of synthetic cathinones may benefit from medical detox to ensure they remain safe and comfortable during the withdrawal process. Medically supervised withdrawal management increases the likelihood that individuals will successfully complete detox, since support is available around the clock.
Treatment for an addiction to synthetic cathinones will include behavioral therapies, such as Cognitive Behavioral Therapy, Contingency Management, and Motivational Enhancement Therapy.