Synthetic cathinones make up a large, ever-changing group of potent and dangerous stimulant drugs. While they are typically referred to as “bath salts,” the name was originally for one type of synthetic cathinone. This drug is illegal in the United States as of 2011 when the Drug Enforcement Administration (DEA) placed the drug on the emergency schedules list.
Synthetic Cathinones and Bath Salts
The chemical cathinone occurs organically in the khat plant found in East Africa and Southern Arabia. This molecule is part of methamphetamines and amphetamines; however, as new psychoactive substances (NPS) are being developed, legal but life-threatening versions of cathinones are being sold across the world. These laboratory-produced drugs are difficult to predict because their chemistry changes consistently to get around new laws and regulations. Without any regulations, synthetic cathinones like bath salts are hard to dose. This leads to overdoses more often than addiction.
Bath salts are typically marketed as alternatives to other, more expensive stimulants, like cocaine, claiming the drugs are 10 times more powerful. They also have labels stating that they are not for human consumption in order to bypass import regulations.
Researchers are not sure how bath salts affect the brain, although it appears that, like other stimulants, they flood the brain with dopamine. By changing how much dopamine is accessible to neurons, the individual will experience rapidly elevated mood, approaching mania; hallucinations; physical excitement, including tremors and heartbeat changes; and delusions, both paranoid and delusions of grandeur. At first, bath salts can produce a stimulating, euphoric high. Signs of this high include:
- Increased desire for social interaction
- Sexual desire
- Hallucinations that are visual, auditory, or tactile
One of the most dangerous psychological side effects from bath salts is excited delirium. This is a form of extreme agitation and violent behavior induced by too much dopamine flooding the brain. Symptoms of excited delirium include extreme aggression, acute physical and mental distress, and sudden death.
Additionally, potent drugs like bath salts can induce psychosis or mental disorders in people who are prone to these conditions. For example, if someone is genetically predisposed to schizophrenia, taking bath salts may induce the condition. This will lead to co-occurring substance abuse and mental health conditions.
Physical Damage from Bath Salts
Physical effects from taking bath salts can lead to chronic health problems. These include:
- Nosebleeds if snorted
- Panic attacks
- Sweating as core body temperature rises
- Hyperthermia, which can damage the liver and kidneys
- Rapid breathing, leading to oxygen deprivation
- Cardiovascular stress with rapid heartbeat and increased blood pressure
- Chest pains, heart attack, or stroke
- Rhabdomyolysis, or the breakdown of muscles that floods the kidneys with toxins
Emergency room information is the most common source of data about the effects of bath salts, which shows how destructive these chemicals can be. Data from Michigan ERs between 2010 and 2011, reported by the Centers for Disease Control and Prevention (CDC) found that, among 35 patients, the most common signs of bath salts toxicity were:
- Agitation: 23 patients
- Tachycardia (rapid heartbeat): 22 patients
- Delusions and hallucinations: 14 patients
One of those 35 patients died upon arrival at the hospital while 17 others were admitted for long-term treatment. The median age for the patients was 28.
Treatment for Bath Salts Abuse
Understanding the dangers of bath salts is very important. After a few years of declining abuse among grade school students, according to the Monitoring the Future (MTF) survey, 8th grade students in 2016 appeared to increase their abuse of this extremely dangerous drug. Abuse of bath salts among 10th and 12th graders remained the same.
Since these drugs are still fairly new to researchers, it is hard to say if bath salts are specifically addictive; however, behaviors among many people who ingest these drugs indicates that these drugs are habit-forming and induce cravings, which indicates addiction. There are no medications that can ease withdrawal symptoms associated with bath salts; the best process for detox is to get intensive medical oversight to treat symptoms of withdrawal like nausea or anxiety as they appear. Following safe detox, entering a rehabilitation program that provides comprehensive therapy is the best treatment to maintain abstinence and prevent relapse.