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Bath salts (also psychoactive bath salts, PABS, or in the United Kingdom monkey dust) are a group of
recreational Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or pleasure ...
designer drug A designer drug is a structural or functional analog of a controlled substance that has been designed to mimic the pharmacological effects of the original drug, while avoiding classification as illegal and/or detection in standard drug tests. Des ...
s. The name derives from instances in which the drugs were disguised as
bath salts Bath salts are water-soluble, pulverized minerals that are added to water to be used for bathing. They are said to improve cleaning, enhance the enjoyment of bathing, and serve as a vehicle for cosmetic agents. Bath salts have been developed wh ...
. The white powder, granules, or
crystal A crystal or crystalline solid is a solid material whose constituents (such as atoms, molecules, or ions) are arranged in a highly ordered microscopic structure, forming a crystal lattice that extends in all directions. In addition, macros ...
s often resemble
Epsom salts Magnesium sulfate or magnesium sulphate (in English-speaking countries other than the US) is a chemical compound, a salt with the formula , consisting of magnesium cations (20.19% by mass) and sulfate anions . It is a white crystalline solid, s ...
, but differ chemically. The drugs' packaging often states "not for human consumption" in an attempt to circumvent
drug prohibition law The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to prevent the recreational use of certain intoxicating substances. While some drugs are illegal to possess, many governments regulate the ...
s. Additionally, they may be mislabeled as plant food, powdered cleaner, and other such products.


History

Synthetic cathinones such as
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, , White Magic, meow meow, bubble, ''txomin'' and yurrpt. It is chemically similar to the cathinone compounds ...
, which are chemically similar to the
cathinone Cathinone (also known as benzoylethanamine, or β-keto-amphetamine) is a monoamine alkaloid found in the shrub '' Catha edulis'' (khat) and is chemically similar to ephedrine, cathine, methcathinone and other amphetamines. It is probably the m ...
naturally found in the plant ''
Catha edulis Khat or qat ( ''ch’at''; Oromo: ''Jimaa'', so, qaad, khaad, khat or chat, ar, القات ''al-qāt'') is a flowering plant native to eastern and southern Africa. Khat contains the alkaloid cathinone, a stimulant, which is said to cause e ...
'' (khat), were first synthesised in the 1920s. They remained obscure until the first decade of the 21st century when underground chemists rediscovered them and began to use them in designer drugs, as the compounds were legal in many jurisdictions. In 2009 and 2010 there was a significant rise in the use of synthetic cathinones, initially in the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
and the rest of
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a Continent#Subcontinents, subcontinent of Eurasia ...
, and subsequently in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
. Drugs marketed as "bath salts" first came to the attention of authorities in the US in 2010 after reports were made to US poison centers. In Europe, the drugs were predominantly purchased from websites, but in the US they were mainly sold in small independent stores such as gas stations and
head shop A head shop is a retail outlet specializing in paraphernalia used for consumption of cannabis and tobacco and items related to cannabis culture and related countercultures. They emerged from the hippie counterculture in the late 1960s, and ...
s. In the US, this often made them easier to obtain than cigarettes and alcohol. Bath salts have also been sold online in small packets. Hundreds of other designer drugs or "legal highs" have been reported, including artificial chemicals such as
synthetic cannabis Synthetic cannabinoids are a class of designer drug molecules that bind to the same receptors to which cannabinoids (THC, CBD and many others) in cannabis plants attach. These novel psychoactive substances should not be confused with synthetic ...
and semi-synthetic substances such as
methylhexaneamine Methylhexanamine (also known as methylhexamine, 1,3-dimethylamylamine, 1,3-DMAA, dimethylamylamine, and DMAA; trade names Forthane and Geranamine) is an indirect sympathomimetic drug invented and developed by Eli Lilly and Company and marketed as ...
. These drugs are primarily developed to avoid being controlled by laws against illegal drugs, thus giving them the label ''designer drugs''. In the US, the number of calls to poison centers concerning "bath salts" rose from 304 in 2010 to 6,138 in 2011, according to the American Association of Poison Control Centers. Calls related to bath salts then began to decrease; by 2015, the number had declined to 522.


Pharmacology

Pharmacologically Pharmacology is a branch of medicine, biology and pharmaceutical sciences concerned with drug or medication action, where a drug may be defined as any artificial, natural, or endogenous (from within the body) molecule which exerts a biochemica ...
, bath salts usually contain a
cathinone Cathinone (also known as benzoylethanamine, or β-keto-amphetamine) is a monoamine alkaloid found in the shrub '' Catha edulis'' (khat) and is chemically similar to ephedrine, cathine, methcathinone and other amphetamines. It is probably the m ...
, typically
methylenedioxypyrovalerone Methylenedioxypyrovalerone (MDPV) is a stimulant of the cathinone class that acts as a norepinephrine–dopamine reuptake inhibitor (NDRI). It was first developed in the 1960s by a team at Boehringer Ingelheim. Its activity at the dopamine tr ...
(MDPV),
methylone Methylone (also known as "3,4-methylenedioxy-''N''-methylcathinone", "MDMC", "βk-MDMA" and by the slang term "M1") is an empathogen and stimulant psychoactive drug. It is a member of the substituted amphetamine, substituted cathinone and ...
or
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, , White Magic, meow meow, bubble, ''txomin'' and yurrpt. It is chemically similar to the cathinone compounds ...
; however, the
chemical A chemical substance is a form of matter having constant chemical composition and characteristic properties. Some references add that chemical substance cannot be separated into its constituent elements by physical separation methods, i.e., wi ...
composition varies widely and products labeled with the same name may also contain derivatives of
pyrovalerone (Centroton, 4-Methyl-β-keto-prolintane, Thymergix, O-2371) is a psychoactive drug with stimulant effects via acting as a norepinephrine-dopamine reuptake inhibitor (NDRI), and is used for the clinical treatment of chronic fatigue or letharg ...
or
pipradrol Pipradrol (Meratran) is a mild central nervous system stimulant ( norepinephrine-dopamine reuptake inhibitor) that is no longer widely used in most countries due to concerns about its abuse potential. Pipradrol is still used in some European cou ...
. In Europe the main synthetic cathinone is mephedrone, whereas in the US MDPV is more common. Very little is known about how bath salts interact with the brain and how they are
metabolized Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cell ...
by the body. Scientists are inclined to believe that bath salts have a powerful addictive potential and can increase users' tolerance. They are similar to amphetamines in that they cause stimulant effects by increasing the concentration of
monoamines Monoamine neurotransmitters are neurotransmitters and neuromodulators that contain one amino group connected to an aromatic ring by a two-carbon chain (such as -CH2-CH2-). Examples are dopamine, norepinephrine and serotonin. All monoamines are ...
such as
dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic compound, organic chemical of the catecholamine and phenethylamine families. Dopamine const ...
,
serotonin Serotonin () or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter. Its biological function is complex and multifaceted, modulating mood, cognition, reward, learning, memory, and numerous physiological processes such as vomiting and vas ...
, and
norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as both a hormone and neurotransmitter. The name "noradrenaline" (from Latin '' ad'', ...
in
synapse In the nervous system, a synapse is a structure that permits a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or to the target effector cell. Synapses are essential to the transmission of nervous impulses from ...
s. They are generally less able to cross the
blood brain barrier Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the Cell (biology), cells, and transports Metabolic waste, metabolic waste products away from th ...
than amphetamines due to the presence of a beta-keto group that increases the compound's
polarity Polarity may refer to: Science *Electrical polarity, direction of electrical current *Polarity (mutual inductance), the relationship between components such as transformer windings * Polarity (projective geometry), in mathematics, a duality of ord ...
.


Usage

Bath salts can be ingested orally, snorted,
smoked Smoking is the process of flavoring, browning, cooking, or preserving food by exposing it to smoke from burning or smoldering material, most often wood. Meat, fish, and ''lapsang souchong'' tea are often smoked. In Europe, alder is the tradi ...
, or injected. Bath salts can be detrimental to human health and can potentially cause erratic behavior, hallucinations, and delusions. This is often due to their wakefullness-promoting effect, leading to insomnia.


Interaction with alcohol

Bath salts are often consumed concurrently with
alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...
. A 2015 study has investigated the interrelation between
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, , White Magic, meow meow, bubble, ''txomin'' and yurrpt. It is chemically similar to the cathinone compounds ...
and alcohol, focusing on psychostimulant and rewarding effects. It showed that
alcohol Alcohol most commonly refers to: * Alcohol (chemistry), an organic compound in which a hydroxyl group is bound to a carbon atom * Alcohol (drug), an intoxicant found in alcoholic drinks Alcohol may also refer to: Chemicals * Ethanol, one of sev ...
, at low (non-stimulant) doses, significantly enhances the psychostimulant effects of mephedrone. This effect is mediated by an increase in synaptic
dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic compound, organic chemical of the catecholamine and phenethylamine families. Dopamine const ...
, as
haloperidol Haloperidol, sold under the brand name Haldol among others, is a typical antipsychotic medication. Haloperidol is used in the treatment of schizophrenia, tics in Tourette syndrome, mania in bipolar disorder, delirium, agitation, acute psychosi ...
, but not
ketanserin Ketanserin (INN, USAN, BAN) (brand name Sufrexal; former developmental code name R41468) is a drug used clinically as an antihypertensive agent and in scientific research to study the serotonin system; specifically, the 5-HT2 receptor family. I ...
, was capable of blocking the potentiation by alcohol.


Subjective effects

Bath salts or monkey dust come in a powdered or crystallised form which can be swallowed, smoked, injected or snorted. Subjective effects are similar to MDMA or cocaine but with a duration of 5–6 hours. Both substances cause a rapid onset of action in the central nervous system, and stimulant toxicity. In larger doses this class of substances can cause effects similar to those seen in cases of
serotonin syndrome Serotonin syndrome (SS) is a group of symptoms that may occur with the use of certain serotonergic medications or drugs. The degree of symptoms can range from mild to severe, including a potentiality of death. Symptoms in mild cases include high ...
. Due to their rapid onset, synthetic cathinones are powerful reward/reinforcers, with high addiction potential. "Monkey dust", "bath salts" or plant food are often used at the same time as classical psychoactive drugs. Users who have overdosed often display symptoms of agitation,
delirium Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in ...
,
hallucinations A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinatio ...
, excessive motor activity, seizures,
tachycardia Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal (su ...
, hypertension, and/or hyperthermia.


Health issues

Bath salt/Monkey dust users have reported symptoms that include
headache Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result ...
,
heart palpitations Palpitations are perceived abnormalities of the heartbeat characterized by awareness of cardiac muscle contractions in the chest, which is further characterized by the hard, fast and/or irregular beatings of the heart. Symptoms include a rapi ...
,
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
, cold fingers,
hallucination A hallucination is a perception in the absence of an external stimulus that has the qualities of a real perception. Hallucinations are vivid, substantial, and are perceived to be located in external objective space. Hallucination is a combinatio ...
s,
paranoia Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concer ...
, and
panic attack Panic attacks are sudden periods of intense fear and discomfort that may include palpitations, sweating, chest pain or chest discomfort, shortness of breath, trembling, dizziness, numbness, confusion, or a feeling of impending doom or of losing ...
s. News media have reported reactions that include
violent Violence is the use of physical force so as to injure, abuse, damage, or destroy. Other definitions are also used, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened o ...
behavior,
heart attack A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may tr ...
,
kidney failure Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
, liver failure,
suicide Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
, an increased tolerance for
pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...
,
dehydration In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
, and breakdown of skeletal muscle tissue. Furthermore, there is evidence to support the claim that a psychoactive compound could catalyze psychosis in a person who is already susceptible to psychotic disorders. Visual symptoms similar to those of stimulant overdoses include dilated pupils, involuntary muscle movement, rapid heartbeat, and high blood pressure.


Detection

MDPV Methylenedioxypyrovalerone (MDPV) is a stimulant of the cathinone class that acts as a norepinephrine–dopamine reuptake inhibitor (NDRI). It was first developed in the 1960s by a team at Boehringer Ingelheim. Its activity at the dopamine tra ...
and other synthetic cathinones cannot be smelled by
detection dog A detection dog or sniffer dog is a dog that is trained to use its senses to detect substances such as explosives, illegal drugs, wildlife scat, currency, blood, and contraband electronics such as illicit mobile phones. The sense most used by d ...
s and are not detected by typical
urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and microscopic examination. Macroscopic e ...
, though they can be detected in urine and hair using
gas chromatography-mass spectrometry Gas is one of the four fundamental states of matter (the others being solid, liquid, and plasma). A pure gas may be made up of individual atoms (e.g. a noble gas like neon), elemental molecules made from one type of atom (e.g. oxygen), or com ...
or liquid chromatography-mass spectrometry. Distributors may disguise the drug as everyday substances such as
fertilizer A fertilizer (American English) or fertiliser (British English; see spelling differences) is any material of natural or synthetic origin that is applied to soil or to plant tissues to supply plant nutrients. Fertilizers may be distinct from ...
or
insect repellent An insect repellent (also commonly called "bug spray") is a substance applied to skin, clothing, or other surfaces to discourage insects (and arthropods in general) from landing or climbing on that surface. Insect repellents help prevent and cont ...
.


Prevalence

Little is known about how many people use bath salts. In the UK, mephedrone, commonly known as MCAT, is the fourth most commonly used illicit drug among
nightclub A nightclub (music club, discothèque, disco club, or simply club) is an entertainment venue during nighttime comprising a dance floor, lightshow, and a stage for live music or a disc jockey (DJ) who plays recorded music. Nightclubs gener ...
goers after
cannabis ''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: ''Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternatively ...
,
MDMA 3,4-Methylenedioxymethamphetamine (MDMA), commonly seen in Tablet (pharmacy), tablet form (ecstasy) and crystal form (molly or mandy), is a potent empathogen–entactogen with stimulant properties primarily used for Recreational dru ...
and
cocaine Cocaine (from , from , ultimately from Quechuan languages, Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly recreational drug use, used recreationally for its euphoria, euphoric effects. It is primarily obtained from t ...
. Based on reports to the
American Association of Poison Control Centers The American Association of Poison Control Centers (AAPCC) is a national nonprofit organization founded in 1958 that represents the nation's 55 poison centers. The AAPCC supports poison centers in their public health mission to prevent poisonin ...
, use of bath salts in the US is thought to have increased significantly between 2010 and 2011. The increase in use is thought to result from their widespread availability, undetectability on many drug tests, and sensationalist media coverage. User's age tends to range from 15 to 55, with the average age being 28.


Legal status

The drug policy of Canada since Fall 2012 categorizes methylenedioxypyrovalerone (MDPV) as a schedule I substance under the
Controlled Drugs and Substances Act The ''Controlled Drugs and Substances Act'' (french: Loi réglementant certaines drogues et autres substances) (the ''Act'') is Canada's federal drug control statute. Passed in 1996 under Prime Minister Jean Chrétien's government, it repeals ...
, placing it in the same category as
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
and
MDMA 3,4-Methylenedioxymethamphetamine (MDMA), commonly seen in Tablet (pharmacy), tablet form (ecstasy) and crystal form (molly or mandy), is a potent empathogen–entactogen with stimulant properties primarily used for Recreational dru ...
. Mephedrone and methylone are already illegal in Canada and most of the United States. In the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
, all
substituted cathinone Substituted cathinones, which include some stimulants and entactogens, are derivatives of cathinone. They feature a phenethylamine core with an alkyl group attached to the alpha carbon, and a ketone group attached to the beta carbon, along ...
s were made illegal in April 2010, under the
Misuse of Drugs Act 1971 The Misuse of Drugs Act 1971 is an Act of the Parliament of the United Kingdom. It represents action in line with treaty commitments under the Single Convention on Narcotic Drugs, the Convention on Psychotropic Substances, and the United Nation ...
, but other designer drugs such as
naphyrone Naphyrone, also known as O-2482 and naphthylpyrovalerone, is a substituted cathinone drug derived from pyrovalerone that acts as a triple reuptake inhibitor, producing stimulant effects and has been reported as a novel designer drug. No safe ...
appeared soon after and some products described as legal contained illegal compounds. To avoid being controlled by the Medicines Act, designer drugs such as
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone, , White Magic, meow meow, bubble, ''txomin'' and yurrpt. It is chemically similar to the cathinone compounds ...
have been described as "bath salts", or other misnomers such as "plant food" despite the compounds having no history of being used for these purposes. In July 2012, US federal drug policy was amended to ban the drugs commonly found in bath salts. Prior to that, bath salts were legal in at least 41 states. Prior to the compounds being made illegal, mephedrone, methylone, and MDPV were marketed as bath salts. The "bath salt" name and labels that say "not for human consumption" are an attempt to skirt the
Federal Analog Act The Federal Analogue Act, , is a section of the United States Controlled Substances Act passed in 1986 which allows any chemical "substantially similar" to a controlled substance listed in Controlled Substances Act#Schedule I controlled substance ...
, which forbids selling drugs that are substantially similar to drugs already classified for human use.


Society and the media

Use of bath salts or monkey dust has spread through social media. Anecdotal reports of the drug lowering its users' pain thresholds while simultaneously giving them increased strength can largely be attributed to the emergency services and frontline NHS staff. Such reports have been picked up, and sensationalised by the regional and tabloid press. In the city
Stoke-on-Trent Stoke-on-Trent (often abbreviated to Stoke) is a city and Unitary authorities of England, unitary authority area in Staffordshire, England, with an area of . In 2019, the city had an estimated population of 256,375. It is the largest settlement ...
, Monkey Dust has been reported to be an entirely new compound, when in fact preparations of MDPV and MDPHP or "bath salts" have been available since the early 2000s. The print press and broadcast media have often used textual framing techniques to report on synthetic cathinone use among society's most vulnerable. Terms like "epidemic", "zombie attack" and more recently "incredible hulk" are often used when describing users. In August 2018, Staffordshire police said they were receiving around ten calls per day regarding Monkey Dust. However, it was not clear whether the incidents actually involved Monkey Dust, or a combination of substances. Contrary to popular belief, during the investigation of the
Miami cannibal attack On May 26, 2012, Rudy Eugene attacked and maimed Ronald Poppo, a homeless man, on the MacArthur Causeway in Miami, Florida, making headlines worldwide. During the 18-minute filmed encounter, Eugene accused Poppo of stealing his Bible, beat him un ...
toxicologists found no trace of the components in bath salts during the autopsy of the attacker. But some scientist doubt the claim that no bath salts were involved in the ordeal and say that due to the meager testing capabilities a bath salt could have gone undetected. Bath Salts or Monkey dust were originally a
research chemical Research chemicals are chemical substances used by scientists for medical and scientific research purposes. One characteristic of a research chemical is that it is for laboratory research use only; a research chemical is not intended for human o ...
or legal highs. Users would purchase the chemicals off the internet, ingest them and blog about the effects.


See also

*
Illegal drug trade The illegal drug trade or drug trafficking is a global black market dedicated to the cultivation, manufacture, distribution and sale of prohibited drugs. Most jurisdictions prohibit trade, except under license, of many types of drugs through ...
*
Recreational drug use Recreational drug use indicates the use of one or more psychoactive drugs to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions and emotions of the user. When a ...


References

{{drug use, state=collapsed Drug culture Drug policy