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Bath salts (also psychoactive bath salts, PABS, or in the United Kingdom monkey dust) are a group of recreational designer drugs. The name derives from instances in which the drugs were disguised as bath salts. The white powder, granules, or crystals often resemble Epsom salts, but differ chemically. The drugs' packaging often states "not for human consumption" in an attempt to circumvent drug prohibition laws. 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 and the rest of Europe, and subsequently in the United States. 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 shops. 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. 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 (MDPV), methylone 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 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 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 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 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, 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. 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, 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, cold fingers, hallucinations, paranoia, and panic attacks. News media have reported reactions that include violent behavior, heart attack, kidney failure, 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, 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 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, 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 or insect repellent.


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 goers after cannabis, MDMA and cocaine. Based on reports to the American Association of Poison Control Centers, 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 Canada's drug regulations are measures of the Food and Drug Act and the Controlled Drugs and Substances Act. In relation to controlled and restricted drug products, the Controlled Drugs and Substances Act establishes eight schedules of drugs and ...
since Fall 2012 categorizes methylenedioxypyrovalerone (MDPV) as a schedule I substance under the Controlled Drugs and Substances Act, 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. Mephedrone and methylone are already illegal in Canada and most of the United States. In the United Kingdom, 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 appeared soon after and some products described as legal contained illegal compounds. To avoid being controlled by the
Medicines Act The Medicines Act 1968 is an Act of Parliament of the United Kingdom, more properly: An Act to make new provision with respect to medicinal products and related matters, and for purposes connected therewith. It governs the control of medicines for ...
, 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, 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 *
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