Bath Salts (drug)
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Bath salts (also called psychoactive bath salts, PABS) are a group of recreational
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. ...
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. It is said that these salts improve cleaning, enhance the enjoyment of bathing, and serve as a vehicle for cosmetic agents. Bath salts have been de ...
. 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 Epsomite, Epsom salt, or magnesium sulfate heptahydrate, is a hydrous magnesium sulfate mineral with formula . Physical properties Epsomite crystallizes in the orthorhombic system. The normal form is as massive encrustations, while acicula ...
, 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. An area has a prohibition of drugs when its government uses the for ...
s. Additionally, they may be described as "plant food", "powdered cleaner", or other products.


Drugs

Bath salts usually contain
cathinones Substituted cathinones, or simply cathinones, which include some stimulants and Empathogen-entactogen, entactogens, are chemical derivative, derivatives of cathinone. They feature a substituted phenethylamine, phenethylamine core with an alkyl ...
, typically methylenedioxypyrovalerone (MDPV, also known as "monkey dust", although this term can refer to MDPHP as well),
methylone Methylone, also known as 3,4-methylenedioxy-''N''-methylcathinone (MDMC), is an entactogen and stimulant drug of the amphetamine, cathinone, and benzodioxole families related to 3,4-methylenedioxymethamphetamine (MDMA; "ecstasy"). It is th ...
or
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug belonging to the amphetamine and cathinone classes. It is commonly referred to by slang names such as drone, , white magic, meow meow, and bubble. Chemically, it is similar to ...
; however, the
chemical A chemical substance is a unique form of matter with constant chemical composition and characteristic properties. Chemical substances may take the form of a single element or chemical compounds. If two or more chemical substances can be combin ...
composition varies widely and products labeled with the same name may also contain derivatives of pyrovalerone or pipradrol. In Europe the main synthetic cathinone is mephedrone, whereas in the US MDPV is more common.


Pharmacology

Pharmacologically Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur between ...
, very little is known about how bath salts interact with the brain and how they are
metabolized Metabolism (, from ''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 cellular processes; the co ...
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 aromaticity, aromatic ring by a two-carbon chain (such as -CH2-CH2-). Examples are dopamine, norepinephrine and serotonin. All m ...
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 chemical of the catecholamine and phenethylamine families. It is an amine synthesized ...
,
serotonin Serotonin (), also known as 5-hydroxytryptamine (5-HT), is a monoamine neurotransmitter with a wide range of functions in both the central nervous system (CNS) and also peripheral tissues. It is involved in mood, cognition, reward, learning, ...
, and
norepinephrine Norepinephrine (NE), also called noradrenaline (NA) or noradrenalin, is an organic compound, organic chemical in the catecholamine family that functions in the brain and human body, body as a hormone, neurotransmitter and neuromodulator. The ...
in
synapse In the nervous system, a synapse is a structure that allows a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or a target effector cell. Synapses can be classified as either chemical or electrical, depending o ...
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 cells, and transports metabolic waste products away from those same cells. Blood is compo ...
than amphetamines due to the presence of a beta-keto group that increases the compound's polarity.


Usage

Bath salts can be ingested orally, snorted, smoked, plugged 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 wakefulness-promoting effect, leading to insomnia.


Interaction with alcohol

Bath salts are often consumed concurrently with
alcohol Alcohol may refer to: Common uses * Alcohol (chemistry), a class of compounds * Ethanol, one of several alcohols, commonly known as alcohol in everyday life ** Alcohol (drug), intoxicant found in alcoholic beverages ** Alcoholic beverage, an alco ...
. A 2015 study has investigated the interrelation between
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug belonging to the amphetamine and cathinone classes. It is commonly referred to by slang names such as drone, , white magic, meow meow, and bubble. Chemically, it is similar to ...
and alcohol, focusing on psychostimulant and rewarding effects. It showed that
alcohol Alcohol may refer to: Common uses * Alcohol (chemistry), a class of compounds * Ethanol, one of several alcohols, commonly known as alcohol in everyday life ** Alcohol (drug), intoxicant found in alcoholic beverages ** Alcoholic beverage, an alco ...
, 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 chemical of the catecholamine and phenethylamine families. It is an amine synthesized ...
, 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 psychos ...
, but not
ketanserin Ketanserin, sold under the brand name Sufrexal, is an antihypertensive agent which is used to treat arterial hypertension and vasospasm, vasospastic disorders. It is also used in scientific research as an antiserotonergic medication, agent in th ...
, was capable of blocking the potentiation by alcohol.


Subjective effects

Bath salts come in a powdered or crystallized form that 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.


Adverse effects

Bath salt/monkey dust users have reported symptoms that include
headache A headache, also known as cephalalgia, 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 (mood), depression in those with severe ...
, heart palpitations,
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...
, cold fingers,
hallucination A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...
s,
paranoia Paranoia is an instinct or thought process that is believed to be heavily influenced by anxiety, suspicion, or fear, often to the point of delusion and irrationality. Paranoid thinking typically includes persecutory beliefs, or beliefs of co ...
, and
panic attack Panic attacks are sudden periods of intense fear and Comfort, discomfort that may include palpitations, otherwise defined as a Tachycardia, rapid, Arrhythmia, irregular Heart rate, heartbeat, Hyperhidrosis, sweating, chest pain or discomfort, s ...
s. Visual symptoms similar to those of stimulant overdoses include
mydriasis Mydriasis is the Pupillary dilation, dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, Physical trauma, trauma, or the use of c ...
,
dyskinesia Dyskinesia refers to a category of movement disorders that are characterized by involuntary muscle movements, including movements similar to tics or chorea and diminished voluntary movements. Dyskinesia can be anything from a slight tremor of t ...
,
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 ...
, and
hypertension Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
. 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 Serotonin, serotonergic medications or Recreational drug use, drugs. The symptoms can range from mild to severe, and are potentially fatal. Symptoms in mild c ...
. 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 (formerly acute confusional state, an ambiguous term that is now discouraged) is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or ...
,
hallucinations A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...
,
seizure A seizure is a sudden, brief disruption of brain activity caused by abnormal, excessive, or synchronous neuronal firing. Depending on the regions of the brain involved, seizures can lead to changes in movement, sensation, behavior, awareness, o ...
s,
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 ...
,
hypertension Hypertension, also known as high blood pressure, is a Chronic condition, long-term Disease, medical condition in which the blood pressure in the artery, arteries is persistently elevated. High blood pressure usually does not cause symptoms i ...
or
hyperthermia Hyperthermia, also known as overheating, is a condition in which an individual's body temperature is elevated beyond normal due to failed thermoregulation. The person's body produces or absorbs more heat than it dissipates. When extreme te ...
.


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, semen, currency, blood, and contraband electronics such as illicit mobile phones. The sense most use ...
s and are not detected by typical
urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...
, although they can be detected in urine and hair using
gas chromatography-mass spectrometry Gas is a state of matter that has neither a fixed volume nor a fixed shape and is a compressible fluid. A ''pure gas'' is made up of individual atoms (e.g. a noble gas like neon) or molecules of either a single type of atom ( elements such as ...
or liquid chromatography-mass spectrometry. Distributors may disguise the drug as everyday substances such as
fertilizer A fertilizer or fertiliser 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 liming materials or other non-nutrient soil amendments. Man ...
or
insect repellent An insect repellent (also commonly called "bug spray" or "bug deterrent") is a substance applied to the skin, clothing, or other surfaces to discourage insects (and arthropods in general) from landing or climbing on that surface. 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 A nightclub or dance club is a club that is open at night, usually for drinking, dancing and other entertainment. Nightclubs often have a Bar (establishment), bar and discotheque (usually simply known as disco) with a dance floor, laser lighti ...
goers after
cannabis ''Cannabis'' () is a genus of flowering plants in the family Cannabaceae that is widely accepted as being indigenous to and originating from the continent of Asia. However, the number of species is disputed, with as many as three species be ...
,
MDMA 3,4-Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy (tablet form), and molly (crystal form), is an empathogen–entactogenic drug with stimulant and minor Psychedelic drug, psychedelic properties. In studies, it has been used ...
and
cocaine Cocaine is a tropane alkaloid and central nervous system stimulant, derived primarily from the leaves of two South American coca plants, ''Erythroxylum coca'' and ''Erythroxylum novogranatense, E. novogranatense'', which are cultivated a ...
. Based on reports to the
American Association of Poison Control Centers America's Poison Centers (formerly known as American Association of Poison Control Centers - AAPCC) is a national nonprofit organization founded in 1958 that represents the United States of America, nation's 53 Poison control center, poison cente ...
, use of bath salts in the US is thought to have increased significantly between 2010 and 2012. 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 Control may refer to: Basic meanings Economics and business * Control (management), an element of management * Control, an element of management accounting * Comptroller (or controller), a senior financial officer in an organization * Controll ...
, placing it in the same category as
heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the Opium, dried latex of the Papaver somniferum, opium poppy; it is mainly used as a recreational drug for its eupho ...
and
MDMA 3,4-Methylenedioxymethamphetamine (MDMA), commonly known as ecstasy (tablet form), and molly (crystal form), is an empathogen–entactogenic drug with stimulant and minor Psychedelic drug, psychedelic properties. In studies, it has been used ...
. 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 Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
, all
substituted cathinone Substituted cathinones, or simply cathinones, which include some stimulants and Empathogen-entactogen, entactogens, are chemical derivative, derivatives of cathinone. They feature a substituted phenethylamine, phenethylamine core with an alkyl ...
s were made illegal in April 2010, under the
Misuse of Drugs Act 1971 The Misuse of Drugs Act 1971 (c. 38) 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 ...
, 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, designer drugs such as
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug belonging to the amphetamine and cathinone classes. It is commonly referred to by slang names such as drone, , white magic, meow meow, and bubble. Chemically, it is similar to ...
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 Analogue 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 Schedule I or II to be treated as if it were listed ...
, 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 increasing 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 2018, 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. It has an estimated population of 259,965 as of 2022, making it the largest settlement in Staffordshire ...
, Monkey dust was 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 2012 Miami cannibal attack toxicologists found no trace of the components in bath salts during the autopsy of the attacker. Bath salts or monkey dust were originally a
research chemical Research chemicals are chemical substances which scientists use 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 ...
or legal highs. Users would purchase the chemicals off the internet, ingest them and blog about the effects.


History

Synthetic cathinones such as
mephedrone Mephedrone, also known as , , and , is a synthetic stimulant drug belonging to the amphetamine and cathinone classes. It is commonly referred to by slang names such as drone, , white magic, meow meow, and bubble. Chemically, it is similar to ...
, which are chemically similar to the
cathinone Cathinone (; also known as β-ketoamphetamine) 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 main contributor to t ...
naturally found in the plant ''
Catha edulis Khat (''Catha edulis''), also known as Bushman's tea, especially in South Africa, is a flowering plant native to eastern and southeastern Africa. It has a history of cultivation originating in the Harari Region, Harar area (present day easter ...
'' (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 Northwestern Europe, off the coast of European mainland, the continental mainland. It comprises England, Scotlan ...
and the rest of
Europe Europe is a continent located entirely in the Northern Hemisphere and mostly in the Eastern Hemisphere. It is bordered by the Arctic Ocean to the north, the Atlantic Ocean to the west, the Mediterranean Sea to the south, and Asia to the east ...
, and subsequently in the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
. 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 Drug paraphernalia, paraphernalia used for consumption of cannabis and tobacco and items related to cannabis culture and related countercultures. They emerged from the hippie counterculture in ...
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, or neocannabinoids, 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 co ...
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.


See also

*
Illegal drug trade The illegal drug trade, drug trafficking, or narcotrafficking is a global black market dedicated to the cultivation, manufacture, distribution and sale of drug prohibition, prohibited drugs. Most jurisdictions prohibitionism, prohibit trade, exce ...
*
Recreational drug use Recreational drug use is 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. When a psychoactive drug enters the user's body, it induces an Sub ...


References

{{Drug use, state=collapsed Drug culture Drug policy Designer drugs