Why ‘bath salts’ are dangerous, though not illegal in all states.
WebMD FeatureReviewed byLaura J. Martin, MD
“Ivory Wave,” “Purple Wave,” Vanilla Sky,” and “Bliss”—all are among the many street names of a so-called designer drug known as “bath salts,” which has sparked thousands of calls to poison centers across the U.S. over the last year.
Citing an “imminent threat to public safety,” the U.S. Drug Enforcement Administration (DEA) made illegal the possession and sale of three of the chemicals commonly used to make bath salts—the synthetic stimulants mephedrone, MDPV, and methylone. The ban, issued in October 2011, is effective for at least a year. During that time, the agency will decide whether a permanent ban is warranted.
WebMD talked about bath salts and other designer drugs with Zane Horowitz, MD, an emergency room physician and medical director of the Oregon Poison Center.
“The presumption is that most bath salts are MDPV, or methylenedioxypyrovalerone, although newer pyrovalerone derivatives are being made by illegal street chemists. Nobody really knows, because there is no way to test for these substances,” Horowitz says.
“It’s confusing. Is this what we put in our bathtubs, like Epsom salts? No. But by marketing them as bath salts and labeling them ‘not for human consumption,’ they have been able to avoid them being specifically enumerated as illegal,” Horowitz says.
“Agitation, paranoia, hallucinations,chest pain, suicidality. It’s a very scary stimulant that is out there. We gethigh blood pressureand increased pulse, but there’s something more, something different that’s causing these other extreme effects. But right now, there’s no test to pick up this drug. The only way we know if someone has taken them is if they tell you they have.
The clinical presentation is similar to mephedrone [a chemical found in other designer drugs], with agitation, psychosis, and stimulatory effects. Both of these agents should be of concern, as severe agitated behavior, like anamphetamineoverdose, has occurred.
A second concern is the ongoing suicidality in these patients, even after the stimulatory effects of the drugs have worn off. At least for MDPV, there have been a few highly publicized suicides a few days after their use,” Horowitz says.
“You can find them in mini-marts and smoke shops sold as Ivory Wave, Bolivian Bath, and other names,” Horowitz says. “The people who make these things have skirted the laws that make these types of things illegal. While several states have banned the sale of bath salts, ultimately it will have to be a federal law that labels these as a schedule 1 drug, which means it has no medicinal value but a high potential for abuse, and declare them illegal.”