On Saturday, May 26, a man was brutalized in what has been described by several media organizations as a zombie attack. But unlike the usual plot in zombie films, the perpetrator was not a victim of an apocalyptic virus. According to Miami-Dade law enforcement, the 31-year-old man was under the influence of a synthetic drug called "bath salts."
Armando Aguilar, president of the Fraternal Order of Police, told the media that "When the officer approached [the suspect], told him to stop, pointed a gun at him, [the suspect] turned around and growled like a wild animal and kept eating at the man's face." Given no other option, police were forced to shoot the attacker. The victim is reported to have lost 75 percent of his face.
"[Bath salts] causes them to go completely insane and become very violent," said Aguilar, reflecting on this and four other Florida cases involving extreme violence and this synthetic drug.
When I first heard this story I was watching the television on mute, so all I could see was that someone had become frenzied after using bath salts and resorted to cannibalism. It terrified me -- until I realized that the bath salts being discussed were not the same delightfully-scented crystals I am fond of scattering into my tub.
Now I know that bath salts are a drug -- but what kind of drug? Media outlets can't seem to agree -- is it synthetic cocaine or LSD or ecstasy? Or all of the above? I looked into it and the answer is that it depends. Bath salts are not any one single drug in the same way that "ice," for example, is used to refer to crystal methamphetamine. The term "bath salts" describes a whole class of synthetic stimulants, packed into grab bag of other chemicals, many of which remain unidentified.
Designer drugs mephedrone and methylenedioxypyrovalerone. Structures from chemspider.
Unlike their name suggests, bath salts do not contain fragrant soaps or oils (some actually smell quite foul, like chemicals or fish).
"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," says Zane Horowitz, MD, an emergency room physician and medical director of the Oregon Poison Center.
According to the Drug Enforcement Administration, the most common active ingredients in bath salts are mephedrone and methylenedioxypyrovalerone. Mephedrone (MEF-uh-drone) is a synthetic stimulant that produces effects similar to amphetamines and cocaine. There have been no formal studies into the effects of mephedrone on humans, but it is reported to cause euphoria, sexual stimulation and improved focus. Negative side effects abound, including erratic behavior, breathing difficulty, agitation, anxiety, paranoia and depression.
Methylenedioxypyrovalerone (METH-uh-leen-di-OX-ee-PY-ro-VAL-uh-rone, or MDPV) is a psychotropic euphoriant. It is said to be stronger than Ritalin and cocaine. Though it has not been studied, users report desired effects as euphoria, increased alertness, increased motivation and sociability. Side effects include anxiety, dizziness, breathing difficulty, the persistence of a ringing sound in the ears, confusion, severe vomiting, anxiety, agitation, violent behavior, and suicidal thoughts. Some repeated users remain awake and paranoid for several days.
Bath salts may also contain cathinone, which is a lot like ephedrine and other amphetamines; pyrovalerone, a highly addictive psychoative stimulant used for the clinical treatment of chronic fatigue as well as an appetite suppressant; the stimulant CFT, which is structurally similar to cocaine, but far more potent and known to last longer; naphyrone and desoxypipradrol (2-diphenylmethylpiperidine or 2-dPMP), stimulants that act similarly to reuptake inhibitors (used commonly to treat depression).
Several reports suggest that bath salts cause hallucinations and delusions, going as far as to describe them as the "new LSD," but David DiSalvo, a science writer at Forbes disputes that bath salts are hallucinogens:
Neither of these drugs are hallucinogens like LSD. Hallucinogens are psychoactive drugs, but not all psychoactive drugs are hallucinogens -- the primary difference being that hallucinogens induce changes in perception that are significantly different than normal consciousness, not merely an amplification of conscious states we already experience.
[ ... ] Aside from that, bath salts contain a bevy of harsh chemicals in addition to the psychoactive substances -- like lidocaine, a topical analgesic and anti-itch agent. Why is it in some varieties of bath salts? Who knows, but it along with a lot of other stuff that hasn't even been identified yet is getting circulated throughout your body when you ingest the powder. Think of it this way -- would you knowingly snort a line of athletes foot powder?
Mark Ryan, the director of the Poison Center in Louisiana, a state that has been ravaged by bath salts, puts more emphasis on the results of consumption than what makes up the contents of these little brightly-colored packets.
"These substances are among the worst poison centers have ever seen," Ryan said. "The psychosis seen in some users is truly remarkable, in a very scary way. People high on these drugs have done some bizarre things to themselves and hurt others around them."
These drugs have been reported as being sold at gas stations, convenience stores, truck stops, "head" shops (stores selling drug paraphernalia) and online, costing anywhere between 20 to 50 dollars. A single bag contains about 500 milligrams of crystallized power, which is often white or brownish, and occasionally speckled. Bath salts are generally snorted, taken orally, or injected intravenously.
One recent study by the Centers for Disease Control and Prevention discovered that the majority of users that ended up in the emergency room following an overdose had injected the drugs, suggesting that dosage remains one of the biggest associated concerns. Of those 500 milligrams in each bag, five to ten milligrams are said to be enough, but with no instruction or awareness as to usage, overdose remains a very real concern.
Slang terms for these drugs other than bath salts are insect repellent, pond scum remover, jewelry cleaner, plant food, toy cleaner and bubbles. Known product names include Cloud 9, Ocean, Charge Plus, White Lightning, Scarface, Red Dove, White Dove, Ivory Wave, Pure Ivory, Hurricane Charlie, Ivory Coast, Purple Wave, Vanilla Sky, Bliss, Blue Silk, Zoom, Bloom, Ocean Snow, Lunar Wave and Energy 1.
In 2009, no calls were made to U.S. Poison Control Centers regarding use of bath salts. In 2010, the reports numbered 303. Last year, incidents associated with bath salts were up to 5,625.
"This is an emerging health threat that needs to be taken seriously," Alvin C. Bronstein, medical director of the Rocky Mountain Poison and Drug Center and acting director of toxic surveillance for the American Association of Poison Control Centers, said in a press release.
Late last year, the DEA banned some of the most common chemicals in bath salts. According to a bulletin about bath salts posted by the Drug Enforcement Administration on October 21, 2011:
The United States Drug Enforcement Administration (DEA) today exercised its emergency scheduling authority to control three synthetic stimulants (Mephedrone, 3,4 methylenedioxypyrovalerone (MDPV) and Methylone) used to make products marketed as "bath salts" and "plant food". Except as authorized by law, this action makes possessing and selling these chemicals, or the products that contain them, illegal in the United States. This emergency action was necessary to prevent an imminent threat to the public safety. The temporary scheduling action will remain in effect for at least one year while the DEA and the United States Department of Health and Human Services (DHHS) further study whether these chemicals should be permanently controlled.
[ ... ] In the last six months, DEA has received an increasing number of reports from poison control centers, hospitals and law enforcement regarding products containing one or more of these chemicals. Thirty-seven states have already taken action to control or ban these or other synthetic stimulants. The Comprehensive Crime Control Act of 1984 amends the Controlled Substances Act (CSA) to allow the DEA Administrator to temporarily schedule an abused, harmful, non-medical substance in order to avoid an imminent hazard to public safety while the formal rule-making procedures described in the CSA are being conducted.
"This action demonstrates our commitment to keeping our streets safe from these and other new and emerging drugs that have decimated families, ruined lives, and caused havoc in communities across the country," said DEA Administrator Michele M. Leonhart. "These chemicals pose a direct and significant threat, regardless of how they are marketed, and we will aggressively pursue those who attempt their manufacture and sale."
This ban will remain in effect until October of this year while the DEA decides whether the situation warrants an extension or a more permanent solution. Thus far, street chemists have been able to get around this and various state bans by using derivatives of the banned chemicals in their bath salts.
The words "not for human consumption" on those packages also present a legal impediment: if bath salts did not come with such a warning, they could technically be considered a scheduled drug under the Controlled Substances Act's Federal Analogue Act (title 21 of section 813) because many of their components are analogous (or comparable) to already scheduled substances.
Because of the labeling, however, it is only possible to prosecute the sale or possession synthetic drugs that do not fall under the DEA's or individual states' bans if it can be proved that these are intended to be used for human consumption.
The U.S. is not the only country being affected. These synthetic designer drugs, created to get around the law, are becoming a problem around the world. In their 2011 report, the International Narcotics Control Board reported that 41 new psychoactive substances had been identified across the European Union in 2010, almost doubling the number that was reported the previous year. In Australia, the surge of new drugs has resulted in new import authorization requirements for 11 substances that are not yet under international control. Mephedrone was among them.
Will the law manage to keep up with this rogue chariot of chemistry that is being spurred around the world by the prospect of incredible financial gain? Will regulation make substances difficult to acquire for scientists who have legitimate reasons for using the chemicals that are processed into these designer drugs? Have we seen the worst of these drugs' effects?
If only the bath salts had stayed in our bath tubs...
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