"Bath salts," a slang term used to describe a group of stimulant drugs that contain chemicals called cathinones, are chemically distinct from the bath salts they resemble. (Traditional bath salts used for bathing are usually a combination of sodium chloride, magnesium chloride, sodium bicarbonate, glycerin, and fragrances.)
Cathinones are amphetamine Amphetamines Amphetamines are stimulant drugs that are used to treat certain medical conditions but are also subject to abuse. Amphetamines increase alertness, enhance physical performance, and produce euphoria... read more -like stimulants derived from the plant Catha edulis (khat). The khat plant is a shrub grown in East Africa and on the Arabian peninsula. For centuries, people there have chewed the leaves for their mild stimulant effect. In those regions, chewing khat is often a social activity, similar to coffee drinking in other societies.
Recently, khat use has spread to other countries, and much stronger, man-made (synthetic) cathinones (marketed as "bath salts" to circumvent laws regarding controlled substances) have become drugs of abuse. Bath salts can be inhaled, smoked, and sometimes injected. These products, which are frequently labeled "not for human consumption," are not used for bathing.
(See also Drug Use and Abuse Overview of Substance-Related Disorders Medications and other substances, whether used for legitimate medical purposes, as a habit (for example, caffeine), or recreationally, are an integral part of everyday life for many people ... read more .)
Symptoms of Bath Salts Toxicity
The effects of bath salts are similar to those of amphetamines and include headache, a rapid heart rate (tachycardia Ventricular Tachycardia Ventricular tachycardia is a heart rhythm that originates in the ventricles (lower chambers of the heart) and produces a heart rate of at least 120 beats per minute (the normal heart rate is... read more ), palpitations Palpitations Palpitations are the awareness of heartbeats. The sensation may feel like pounding, fluttering, racing, or skipping beats. Other symptoms—for example, chest discomfort or shortness of breath—may... read more , hallucinations, agitation, and an increased endurance and tolerance for pain. Some people become violent.
Bath salts can cause a dangerously high body temperature (hyperthermia Overview of Heat Disorders Humans, who are warm-blooded animals, maintain their body temperature within 1 or 2 degrees of 98.6° F (37° C) as measured by mouth and 100.4° F (38° C) as measured rectally, despite large fluctuations... read more ). They also may cause serious organ damage, although doctors are not sure why. Organ damage can include
Breakdown of muscle (rhabdomyolysis)
Diagnosis of Bath Salt Toxicity
A doctor's evaluation
Blood and urine tests
Because bath salts are not detected with routine urine or blood testing, doctors usually base the diagnosis on symptoms in people known to have used the drug. Doctors typically order the following specific tests for anyone showing signs of severe acute bath salt intoxication to check for other problems caused by using bath salts:
Blood tests (to check blood count, levels of electrolytes, and kidney function)
Urine testing for myoglobinuria (to test for muscle destruction)
Treatment of Bath Salt Toxicity
Observation and monitoring until the person is sober
Typical treatments, which include IV sedatives and fluids and supportive care, are usually adequate. People with dangerously high body temperature (hyperthermia Serotonin Syndrome Serotonin syndrome is a potentially life-threatening drug reaction that tends to cause high body temperature, muscle spasms, and anxiety or delirium. Serotonin is a chemical that transmits impulses... read more ), persistently high heart rate or agitation, and blood tests that suggest possible kidney problems should be hospitalized and monitored for muscle breakdown and heart and kidney damage.
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
National Institute on Drug Abuse (NIDA): Cathinone-specific information from the federal agency that supports scientific research into drug use and its consequences and supplies information about commonly used drugs, research priorities and progress, clinical resources, and grant and funding opportunities.
Substance Abuse and Mental Health Services Administration (SAMHSA): US Department of Health agency that leads public health efforts to improve behavioral health and provides resources, including treatment locators, toll-free helplines, practitioner training tools, statistics, and publications on a variety of substance-related topics.