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President's Message: Bath Salts Not the Harmless High Patients May Believe
Posted on: 2/1/2013
Werner - regular
ISMS President
William N. Werner, MD

"Bath salts" is the street name for certain types of highly addictive and dangerous designer drugs. I first learned about these drugs at an ISMS House of Delegates meeting a few years ago. A fall meeting of the Sangamon County Medical Society hosted agents from the Illinois Attorney General's office, who provided an informative presentation on both the legal and social aspects of their use.

Because these drugs are in the form of white crystal powder, they have a physical resemblance to legitimate bathing products, such as Epsom salts. However, the so-called "bath salts" are chemically not related to the legal version.

These dangerous products are usually packaged in colorful foil packets with names such as "Potpourri," "Cotton Candy," "K2XXX," or "TranQuility" and are labeled "not for human consumption," all in an attempt to make them appear legal and evade law enforcement.However, "bath salts" are intended to be swallowed, inhaled, smoked or injected.

While these drugs have been illegal in Illinois since 2011, I learned from the Attorney General's office that "bath salts" are readily available on the street, in gas stations, head shops and through the Internet.

These drugs have become popular in the last few years and have caused an increase in ER visits and calls to poison control centers. What makes "bath salts" so dangerous is that they are made of synthetic chemicals that resemble amphetamine and cocaine. The active chemicals are cathinones including methylenedioxypyrovalerone (MDPV), which have stimulant and hallucinogenic effects. Users may experience headaches, nausea, feelings of hot or cold, high blood pressure and palpitations. There have been reports of users experiencing hallucinations, panic attacks and paranoid or violent behavior. There is also concern that "bath salts" may be related to heart attacks, kidney failure, liver failure and even suicide.

These synthetic drugs are also very addictive, so much so that users may repeat even after experiencing horrible effects. Growing evidence supports that users may experience long lasting episodes of psychosis that may be related to significant alterations in brain chemistry. "Bath salts" may contain any number of harmful chemical ingredients and contaminants because they are manufactured in illegal underground street labs or imported from overseas.

ISMS backed Illinois' move to make these drugs illegal. In 2011, the ISMS House of Delegates adopted policy that supports banning "bath salts" which contain MDPV. In July 2012, President Obama signed legislation into law that added MDPV and some 30 other synthetic compounds used to make synthetic marijuana and hallucinogens to Schedule I controlled substances. Part of the problem is that street drug makers can get around legal prohibitions by using other cathinone derivatives.

Despite being illegal here, dangerous "bath salt" drugs are still easily available. Therefore, it is imperative that we talk with our patients about avoiding their use – even if their peers claim that the drugs only produce a harmless high or appear to be legal due to the misleading packaging. We must be vigilant in educating patients about the truth of these drugs. Drug-induced violent behavior can have lifetime consequences, including a criminal record. Other horrible effects of the drug include addiction, mental health impairment, bodily damage and the worst possible outcome, taking one's own life.

Tell your patients the debate is over. These "bath salts" are without question dangerous to their well-being.



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