Medical Toxicologists Report Deadly Effects with Bath Salts

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A review of ToxIC registry data to be published in an upcoming issue of the Journal of Medical Toxicology reveals that intoxication with “bath salts” is being reported by medical toxicologists nearly as frequently as intoxication with other common stimulant drugs. Bath salt intoxication produces life-threatening illness similar to that resulting from cocaine and methamphetamine poisoning. ACMT supports the new FDA Safety and Innovation Act that strictly regulates sale and use of such products.

American College of Medical Toxicology

Data from the American College of Medical Toxicology’s Toxicology Investigators Consortium (ToxIC) registry reveals that bath salt intoxication frequently leads to hospitalization and severe illness. Medical toxicologists reported that over the past two years they treated nearly as many patients with severe illness resulting from abuse of bath salts as they did patients with cocaine or methamphetamine intoxication. Bath salts are products that contain synthetic chemicals related to amphetamine that are sold in various outlets to users seeking a stimulant high. These drugs received national media attention recently when two separate incidents occurred where individuals were bitten in the face by people initially suspected to be intoxicated with bath salts. The bizarre behavior produced by use of bath salts is a common feature of poisoning by many stimulant drugs.

An extensive review of bath salts, published in the Journal of Medical Toxicology, describes the most common effect of intoxication as agitation, which may range from mild to severe, and may be accompanied by psychosis, elevated body temperature, and dehydration. The majority of cases of stimulant intoxication reported to the ToxIC registry were due to cocaine toxicity, with patients experiencing agitation, hyperthermia, seizures, and cardiovascular toxicity. The illicit drug methamphetamine, as well as bath salts and other amphetamine-like drugs (such as Ecstasy), were also responsible for producing severe agitation and cardiac effects necessitating admission to emergency departments and critical care units. Other effects reported in the registry that were associated with use of bath salts, as well as with cocaine and various amphetamine derivatives, included psychosis with hallucinations, severe muscle damage, kidney injury, and stroke.

Bath salts, sold under various names including Ivory Wave, EightBallz, and Magic, are generally labeled as ‘not for human consumption’. Unlike bath salts used to enhance the bathing experience, these products are sold in small volume, are not fragrant, and carry names and graphics suggesting their actual intent. Bath salts are named and labeled to promote their abuse potential while skirting laws prohibiting sale and use of products for such intent. In addition, the specific chemicals contained in bath salts are frequently changed, as current products are identified and made illegal. According to Dr. Michelle Ruha of Banner Good Samaritan Medical Center in Phoenix, Arizona “Initially all of our patients admitted with bath salt toxicity tested positive for mephedrone or methylenedioxypyrovalerone, often referred to as MDPV, but within a year we began to detect different, but closely related, products instead, including pyrovalerone and alpha-PVP”.

Many street drugs are designed and marketed to evade current laws prohibiting use. New national legislation prohibiting the sale of chemical compounds sold as bath salts, incense, and synthetic marijuana is included as part of the FDA Safety and Innovation Act just passed by Congress. The ACMT strongly supports this legislation and reminds potential abusers of any amphetamine-like drug or cocaine that such use can lead to severe, life-threatening effects.

The American College of Medical Toxicology (ACMT) is a professional, nonprofit association of physicians with recognized expertise in medical toxicology. The College is dedicated to advancing the science and practice of medical toxicology.

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