“Bath salts” is the informal term that generally refers to synthetic cathinones, a type of designer drug that produces effects that are somewhat similar to stimulants like methamphetamine or cocaine. Synthetic designer drugs exist in a confusing legal gray area because their chemical structure is constantly being altered just enough to stay ahead of drug laws and restrictions.
As soon as one version of bath salts are identified and made illegal, five more appear that are just different enough, and they are cheap and easy to make. It’s also what makes bath salts so dangerous; no one can ever be sure exactly what they are taking or how strong the substance will be.
This legal loophole is how bath salts can legally be purchased in head shops, gas stations, convenience stores, and the internet. However, it obviously cannot be legally sold as a drug, which is how bath salts have gotten their name: by being labeled “not for human consumption” and packaged as not only bath salts but also incense, fertilizer, jewelry cleaner, and more.
Even slight changes to the substance’s chemical makeup can lead to huge variations in how it affects someone. Abusers of bath salts have reported a long list of different side effects that can cause permanent damage to the brain and major organs, as well as death.
The cathinone that is most commonly identified in bath salts is methylenedioxypyrovalerone (MDPV), and it works much like many other amphetamines, raising the levels of different brain chemicals responsible for alertness, energy, pleasure, and euphoria, including dopamine, serotonin, and norepinephrine.
MDPV does this by inhibiting a process called “reuptake.” Reuptake is when certain neurotransmitters like dopamine are no longer needed, and so the brain reabsorbs them for future use. MDPV blocks this reuptake from happening, so these chemicals will remain and build up in the brain, which makes their effects more powerful and longer-lasting.
Sometimes, the signs that someone is engaging in substance abuse can be difficult to spot until the person using has slid all the way into addiction. However, in the case of bath salts, the extremely bizarre and aggressive behavior commonly associated with the drug’s abuse will usually stand out. Other noticeable side effects of bath salts abuse that point to a growing addiction includes:
When someone has crossed the line from bath salts abuse to addiction, it means they have lost the ability to control themselves when it comes to bath salts and will become obsessed with compulsively using it. An addiction to bath salts will generally lead to increasingly abnormal and erratic behavior, both as a result of the substance itself as well as how addiction rewires the brain.
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When someone is in the grip of a substance use disorder, obtaining and using the substance they are addicted to becomes the driving force behind their actions and decision-making. Previously important priorities such as family, relationships, work, or school will become neglected in favor of bath salts.
Common signs of bath salt addiction include:
If you have observed these symptoms in a family member or friend or are experiencing them yourself, it is vital that you do not wait to seek professional addiction treatment. Bath salts are powerful and dangerously unpredictable to the point where waiting too long to get help can mean the difference between life and death.
Medical detox is the critical first step in bath salt addiction treatment. The purpose of detoxification is to rid someone’s system of any drugs, alcohol, and associated toxins. There is almost no way of accurately assessing the strength, toxicity, or exact contents of a given dose of bath salts, so removing all traces of it as soon as possible is the top priority.
Under no circumstances should a bath salts detox be attempted without the supervision of an experienced medical detox team. People with acute bath salts intoxication will generally exhibit delirious, panicked, violent behavior that makes them a danger to themselves and those around them.
The withdrawal symptoms associated with detoxing from bath salts can vary significantly because of the inherent inconsistency in the drug’s chemical makeup. Someone may experience anything from anxiety, depression, and paranoia to hallucinations, memory loss, and even psychosis. Again, this just highlights the importance of detoxing in a safe, controlled environment under the careful monitoring of a medical professional.
After completing detox, the next step of bath salts addiction treatment is continuing care in an addiction rehabilitation program. In a recovery treatment program, clients will engage in different treatments and therapies that are meant to help them better understand the underlying issues at the root of their addiction. From there, they will be able to manage their addiction more effectively and maintain long-term sobriety.
An addiction rehabilitation program can be carried out through several forms of inpatient treatment, all of which involve living at a treatment facility for the duration of the program, with 24/7 access to medical and therapeutic resources. Inpatient treatment is generally most useful for those with a history of addiction and relapse who would benefit from being removed from their regular environment and any potential triggers and temptations.
Those with less severe addictions who are in good health and have a supportive home environment may prefer an outpatient program, during which the client will remain at home and continue their everyday routine while also attending regular therapy sessions and medical check-ins at a treatment center.
Whichever type of treatment someone chooses to go with, they will usually work with a clinician or therapist to create a treatment plan that’s customized to their needs. Some common therapies and treatments that might be included in a treatment plan are:
If it is not already apparent, bath salts are incredibly dangerous, primarily because of their unpredictability. While cathinones are known to act in a way that is similar to stimulants, there is no way of predicting the potential strength of a given dose, as well as what other substances it might also contain and how they will affect someone.
A person does not even have to be abusing bath salts to put themselves in life-threatening danger. Depending on what the chemical makeup of the version of the drug they happen to be taking, they can experience a wide range of potentially fatal side-effects, including:
With so many uncertain factors involved, doing bath salts even once can be enough to kill someone. Adding to this is the fact that with so many different versions of bath salts, many of which have not yet been properly identified and studied, doctors and emergency medical services may not be able to properly treat someone because they don’t know enough about what may be causing the symptoms. This also increases the risk of a misdiagnosis that could create potential complications and cause more problems.
Psychiactric Times. Synthetic Cathinones: Signs, Symptoms, and Treatment. (April 30, 2013) Beaman, J. DO, Hayes, E. MSIV from https://www.psychiatrictimes.com/qa/synthetic-cathinones-signs-symptoms-and-treatment
National Institute on Drug Abuse. (2018, February). Synthetic Cathinones ("Bath Salts"). from https://www.drugabuse.gov/publications/drugfacts/synthetic-cathinones-bath-salts
American Association of Poison Control Centers. (2018, September 8) Poison Control Centers Applaud DEA’s Ban of Bath Salts from https://news.cision.com/american-association-of-poison-control-centers/r/poison-control-centers-applaud-dea-s-ban-of-bath-salts,c9160029
Palamar, J. J., Ph.D. (2015, July 14). "Bath Salt" Use Among a Nationally Representative Sample of High School Seniors in the United States. from https://onlinelibrary.wiley.com/doi/full/10.1111/ajad.12254
Prosser, J. M., & Nelson, L. S. (2012, March). The Toxicology of Bath Salts: A Review of Synthetic Cathinones. from https://link.springer.com/article/10.1007/s13181-011-0193-z
Drug Enforcement Administration. 3,4-Methylenedioxypyrovalerone (MDPV) (July 2019) from https://www.deadiversion.usdoj.gov/drug_chem_info/mdpv.pdf