Friday, March 29, 2013

What's new about "Bath Salts"

One of the most popular posts on CPDDBLOG reported on the Bath Salts Symposium presented at the College on Problems of Drug Dependence (CPDD) Annual Meeting in June 2012.  At that time, most published scientific studies on the effects of bath salts in humans were case reports describing outcomes in individual users or in small groups of users.   More recent studies in larger cohorts surveyed national Poison Control Center data and report on the demographics and medical consequences of bath salts abuse.

The demographics of bath salts cases reported to Poison Control Centers nationwide during the period January 2009 – April 2012 (7467 cases) indicates that the epidemic began in 2010 and was centered in Ohio and other Midwestern states.  Large numbers of cases also were reported in North Carolina and several Southeastern states.  Poison Control Center data from 9 Midwestern states (1633 cases) indicates that bath salts abuse peaked in mid-2011 and began to decline later that year after bath salts preparations were placed on Schedule I by the Drug Enforcement Administration, meaning that they became controlled (and effectively banned) substances.
Data Source: Warrick et al., Annals Emergency Medicine, in press.

The most common symptoms associated with bath salts cases were agitation (62%), racing heart (55%), and hallucinations (33%), with nearly 75% of cases associated with moderate or major medical effects (Figure).  These medical consequence statistics are in line with those described in an earlier report from a smaller cohort (236 cases) based on Louisiana and Kentucky regional Poison Control Center data, including agitation (82%), racing heart (56%), and hallucinations (40%). 

It is worth bearing in mind that statistics based on Poison Control Center data, while representative of the national epidemic, do not provide any details on unreported cases (likely a majority of cases), so these statistics do not fully capture the scope of the bath salts epidemic.   Further, while it appears that bath salts abuse is on the wane, which is good given the serious side effects frequently experienced by bath salts abusers, other synthetic drugs capable of inducing similar behavioral effects and dangerous side effects, such as synthetic cannabinoids (e.g., K2 or spice), may take their place. 

CPDDBLOG welcomes CPDD member’s thoughts on this issue.