By Medical Discovery News

Nov. 31, 2012

When a nude Miami man chewing on another man’s face made headlines and sparked fears of “zombie” attacks, the public became acutely aware of a designer drug with the street name “bath salts.” Authorities speculated the man was high on bath salts since similar bizarre events were reported in other cities. Toxicology reports have since shown the man only had marijuana in his system. Yet the case highlights the growth of designer drugs and the violent highs they create while skirting the law.

Bath salts’ innocuous name is meant to make them appear safe and legal. They resemble bath crystals but are synthetic drugs sold under innocent names such as “Ivory Wave,” “Purple Wave,” “Vanilla Sky,” and “Bliss,” and are widely available on the Internet, head shops and some convenience stores. To confuse the public even further, they’re also sold as glass cleaners or plant food, which again is an attempt at avoiding drug laws.

Sold in small packets, these stimulants can be smoked, swallowed, snorted, or put into a solution and injected. They’re far cheaper and easier to get than cocaine or ecstasy, yet like those, they act on the central nervous system with far less predictable effects. Since “street chemists” produce bath salts, no one knows exactly what’s in them.

The main compounds in bath salts are synthetic stimulants including MDPV, mephedrone, and methylone, but there are many others. These compounds are synthetic derivatives of cathinones, which are naturally found in the Catha edulis plant. The North African shrub known as khat is a hallucinogenic stimulant and illegal in the U.S. But the synthetic derivatives are far more concentrated and acutely toxic.

Bath salts affect behavior by altering levels of the neurotransmitters dopamine, norepinephrine, and serotonin. Dopamine controls movement, emotional responses, and the ability to experience pleasure and reward. Norepinephrine regulates heart rate, blood pressure, and sugar levels, and is part of the fight or flight response. Serotonin modulates mood, emotion, sleep, and appetite, and is implicated in the control of numerous behavioral and physiological functions.

Bath salts raise the concentration of these neurotransmitters in two ways. First, they block the reuptake of neurotransmitters, leaving extra dopamine, norepinephrine, and serotonin to react with other receptors instead of being stored safely inside neurons. Second, the drug stimulates the release of additional internal stores of neurotransmitters.

The results are increased heart rate and blood pressure, agitation, anxiety, hallucinations, extreme paranoia, and even full-blown psychosis. There also have been cases of suicide days after the more obvious effects of the drugs have worn off.

In October 2011, the US Drug Enforcement Agency banned three of the key ingredients used to make bath salts for at least a year, and 40 states have outlawed the drug. But producers can make small chemical adjustments in the molecules to stay ahead of the law, which challenges the legal system’s ability to crack down on drug use. The drug is mostly being made in China and imported through other countries, but that’s expected to change as dealers learn to manufacture it here in the United States.

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