What:
- Physical: Bath Salts are white to tan granular powders sold in packets that are deliberately spiked with psychoactive stimulants for abuse purposes.
- Ingredients: Analogs of tryptamines, phenylethylamines and piperazines induce an agitated delirium similar to amphetamines. Only some of these analogs are specifically banned now under controlled substance legislation.
- Chemical names of more common ingredients:
- 3,4-Methylenedioxypyrovalerone (MDPV)
- 4-Methylmethcathinone (Mephedrone or 4-MMC)
- 4-Methoxymethcathinone (Methedrone, bk-PMMA, PMMC)
- 3,4-Methylenedioxymethcathinone (methylone, MDMC)
- Brand names: A variety of brand names have been used including Ivory wave, Vanilla Sky, White Lightening, Bolivian Bath, Cloud 9, and many others. Common street names include Pixie Dust, Monkey Mash, etc.
Where: They can be purchased over the Internet and at various local head shops. They are not sold in most grocery or department stores.
How: They generally are re-packaged in small bags or foil for inhaling, placing in rolling paper for smoking, or for injecting. Skin popping is very dangerous.
Clinical effects: They contain stimulants that have lead to cases of seizures and death. Symptoms include high temperatures, hypertension, tachycardia, violent behavior, hallucinations, tremor and seizures. Complications include muscle breakdown, kidney injury, organ ischemia and vascular catastrophes. Patients may be extremely paranoid.
Management:
- Acute management includes ensuring staff and patient safety by attempting to provide verbal reassurance and a low stimulation environment.
- In the setting of an unclear history, a broad differential must be considered for acute mental status changes, which include hypoxia, hypoglycemia, occult trauma and co-ingestants.
- Prolonged physical restraint should be avoided for risk of sudden death.
- Drug effects from repeated dosing may be present for hours to days (or longer).
updated 2/8/12
This information is not intended for specific patient treatment. Please call the NNEPC for guidance at 1-800-222-1222.
For more information, watch our webinar on bath salts.
