Bath Salts – Synthetic Cathinones Poisoning

Basics

“Bath salts”:

General term for “designer drugs” containing synthetic cathinones:
- 3,4 methylenedioxypyrovalerone (MDPV) is most common in the U.S.:
  - Also mephedrone, methylone, and many others
Sold under numerous names including:
- Aura, Bliss, Bolivian Bath, Bromo-Dragonfly, Cloud 9, Ivory Snow, Ivory Wave, Meow-Meow, Vanilla Sky, White Dove, White Rush:
  - Labeled “not for human consumption” to evade regulatory control
  - Falsely marketed as plant food, insect repellents, “bath salts” to further evade regulation
  - Not chemically related to epsom salts or bath salts for bathing in any way
Substances may be powders, tablets, or crystals:
- Ranging in color from white, yellow, brown, or gray
May be ingested, snorted, smoked, injected
Highly addictive CNS stimulant, often with hallucinogenic properties:
- Many effects similar to cocaine, or ecstasy
- Severe delirium, psychosis, violence, multiorgan failure, DIC, myocardial infarction, stroke, and deaths have been reported

Incidence and Prevalence Estimates

First use in the U.S. reported in 2010:
- MDPV and mephedrone noted in Europe since 2004
Called “America's new drug problem” in 2011:
- Thousands of cases reported to poison control centers nationwide
Immediate temporary classification in 2011 as a DEA schedule I controlled substance
Still available at retail shops or through the internet

MDPV is structurally similar to cathinone, an alkaloid derived from the khat plant (chewed socially and abused for centuries in East Africa and Arabian peninsula)
Structurally derived from phenethylamine (common to dopamine, norepinephrine, amphetamines, synthetic cathinones)
Drug chemical formulas change regularly to evade detection, compound identification, and classification as “illegal”
Principal toxicity derives from effects on dopamine, norepinephrine, and serotonin receptors
Effects from potential adulterants and contaminants in the drugs remain unknown

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