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Responding to Patients Abusing Bath Salts

 

Take This Course

 

This is a one hour, CME-certified activity designed to educate clinicians about the current “bath salt” (illicit designer drugs containing cathinones) epidemic in Maine and throughout the country.

The activity consists of four webinars that cover the characteristics of bath salt users; teamwork strategies to minimize morbidity and maximize the safe management of acute bath salt intoxication; effective treatment modalities for acute bath salt intoxication; and prevention strategies to limit bath salt use and its deleterious consequences. Faculty includes experts from Eastern Maine Healthcare System’s Acadia Hospital and Eastern Maine Medical Center, Bangor Health and Community Services, and the Bangor Police Department. These experts share their proactive community response to this growing problem in Maine, and share their successful, clinically-based interventions.

Background Information

“Bath salts” is the code name used to refer to a newer, alarming and very risky synthetic psychoactive designer drug.

  • The Northern New England Poison Center lists the highest use of bath salts as occurring within the ages of 20-29.
  • Prior to 2011, there was no federal ban on the use of bath salts. The Synthetic Drug Abuse Prevention Act, banning MDPV, mephedrone and 29 other bath salts ingredients was signed into law on July 9, 2012.
  • Calls to poison control centers and disclosure of use to providers have decreased since the ban took effect.

Drug Chemistry/Components

Bath salts are comprised of synthetic cathinones and are described in the literature as “methcathinone.”

  • The most common are mephedrone, methylone and methylenedioxypyrovalerone (MDPV).
  • The chemicals are described as mimicking cocaine, lysergic acid, MDPV and methamphetamine.
  • The consistency of ingredients in each package is highly variable making diagnosis challenging and increasing the risk for adverse reaction and overdose.
  • MDPV is believed to be up to ten times more potent than cocaine.
  • The drug response pattern is long and unpredictable and the long term effects of use are unknown.

Drug Packaging

Bath salts can be supplied in the form of a tablet, capsule, powder or combined with leaves, as in a potpourri.

  • The drug is taken orally, rectally, nasally, sublingually, smoked, or injected intramuscularly or intravenously.
  • It can be packaged in envelopes, clear small plastic bags or foil bags.
  • It is labeled by many different names (Ivory Wave, Vanilla Sky, White Lightening, Bliss, Kamikaze, Monkey Dust, Purple Rain or Wave) and the names are often designed for the area of sales.
  • The packets might be labeled as plant food, jewelry cleaner or insect repellent.
  • The words “not for human consumption” will be on the packets as a way to avoid the federal ban.

Appeal to Users

Bath salts use produces a dangerous response likened to cocaine use.

  • The cost is low and they’re readily available in general stores, gas stations, at the mall and via Internet.
  • Routine drug screens do not detect bath salts components.