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‘Bath salts’: Media hype or major national drug problem? Addiction expert weighs in

Over the past several years, designer drugs known as “bath salts” have gained widespread attention following national media reports linking the substances to overdoses, suicides, and even cannibalism. But are these drugs, which are considered among the most addictive of the psycho-stimulants, becoming a major national problem or are growing concerns simply a byproduct of media hype?
Matthew Howard at the UNC School of Social Work is among those researchers trying to better understand this latest addictive phenomenon. Howard, the Frank A. Daniels Distinguished Professor for Human Services Policy Information, has published more than 200 scientific and professional articles on substance abuse, delinquency, and psychiatric disorders and was recently interviewed for a piece on bath salts that will be published in The Forensic Examiner, the peer-reviewed, quarterly journal of the American College of Forensic Examiners.


Matthew Howard, Ph.D.

“It’s hard to know how big the bath salts problem is and how much of the attention that it’s gotten is a function of the public misperception of this kind of abuse,” the social work professor explained. “It’s also hard to know how much of it is a problem because there were these graphic media reports that seemed to suggest that abuse of this substance leads to what some have called ‘zombie attacks.’”
What is clear, he said, is that these synthetic stimulants are marketed as everyday products such as bath salts, spice, or plant food, for the purpose of disguising their intended use. In reality, these substances are cooked up by underground chemists generally using four or five chemicals, including mephedrone, which can severely damage the brain, kidney and liver, Howard said. Moreover, these stimulants, which can be swallowed, injected, smoked or snorted, cause the same kind of psychological and physical effects on the human body that powder cocaine, crack cocaine, and methamphetamines produce, he said.
“These drugs tend to increase heart rate and blood pressure, and they activate the same parts of the pleasure centers of the brain,” Howard said. “Essentially, all of these psycho-stimulants operate in different ways to achieve the final common effect, which is to increase neurotransmission using this dopamine neurotransmitter in the part of the brain that produces profound sensations of pleasure.”
However, the latest line of designer drugs are so addictive that someone who tries them one time runs the risk of becoming hooked, Howard added.
“They are the most addictive of all drugs of abuse,” he said. “There’s nothing that’s even in the same ballpark.”
Although the magnitude of abuse for bath salts is still unclear, the number of reports of exposure to the psycho-stimulants has increased. According to the American Association of Poison Control Centers, there were 6,138 reports of exposure in 2011, a 19 percent increase over the previous year. These reports could include first-time users but overwhelmingly, research has shown that individuals who use bath salts were already abusing other powerful drugs such as cocaine, Howard said.
States have moved fairly quickly to try to address the drug phenomenon. According to the National Conference of State Legislatures, at least 44 states have banned “two classes of synthetic drugs,” such as bath salts. North Carolina lawmakers issued its ban last year, prohibiting the substances from being sold in retail businesses, such as gas stations, tobacco shops and convenience stores. However, because these substances remain widely available over the Internet, the public, including clinicians, medical workers and social workers still need to be more aware of what “psycho-stimulant abuse and its symptoms look like,” Howard said.
Once consumed, the drugs have been shown to cause confusion, paranoia, hallucinations, delirium and violent behavior. The “zombie” case that garnered much press earlier this year involved a Florida man who was shot and killed by police after being caught using his bare teeth to rip apart another man’s face. Such a horrific crime is difficult to explain, Howard said. But for those who work with substance abusers, especially with individuals who use extremely high doses of drugs such as methamphetamines, the end result is generally the same.
“…Normally, you see people acting out after they have used escalating doses of the drug and after they haven’t slept for days,” he said. “You see the same kind of physical consequences and you see the same kind of psychiatric consequences, too, because these are really, really nasty drugs.”
Even as the number of bans to prohibit these kinds of drugs increases, more than likely, other similar and perhaps more powerful substances are already being created to take their place, Howard said. By altering the chemicals just slightly, underground chemists are able to market a new product that appears legal and that allows them to stay just one step ahead of law enforcement.
“Sometimes they get away with it for one or two years before they get caught,” he said. “But then they just go on and develop another one. People love them, and that’s the problem.”
By Susan White
“Bath salts” image source: National Institutes of Health