Addiction to Bath Salts Explained
Synthetic cathinones are chemically similar to stimulant drugs (such as cocaine, amphetamines and ecstasy) however some research suggests that they can be much stronger. A study (5) on one common synthetic cathinone found that it was similar in psychoactive effect to cocaine, but at least 10 times more powerful.
Animal studies demonstrate that synthetic cathinones are addictive and it is reported that people report intense, uncontrollable urges to use the drugs again and again. Withdrawal symptoms include depression, anxiety, tremors, sleeping difficulties and paranoia.
What Are Bath Salts/Psychoactive Bath Salts?
Synthetic cathinones, known colloquially as ‘bath salts’, are a form of man-made ‘designer drugs’ chemically related to the khat plant(1). Khat, a shrub native to East Africa and southern Arabia, is a natural stimulant. It is customary amongst cultures in these areas to chew the leaves of khat plant to achieve a euphoric effect. Man-made cathinones are chemically similar and aim to replicate this effect, however they are much stronger than the cathinones of natural origin, much more prone to dependency and can cause serious health and mental health effects.
Synthetic cathinones are marketed as a cheap substitute for more commonly known recreational drugs used for their stimulant effects such as cocaine and ecstasy. They can be purchased online and ingested through swallowing, snorting, smoking or injecting. They are so-called due to their similarity in appearance to bath salts, such as Epsom salts, when in powdered form. Please note that the designer drug category ‘bath salts’ bears absolutely no connection with the bathing products of the same name.
Regular commercial bath salts do not produce a psychoactive effect and there is no concern with using bath salts, bath bombs or Epsom salts whilst bathing when used according to their instructions.
What Exactly Are Designer Drugs?
‘Designer drugs’, also known as ‘legal highs’ are purposefully designed recreational drugs which aim to replicate the chemical structure and pharmacological effects of an original drug, whilst avoiding detection in standard drug testing. Included in this category are ‘new psychoactive substances’ (NPS) under European law (2) and designer steroids (3), used as performance-enhancing drugs in sports.
Designer drugs are created by ‘underground’ chemists who continually create new formulations to avoid changes in drug testing and drug legislation. This makes it an incredibly difficult area to legislate and is considered a ‘grey market’ in terms of regulation. In the UK, the draft Psychoactive Substances Act 2015-16 (4) aims to restrict the production, sale and supply of designer drugs on the basis of banning any substance which produces a psychoactive effect.
It is a highly controversial bill due to its ambiguous phrasing. It has been criticised as an infringement on civil liberties due to the fact that it can be interpreted to include any substance which potentially causes pleasure. This demonstrates how vague and challenging this area of law is and how difficult it can be to implement restrictions on legal highs successfully.
Designer drugs present new challenges in terms of management due to their accessibility and their potential to escape legal control. They are commonly sold online and are therefore much easier to gain access to than illegal drugs. Anyone with access to the internet is able to purchase bath salts.
Street Names for Bath Salts
A wide variety of names may be used to refer to ‘bath salts’ or synthetic cathinones. These include but are not restricted to the following:
- Ivory Wave
- Vanilla Sky
- Cloud Nine
- Blue Silk
- Purple Sky
- Purple Wave
- Red Dove
- Ocean Snow
- Lunar Wave
- White Lightening
- Hurricane Charlie
- Meow Meow
- Ocean Burst
- Pure Ivory
- Snow Leopard
- White Night
- White Rush
- Charge Plus
- White Dove
- Plant fertilizer
- Plant food
The Different Types of Recreational Bath Salt Drugs
Bath salts generally contain a cathinone such as methylenedioxpyrovalerone (MDPV), methylone or mephedrone (6). Each of these causes a stimulant effect by increasing the concentration of dopamine, serotonin, and norepinephrine in the brain, but have slightly differing properties.
Mephedrone was first synthesised in 1929 but was not used recreationally in 2003. It gained media attention due to a surge in hospital admissions and deaths as a result of mephedrone toxicity. Patients presented with delusional psychosis as well as symptoms of physiological hyperarousal such as increased heart rate, blood pressure, sweating, and flushing. Methylone is another of the major groups of bath salts and has been associated with suicidal behaviour, highly violent crimes and delirium (6). It has also been associated with seizure activity and unusually high body temperatures. Of all the bath salts, MDPV has been most strongly associated with bizarre behaviours (6).
Why are bath salts addictive?
How Bath Salts Are Abused
Bath salts are dangerous because of their high risk of abuse and addiction, in combination with the fact that they have unusually severe negative physical and psychological effects. They have been found to be more addictive than cocaine and crystal meth. At the same time, they are notorious for posing very serious health risks such as seizures, violent episodes and heart attacks.
Bath salts contain synthetic cathinones which aim to replicate the structure and effects of amphetamines. “Bath salts” is an umbrella term for a wide range of synthetically created drugs which are formulated slightly differently. There are no known medical uses for bath salts since they have been created for the specific purpose of replacing more commonly known illicit substances. There are no health benefits to taking bath salts; hence, all use is abuse.
Bath Salts Addiction: Causes and Risk Factors
Common reasons for the development of habitual drug usage can include genetic and environmental factors.
Genetic factors such as parents or other relatives suffering from addiction to drugs or any other kind of substance or behaviour are very important when discussing bath salts addiction. There is also a complex interplay between the symptoms of mental health difficulties and drug usage, so that some people may use drug usage to ‘self-medicate’ or escape from symptoms of common mental health problems, especially hereditary ones, such as depression, anxiety, phobias, personality disorders or symptoms of mood imbalance or psychosis.
This can be seen as a circular problem in the sense that drug usage can serve as a perceived ‘solution’ to symptoms of mental health difficulties, and yet the use of illicit substances can then exacerbate mental health symptoms. This can drive the person to continue or even increase their usage.
Yet another complicating factor is that some people may be more predisposed to developing addiction as a result of challenging life circumstances or stressors which lead to a need for escape. Your peer group and the people you communicate with on a daily basis may be using bath salts regularly. The surrounding environment has often been quoted as a factor in bath salts addiction.
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Interaction of Bath Salts with Alcohol
A 2015 study (9) looked at the interaction between a common bath salt known as mephedrone with alcohol. It was found that alcohol significantly enhances the psychostimulant effects of mephedrone. It is commonplace for users to report combining alcohol with bath salts for an increased ‘high’ and this increases the risks of taking either substance alone. Bath salts are a stimulant and alcohol acts as a depressant, with regard to its effect on the nervous system.
This sends conflicting messages to the brain and nervous system which may cause unpredictable effects. There is a much greater risk of experiencing dehydration as a result of combining bath salts with alcohol and as both these substances produce dehydrating effects. This is of particular concern when the drugs are consumed in a ‘clubbing’ environment where the user may be dancing and therefore experience increased sweating and body temperature.
Signs and Symptoms of Bath Salts Abuse
Due to the stimulating effects of bath salts and their action on the dopaminergic system, tolerance is common. This means the user no longer feels the same ‘reward’ or sense of pleasure at the same dosage they are used to. As a result, they feel an urge to increase their dosage over time, increasing the risk of harmful effects.
Physical and Psychological Effects of Bath Salt Abuse
The following psychological and physiological effects are commonplace reactions to the use of bath salts.
- increased wakefulness, concentration
- elevated sex drive
- a “rush”
- rapid heart rate
- chest pain
- high blood pressure
- hyperthermia (elevated body temperature)
- excess sweating (diaphoresis)
- pupil dilation (mydriasis)
- vessel constriction
- reduced appetite
- muscle spasm or tremor
Severe Behavioural and Psychiatric Effects
The regular use of bath salts recreationally can cause severe psychological and physiological health problems and can lead to more severe psychological and physiological reactions, such as:
- severe panic attacks
- psychosis (hallucinations, delusions)
- paranoia (extreme distrust)
- insomnia (inability to sleep)
- violent behaviour
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Dangers of Overdose of Bath Salts
Bath salt overdose can lead to potentially fatal reactions. It can also lead to agitation, psychomotor disorder and violence. The care of an individual who has overdosed on bath salts would involve admission to hospital where they may be treated with benzodiazepines (a class of medications which calm down the nervous system), antipsychotics (medications which reduce psychosis), hydration, electrolyte balancing and potentially cardiac care. There is no known specific antidote for bath salt toxicity. Bath salt toxicity can manifest in diarrhoea, tremors, seizures and unconsciousness.
A further risk of bath salt usage is the risk of serotonin syndrome, a dangerously raised level of serotonin concentration in the brain. Serotonin syndrome can be fatal. Common effects are disorientation, headaches, changes in blood pressure and increased heart rate.
Teen Abuse of Bath Salts
It is reported that drugs falling under the category of bath salts constitute one of the four most popular drugs in the UK for teenagers who go out clubbing. Teenagers are particularly susceptible to being targeted because the marketing around bath salts focuses on them being a cheaper alternative to common street drugs, which are easily accessible online. Teenagers may purchase them from vendor websites and receive them in unmarked packaging to their home address. The fact that they do not need to go out and seek a ‘drug dealer’ makes this an attractive option.
Bath Salts Withdrawal Effects
The withdrawal effects of bath salts include intense cravings to take the drug again, aggressive/violent outbursts, depression, anxiety, brain fog (inability to think clearly) and reduced cognitive abilities. You may also experience an inability to feel pleasure (anhedonia) and difficulties with sleeping. Some people experience hallucinations and paranoia or delusional feelings and beliefs; others experience increased heart rate. Severe agitation is a common effect.
Properly managing bath salts withdrawal symptoms
Different medications or medical interventions may be used to manage the various symptoms of withdrawal. For instance, benzodiazepines may be used to manage anxiety and cravings, antipsychotics may be used to assist with delusional ideas, paranoia or hallucinations and sleeping tablets may be used to assist with insomnia. This must be done in a safe environment with access to medical support.
Bath Salts Addiction Rehab & Treatment
Treatment for an addiction to bath salts is a three-step process, involving detoxification from the substance and its ill-effects on the body, followed by psychological therapies for emotional support and guidance and finally a treatment plan for ongoing recovery.
Bath salt detox treatment
Bath salt detox treatment involves managing the withdrawal process in a medically safe way. Withdrawal effects of bath salts may include depression, anxiety, tremors, difficulties in sleeping and paranoia. There is not a specific medication which is able to treat the withdrawal per se.
Ongoing recovery may include the use of peer-support programmes and ongoing access to emotional support.
Therapeutic programmes for bath salts addiction
Psychological therapy will help you to understand your addiction and what triggers might make you more prone to relapse. It can help to build stronger foundations to cope with stress more effectively and to learn how to use your support network so that you may feel less alone with your difficulties. Psychological therapy for addiction may involve individual therapy, group therapy or a combination of both.
Synthetic Cathinones (“Bath Salts”): Drug Facts and Statistics
- Synthetic cathinones were first created in 1912; however, they were not used recreationally until around 2010.
- The age of users ranges from around 15 to 55, with the average being 28.
- The class of drugs that come under the umbrella term ‘bath salts’ were made illegal in the UK in 2016.
- In the US, calls to poison control centres about bath salts rose from 304 in 2010 to 6,138 in 2011.
Are You or a Loved One Struggling with Bath Salt Addiction?
Acknowledging that you need help, or approaching a loved one about bath salt addiction, can be daunting. There are services available that offer support with interventions and assisting people into detoxification programmes. If someone you care about is struggling with bath salt addiction, it is important that you set healthy boundaries to keep yourself safe, and avoid enabling drug use. Enabling means supporting the person either emotionally or financially to continue with behaviours that are self-destructive and may cause harm to others.
There is a wide range of options available, and many people find that private treatment centres provide the necessary medical and psychological support to assist them on their journey to recovery. Rehabilitation centres provide bespoke treatments that are tailored to the individual and may use a combination of medical detoxification, psychological therapies and support, holistic therapies and any other support required.
Call our admissions line 24 hours a day to get help.
- Baumann MH. Awash in a sea of “bath salts”: implications for biomedical research and public health. Addict Abingdon Engl. 2014;109(10):1577-1579. doi:10.1111/add.12601.
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