Tuesday, June 26, 2012

Incense and Bath Salt Intoxicants

I've been hearing about kids ingesting bath salts and incense to get high for the past year.  I had never heard of this before.  These synthetic legal intoxicating drugs (SLIDs) have come on the scene and have increased in popularity.  Who would want to snort bath salts or smoke incense?   What the heck are these things?

Although they are sold as bath salts and incense to avoid FDA regulation, they are really powerful psychoactive drugs that can have intoxicating effects.  They are sold over the counter at quick-marts and on the Internet.  Herbal incense products affect the cannabinoid receptors in the brain just like marijuana (THC).  Although they differ in chemical structure from natural occurring cannabinoids, they affect the same receptors and can be stronger than THC with potential for overdose and severe toxic effects.  Some of the effects reported by emergency departments and poison control centers were agitation, anxiety, dysphoria, elevated blood pressure, hallucinations, nausea, paranoia, seizures and tachycardia.  Natural THC rarely affects users in this way.

Bath salts are also labeled "not for human consumption" in an effort to bypass laws governing mind-altering substances.  Two of the more common ingredients are 3,4-methylene-dioxypyrovalerone (MDPV) and 4-methyl-cathinone (mephedrone).  The effect is on the dopamine and norepinepherine reuptake inhibitor that acts as a powerful stimulant.

The US government made it illegal to possess or sell any substance containing MDPV or Mephedrone for one year to allow the DEA time to collect data.  These are difficult to regulate, however,  because new stimulants and formulations take their place and are freely sold.  There are numerous sites on the Internet where you can buy these substances and they are so blatant they show up in "google ads".

Most patients that become intoxicated with SLID drugs exhibit anxiety, agitation and psychosis.  Seizures and chest pain have been reported along with a number of deaths.  The clinical effects persist for more than 24 hours which is far longer than other drugs in this class.  Emergency Room physicians need to be on high alert that patients who present with psychiatric symptoms or seizures with elevated blood pressure and tachycardia may have SLID intoxication.

These are very dangerous substances with benign names.  "Bath Salts" and "Incense" (also known as "Spice" or "K2") are truly not for human consumption.


WhatWorksMarketing said...

It is a terrible epidemic that is being underestimated. There have been recent cases in the news connecting cannibalism to the ingestion of bath salts. The most horrific was the case of a man who stripped himself naked in Miami and attacked a homeless man literally eating his face off. There are two other cases around the country that are similar. The bath salts cause your internal temperature to shoot up causing the user to want to take their clothes off and become extremely agitated, resulting in these terrible crimes.

Anonymous said...

What can be done when a person is brought to an ER with this to treat and bring a person's chemistry back to a normal healthy balance? Does giving them charchoal help with absorbing it to not get in their system?

Ronnie said...

It was recently found that the case of cannibalism in Floriday was not due to bath salts, but due to marijuana. In any case, these bath salts are extremely dangerous. I first read about them in an article on ABC in 2011 and thought little of it, but it seems to be an increasing epidemic. I'm so glad your shedding light on these very important topics, thanks and I really enjoy your blog!

Toni Brayer, MD said...

Anon: Charcoal will not work if the substance has been absorbed through the blood stream. In the case of smoking (incense) it would not work at all because charcoal absorbs stomach contents. I doubt it has any place in either substance for detoxification.

Anonymous said...

Here you mainly discuss digesting them. Do you think we are better off not even using them at all for their intended purpose? Do they have trace amounts chemicals which we could absorb through our skin or inhale that we are better off without? I have begun waking up lately to how many chemicals we absorb through our everyday skin products, cleaning products, etc that we are better off without and how natural products (i.e cleaning with vinegar) would do the job just as well without slowly adding harmful chemicals to our bodies over the years. For example, I have been learning how my use of flouride and chlorine over the years has been affecting my thyroid. Do you have natural alternatives for these products, such as the bath salts, that you recommend instead?

Toni Brayer, MD said...

Anonymous: The term "bath salts" is just a name for the synthetic chemical that gets a person high. It has nothing to do with real bath salts that are used in bathing.