Bath Salts, Zombies, and Crossbows: An Update - Pacific Standard

Bath Salts, Zombies, and Crossbows: An Update

Scientists are working to study the make-up and effects of bath salts, while ER doctors are struggling to treat its victims.
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Theatrical release poster for Hannibal. (POSTER: UNIVERSAL PICTURES)

Theatrical release poster for Hannibal. (POSTER: UNIVERSAL PICTURES)

It’s been about a year since the dangerous new synthetic drug, packaged and disguised as “bath salts,” entered America’s mainstream consciousness. Last summer the drug was blamed for a series of bizarre, violent, and seemingly random attacks of cannibalism; it felt, for a few weeks there, like the beginning of a zombie apocalypse.

It should be noted that the drugged-out perpetrator of the first and most well known of these attacks, on a homeless man on a Miami highway overpass, later turned out to not actually have been on bath salts. But still: local news sites across the country are positively shrieking with reports of bath-salt-fueled violence. The drug has been shown to cause hallucinations, insomnia, and outbursts of anger. Here’s one from the past week, from Erie, Pennsylvania:

A Boggs Township man was behind bars Friday after police charged him with a series of brutal assaults on a woman that culminated with three days of alleged bath salts-fueled violence last week.

Pennsylvania State Police at Rockview said Justin D. Hinds, 35, allegedly beat the woman with a crude weapon made by affixing a nail to a heavy flashlight, threw a cell phone at her face, breaking a tooth, and pointed a loaded shotgun at her.

What’s the appeal of this drug, exactly? Cathy Coonz, a behavioral specialist, explained the side effects in a recent presentation to one West Virginia community. From the West Virginia Inter Mountain:

Bath salts are appealing to users because they may induce euphoria, increased sociability and music appreciation, sexual arousal and pleasant hallucinations. However, users also frequently experience extremely unpleasant side effects such as paranoia, profuse sweating, delusions, intense thirst, vomiting, violent or psychotic behavior and self-mutilation, Coontz said.

Not the best trade-off, eh? But despite the media attention the scariest bath salts fatalities have continued to receive, people are still experimenting with this stuff. Meanwhile, ER doctors, law enforcement agencies, and scientists have all struggled to keep up.

A research team from the University of Virginia, hoping to increase our collective understanding of the sinister salts, compiled data about its use and effects for the latest issue of the Journal of Addiction Medicine. The researchers, led by addiction medicine specialist Dr. Erik W. Gunderson, found that the drug’s effects are similar to those of cocaine and amphetamine, though the compound may be slightly different. Short-term “acute toxicity” has led to both suicides and homicides, and in the long term, the drug does appear to be addictive.

Since the drug is so new, and since manufacturers keep tweaking the recipe to circumvent each new ban on its ingredients, ER doctors and poison control centers don’t always know how to test for its presence in a patient’s body, or to respond to overdose situations. The UVA report recommended that, when in doubt, treatment for bath salt toxicity should resemble the treatment of other more familiar stimulants. According to Science Daily:

Substituted cathinone products are still new, so there are no formal guidelines for medical treatment of acute toxicity. Experience suggests that physical symptoms resolve after a few days, with supportive care. However, psychotic effects such as hallucinations may persist for a longer time. Intoxicated patients need close psychiatric observation and monitoring to keep them from harming themselves or others.

Another dangerous aspect of this drug is the propensity of its users to want to use other types of readily available drugs in combination, to calm themselves down or counteract the insomnia it causes. For instance, the UVA team found in a case study of one man’s three-week-long bath salts binge that his symptoms were exacerbated by his use of Benadryl to try to “come down” and sleep each night. He was hallucinating people in his yard. The drug’s interaction with the Benadryl only made things worse. An excerpt of the case study:

...the hallucinations had increased after taking diphenhydramine, which prompted him to climb onto his roof with a crossbow. He fired 2 arrows into the yard after giving the figures “the opportunity to identify themselves.” He had transient suicidal ideation later in the night, which occurred after the number of people increased from what were “always” there, 3 individuals dressed in white to 6 to 7 individuals. His plan was to use the crossbow.

Luckily, the cross-bow-wielder eventually made it to an emergency room and got help. It took about 24 hours after his last bath-salt ingestion (he was snorting the drug), until he seemed to be thinking clearly again and his heart rate was back to normal.

The UVA report ended with an extreme understatement: “a greater understanding of the behavioral pharmacology, health effects, and management of substituted cathinone use remains urgently needed.”

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