Emergency department visits after use of a drug sold as "bath salts" - Michigan, November 13, 2010-March 31, 2011 (2011)

Through March 22, 2011, poison control centers representing 45 states and the District of Columbia had reported receiving telephone calls related to "bath salts" in 2011. By April 6, centers had already received five times more "bath salts" calls in 2011 than in 2010. Although "bath salt" abuse has been documented nationwide, this report is the first to summarize the epidemiology of a number of ED cases. Of note in this investigation, nearly half the patients had a history of serious mental illness (e.g., bipolar disorder, schizophrenia, or depression) in their medical records, and 16 of 17 patients with known drug test results tested positive for drugs other than those in the "bath salts."
Drug overdose, including from designer drugs, continues to grow as a public health concern. Multistate investigations have been conducted as a result of exposure to nonpharmaceutical fentanyl, levamisole-contaminated cocaine, and opiates. Classes of designer drugs like "bath salts" are intended to have pharmacologic effects similar to controlled substances but to be chemically distinct from them, thus avoiding legal control. "Bath salts" for recreational use are sold at "head shops" and on the Internet with names such as Zoom and White Rush. These products also have been labeled as "plant food" and "pond water cleaner" and sold in ways to circumvent detection or enforcement. Some products are labeled as "novelty collector's items," despite additional, pharmaceutical-like labels that indicate dosage. Before "bath salts," synthetic marijuana (e.g., K2 or Spice) was sold legally in convenience stores and gas stations as "incense." [Extract of the editorial note]