Getting high on bath salts: 2010 data from the National Poison Data System

INTRODUCTION: Synthetic cathinone abuse (“bath salts”) appeared in Europe in the mid-2000s but did not emerge in the US until July 2010 when US Poison Centers (PCs) began receiving exposure calls with amphetamine-like effects to these legally sold products. PCs track exposures reported by the public and health care professionals using a standardized electronic data set that is uploaded to the American Association of Poison Control Center's National Poison Data System (NPDS) every 19 minutes. We describe the “bath salts” phenomenon as reported to NPDS. METHODS: NPDS was queried for 2010 closed, human exposures to at least one of five substances: “bath salts (slang term)”, 4-Methylmethcathinone, 3,4-ethylenedioxypyrovalerone, synthetic cathinone derivatives, or synthetic cathinones. Cases were summarized using descriptive statistics. RESULTS: NPDS reported 292 human exposures peaking in December (n=177; 61%). Median age was 26 years (range 4-64). Males outnumbered females (n=231; 79%). Clinical effects included: agitation (47%), tachycardia (46%), hallucinations (27%), hypertension (17%), confusion (11%). Nearly all exposures (n=275; 94%) were classified as intentional abuse or misuse or involved routes associated with abuse behavior (e.g. inhalation, parenteral). Eleven (4%) were suspected suicides. Of the 235 exposures followed to a known outcome, 136 (58%) were moderate or major. No deaths were reported. DISCUSSION/CONCLUSION: Bath salt abuse is associated with a variety of CNS and cardiovascular effects. NPDS and PCs provide a real-time surveillance system to monitor this evolving public health issue. NPDS surveillance data can be useful to measure the impact of new legislation banning “bath salts” in some states.