Chronic use of bath salts, or synthetic cathinones, can result in various physical and psychological effects, including addiction and death.1,2 General signs of bath salt addiction include intense cravings, withdrawal symptoms, and neglecting important responsibilities. Treatment options for bath salt addiction typically involve a combination of therapy, counseling, and support programs tailored to address the individual’s specific needs.
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What to Know About Bath Salts
Bath salts, as substances of abuse, are synthetic stimulant drugs that belong to the class of cathinones, which is a naturally occurring stimulant found in the leaves of the Khat plant, native to East Africa.1,2 Despite the name, they have no relation to actual bathing products, which contain the active ingredient magnesium sulfate, also known as Epsom salts.3 Synthetic cathinones are substantially more potent than naturally occurring cathinone and are one of a variety of potential synthetic chemicals which may include substances like mephedrone, methylone, or methylenedioxypyrovalerone (MDPV).4 These mind-altering drugs are strong central nervous system stimulants that inhibit the dopamine-norepinephrine reuptake system. Due to the chemical similarities between MDPV and cocaine or methamphetamine, their effects on the brain are experienced similarly, though potentially much more intense, as MDVP is reportedly 10 times more powerful than cocaine. Synthetic cathinone may be produced as a standalone substance or combined with other drugs, such as 3,4-methylenedioxymethamphetamine (ecstasy, molly), for an even stronger effect.
Bath salts are commonly sold in powder form and come in capsule or tablet form that may be swallowed or modified to snort, smoke, or inject. These drugs are typically purchased online or on the black market, and their packaging may be labeled as “plant food,” “cleaners,” or “research chemicals” and “not for human consumption” to evade legal restrictions.5 When abused, bath salts activate the brain’s reward pathway and can produce intense euphoria, increased energy, heightened alertness, and a sense of sociability. Users may also seek feelings of empathy and enhanced sexual experiences. This is what makes them especially appealing at dance parties, such as at nightclubs or raves.
The effects of bath salts can be unpredictable and potentially dangerous. Beyond sharing similarities with other stimulant drugs, such as amphetamines and cocaine, their chemical composition can vary significantly as a standalone substance or in combination with others, which makes it challenging for doctors to understand their effects and potential risks fully.
In the early 2010s, when bath salts were first manufactured and flooded the market, they quickly gained prevalence due to their easy accessibility and the perception that they can mimic the effects of illicit substances while avoiding legal repercussions. Accordingly, the Drug Enforcement Agency (DEA) placed an emergency ban on three common lab-made cathinones, and in July 2012, the DEA and the Obama Administration passed the Synthetic Drug Abuse Prevention Act (SDAPA), which classified bath salts under Schedule I of the Controlled Substances Act. Even still, the chemical diversity of bath salts, with new variations constantly emerging, makes it difficult for medical professionals to keep up with their evolving composition and potential harm.
Bath salts may be referred to as:5
- Flakka
- Zoom
- Vanilla Sky
- White Dove
- K2
- Spice
- Bliss,
- Blue Silk
- Cloud Nine
- Drone
- Energy-1
- Ivory Wave
- Lunar Wave
- Meow Meow
- Ocean Burst
- Pure Ivory
- Purple Wave
- Red Dove
- Snow Leopard
- Stardust
- Vanilla Sky
- White Dove
- White Knight
- White Lightning
Effects of Bath Salts Abuse
Bath salts exert their effects by acting on the central nervous system, specifically by affecting the release and reuptake of neurotransmitters, including dopamine, norepinephrine, and serotonin.6 These drugs have stimulant properties, leading to increased energy, alertness, and euphoria. The release of dopamine contributes to feelings of pleasure and reward. The physiological impacts of bath salts can influence both their stimulant and psychedelic aspects. The stimulant effects are primarily driven by their ability to increase dopamine levels, resulting in heightened arousal and a surge of energy. On the other hand, the psychedelic aspects can be attributed to the drugs’ impact on serotonin receptors, leading to altered perception, hallucinations, and feelings of dissociation.6
Bath salt use can pose significant dangers to individuals. The intense stimulation and altered mental state caused by these drugs can lead to impaired judgment, reckless behavior, and increased risk-taking. Users may become more prone to engaging in violent or erratic behaviors, which can put themselves and others at risk of harm. The combination of heightened physical and mental states, coupled with potential hallucinations, can result in unpredictable and dangerous situations.
Bath salts can cause side effects such as:
Common effects:7
- Euphoria
- Increased energy and alertness
- Decreased appetite
- Elevated heart rate and blood pressure
- Dilated pupils
- Increased sociability and talkativeness
- Excessive sweating
- Insomnia or disturbed sleep patterns
- Teeth grinding or jaw clenching (bruxism)
High-Risk Effects:7
- Agitation and irritability
- Paranoia and hallucinations
- Panic attacks and anxiety
- Delusions or psychosis
- Violent or aggressive behavior
- Suicidal thoughts or self-harm tendencies
- Seizures or convulsions
- Cardiac complications, including heart attack or stroke
- Kidney damage or failure
Complications that can be persistent:7
- Chronic fatigue
- Cognitive impairments, including memory loss and difficulty concentrating
- Mood disorders, such as depression or anxiety disorders
- Persistent hallucinations or psychosis
- Respiratory problems
- Damage to the nasal passages or sinuses (if snorted)
- Dental problems, including tooth decay and gum disease
- Impaired sexual function and libido
- Social and occupational dysfunction due to addiction or behavioral changes
Please note that these lists are not exhaustive, and individual experiences with bath salts can vary. The effects can also depend on various factors, including the specific compound used, dosage, route of administration, and individual susceptibility.
More serious effects that can cause unintentional harm include:
- Severe hallucinations and distorted perception of reality
- Psychosis, characterized by delusions and detachment from reality
- Intense panic attacks and severe anxiety
- Suicidal ideation and self-harm tendencies
- Extreme agitation and aggression, leading to violent behavior
- Severe paranoia and fearfulness
- Increased risk of accidents and injuries due to impaired judgment and coordination
- Overdose, which can result in life-threatening conditions like seizures, cardiac arrest, or organ failure
- Long-term neurological damage, including cognitive impairments and memory loss
Chronic use of bath salts can lead to effects such as:
- Seizures or convulsions
- Impaired attention and concentration
- Cardiovascular problems, including hypertension and increased risk of heart disease
- Respiratory complications, such as difficulty breathing or lung damage
- Brain swelling or edema
- Persistent headaches or migraines
- Liver damage or dysfunction
- Kidney problems, including renal failure
- Muscle breakdown (rhabdomyolysis)
- Psychiatric disorders, such as depression, anxiety, or schizophrenia-like symptoms
Accordingly, chronic use of bath salts can have severe and long-lasting effects on various organ systems and mental health.
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Are Bath Salts Addictive?
Bath salts can be highly addictive, and their use can lead to the development of a substance use disorder. Addiction is a complex condition characterized by thoughts, emotions, and behaviors surrounding use, such as compulsive drug-seeking and drug use despite negative consequences. It is different from dependence, which refers to the body’s adaptation to the drug and the occurrence of withdrawal symptoms when drug use is discontinued. Bath salt addiction shares similarities with other substance addictions, such as methamphetamine addiction, in terms of the compulsive nature and the potential for severe physical and psychological dependence.
Research on bath salt addiction is limited, primarily due to the constantly evolving chemical composition. The lack of comprehensive research hinders our understanding of the long-term impacts of chronic use and the most effective treatment approaches. Animal studies, though limited, have provided some insights into the potential neurotoxic effects of bath salts on the brain and the addictive properties of these substances.8
Bath Salts Addiction Statistics
Bath salt addiction is a relatively new phenomenon, and comprehensive data on its prevalence can be limited. However, a synthesis of available research indicates the following:
- The use of bath salts tends to be more prevalent among younger individuals, particularly those in their late teens to mid-30s.
- Both males and females can be affected by bath salts addiction, although some studies suggest that males may have a slightly higher propensity for use.
- Socioeconomic status does not appear to be a determining factor in bath salts addiction. It can affect individuals from various backgrounds.
- Comorbid mental illness, such as mood disorders or substance use disorders, is often associated with bath salt addiction. The use of bath salts may be an attempt to self-medicate or alleviate symptoms.7
More specific numbers collected from the Drug Abuse Warning Network (DAWN) when bath salts were initially recognized in the early 2010s first detected a measurable number of emergency department (ED) visits involving bath salts in 2011 as follows:
- Of the nearly 2.5 million ED visits that involved drug misuse or abuse in 2011, bath salts were named in 22,904 visits.
- 33% of these visits involved bath salts only,
- 15% involved bath salts combined with marijuana or synthetic marijuana, and
- 52% involved bath salts in combination with other drugs.9
“In 2014, the American Association of Poison Control Centers (AAPCC) reported over 500 exposures to bath salts, citing that these products may cause a dangerous spike in heart rate or blood pressure as well as paranoia, hallucinations, delusions, violence, suicidal tendencies, seizures, panic attacks, chest pain, and nausea and vomiting.”7
More recent research by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2020 revealed:10
- Approximately 118,000 people ages 12 and older used synthetic stimulants within the past year.
- Less than 0.1% of adolescents aged 12-17 reported using a synthetic stimulant within the past year.
- Among adults aged 18+, 0.1% of people reported using synthetic stimulants in 2020.
For further information and detailed addiction facts and statistics, including bath salts, one may reference reputable sources such as the National Institute on Drug Abuse (NIDA) or the Substance Abuse and Mental Health Services Administration (SAMHSA).
Risk Factors & Causes of Bath Salts Addiction
The development of addiction, including bath salts addiction, is influenced by various risk factors and causes. These factors can differ from person to person, and they can contribute to the development of one substance use disorder over another. Both genetic and environmental factors play significant roles in addiction. Certain genetic variations can affect how the brain responds to substances, making some individuals more susceptible to developing an addiction. Environmental factors, such as upbringing, social environment, and exposure to substances, also play a crucial role. Childhood trauma, peer pressure, family history of substance abuse, and easy access to drugs can increase the risk of developing addiction.
Bath salt addiction typically starts with recreational use. Individuals may initially experiment with the drug due to curiosity or to enhance pleasure or performance. Today, bath salts are often obtained illegally, either through illicit drug markets or online sources. In some cases, people may obtain bath salts through friends or family members. Bath salts interact with receptors in the brain, particularly dopamine and norepinephrine transporters. Over time, the brain adapts to these changes, and individuals may require higher doses to achieve the desired effects, leading to dependence and addiction. The maintenance of bath salt addiction can involve continued illegal purchases, seeking out multiple sources, or engaging in risky behaviors to obtain the drug. The compulsion to use bath salts and the fear of withdrawal can drive individuals to maintain their addiction, often at great personal and social costs.
Risk factors that may contribute to addiction include:
- Cross-addiction: Individuals with a history of addiction to other substances are at a higher risk of developing a cross-addiction, which is an addiction to bath salts or other drugs.
- Family history: Having a family history of substance abuse or addiction can increase the likelihood of developing an addiction.
- Trauma: Experiencing traumatic events, such as physical or sexual abuse, can increase the vulnerability to addiction as individuals may turn to substances as a coping mechanism.
- Addictive personality traits: Certain addictive personality traits, such as impulsivity, sensation-seeking, and a lack of self-control, can make individuals more prone to developing addictive behaviors.
- Teenage addiction: Initiating substance use at a young age, such as during adolescence, can increase the risk of developing addiction later in life.
- Socioeconomic factors: Living in poverty or facing socioeconomic disadvantages can contribute to stress, limited resources, and increased exposure to drug use, which can increase the likelihood of addiction.
- Co-occurring mental health disorders: Having a comorbid mental health condition, such as depression, anxiety, or bipolar disorder, can increase the risk of developing addiction as individuals may turn to substances as a form of self-medication.
- Peer influence: Surrounding oneself with peers who engage in substance use or who accept or promote drug use can influence an individual’s likelihood of developing an addiction.
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Symptoms of Bath Salt Addiction
Behavioral symptoms of bath salt addiction can develop as individuals become increasingly dependent on the drug. A compulsion to use bath salts despite negative consequences is a common hallmark of addiction. This compulsion arises due to changes in the brain’s reward system, leading individuals to prioritize drug use over other aspects of their lives. Behavioral symptoms often manifest as individuals try to maintain their addiction and cope with the impact of their substance use.
Behavioral symptoms of bath salt addiction include:
- Lying and deceit: Individuals may engage in dishonesty to conceal their drug use or obtain bath salts.
- Medication seeking: They may engage in doctor shopping or visit multiple healthcare providers to obtain prescriptions for substances like bath salts.
- Isolation and withdrawal: They may withdraw from social activities, hobbies, and relationships as their focus shifts primarily to obtaining and using bath salts.
- Neglecting responsibilities: Addiction can lead to neglect of work, school, or family responsibilities as the drug becomes the central focus.
- Financial problems: Individuals may experience financial difficulties due to spending excessive amounts of money on bath salts or engaging in risky behaviors to obtain funds for drug use.
- Changes in mood and behavior: They may exhibit sudden mood swings, irritability, and unpredictable or aggressive behavior.
- Loss of interest: Previously enjoyed activities may lose significance as the addiction takes priority.
- Risky behaviors: Individuals may engage in risky behaviors to obtain bath salts, such as stealing, engaging in unsafe sexual practices, or driving under the influence.
Complications of a Bath Salts Addiction
Bath salt addiction can have severe negative impacts on various aspects of daily activities and overall functioning. In the short term, individuals may experience immediate physical and psychological effects, including increased heart rate, hallucinations, paranoia, and erratic behavior. These short-term effects can disrupt personal relationships, impair judgment, and hinder daily responsibilities. In the long term, bath salt addiction can result in deteriorating physical and mental health, financial difficulties, legal problems, and social isolation. Without appropriate treatment and support, the consequences of bath salts addiction can be devastating for individuals and those around them.
Left untreated, bath salt addiction may lead to:
- Homelessness: Addiction can lead to unstable housing situations, as individuals prioritize drug use over meeting basic needs.
- Interpersonal conflicts: Relationships with family, friends, and colleagues may be strained or broken due to the negative impact of addiction on behavior and trust. Interpersonal conflicts can become a problem.
- Overdose or death: Bath salts can have unpredictable and dangerous effects on the body, and overdose can lead to serious health complications or even fatal outcomes.
- Impaired cognitive functioning: Prolonged use of bath salts can result in cognitive impairments, including difficulties with memory, attention, and decision-making.
- Legal consequences: Engaging in illegal activities to obtain bath salts or because of impaired judgment can lead to arrests, criminal charges, and legal problems.
- Financial hardships: Addiction can drain financial resources as individuals prioritize purchasing bath salts over meeting financial obligations or pursuing stable employment.
- Physical health complications: Bath salts can cause severe physical health issues, such as cardiovascular problems, organ damage, and respiratory issues.
- Mental health disorders: Bath salt addiction can contribute to the development or exacerbation of mental health disorders, including anxiety, depression, and psychosis.
Co-Occurring Disorders with Bath Salts Addiction
Bath salt addiction can often be accompanied by co-occurring disorders, as individuals may turn to substances to self-medicate or cope with underlying mental health symptoms. Some individuals may use bath salts to alleviate symptoms of anxiety, depression, or other mental health disorders. However, this self-medication approach can exacerbate the complexity of the addiction and negatively impact overall well-being.
Common co-occurring disorders of a bath salt addiction include:
- Anxiety disorders (e.g., generalized anxiety disorder, panic disorder)
- Bipolar disorder
- Depressive disorders (e.g., major depressive disorder)
- Post-traumatic stress disorder (PTSD)
- Attention-deficit/hyperactivity disorder (ADHD)
- Personality disorders (e.g., borderline personality disorder)
- Schizophrenia and other psychotic disorders
- Obsessive-compulsive disorder (OCD)
- Eating disorders (e.g., bulimia nervosa)
- Sleep disorders (e.g., insomnia, sleep apnea)
- Substance-induced mood disorders
It is important to recognize that co-occurring disorders can complicate the treatment process and require integrated care addressing both the addiction and the underlying mental health conditions.
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Symptoms of Bath Salts Withdrawal
Bath salt withdrawal refers to the set of symptoms that occur when an individual abruptly discontinues or reduces their use of bath salts after prolonged and heavy use. The frequency and dosage of bath salts necessary for withdrawal to become a factor can vary among individuals. However, frequent and high-dose use of bath salts is more likely to lead to withdrawal symptoms. It’s important to note that someone does not necessarily need to have a full-blown addiction to experience withdrawal; even individuals who have been using bath salts regularly can experience withdrawal symptoms upon cessation.
Research on bath salt withdrawal is still limited, and much of it is based on personal testimonies and animal studies rather than extensive human empirical evidence. [8] However, the available evidence suggests that withdrawal symptoms can be intense and challenging to manage without appropriate medical intervention. The use of benzodiazepines and antipsychotics may be utilized in the treatment of withdrawal symptoms, as they can help alleviate anxiety, agitation, and psychosis that may arise during the withdrawal process. (One should proceed with caution using drugs such as benzodiazepines due to addiction potential and should first consult with a medical professional.)
Symptoms of bath salt withdrawal may include:
- Symptoms of anxiety, such as restlessness and irritability
- Symptoms of depression, including low mood and feelings of hopelessness
- Insomnia and disturbances in sleep patterns
- Fatigue and lack of energy
- Increased appetite and weight gain
- Intense cravings for bath salts
- Difficulty concentrating and impaired cognitive function
Signs of a Bath Salts Overdose
Bath salts overdose can have severe and potentially life-threatening consequences. The amount of bath salts necessary to cause an overdose can vary depending on factors such as the purity of the drug, an individual’s tolerance, and their overall health.11 Loved ones should intervene immediately during a bath salt overdose to prevent death. Prompt medical attention is crucial in these situations. The purity of bath salts can greatly affect knowledge of overdose effects, as impurities or additional unknown substances in the drug (e.g., molly) can lead to unpredictable reactions. The best way to avoid overdose is not to use them.
Someone should seek immediate medical attention if they show signs of a bath salt overdose such as:11
- Cardiac dysfunction, including irregular heartbeat or chest pain
- Hyperthermia (extremely high body temperature)
- Agitation, confusion, or hallucinations
- Seizures or convulsions
- Profuse sweating and dehydration
- Uncontrollable and excessive muscle movements
- Kidney failure or decreased urine output
- Loss of consciousness or unresponsiveness
- Respiratory distress or difficulty breathing
- Severe hypertension (high blood pressure)
- Stroke or other neurological complications
Bath Salts Addiction Treatment
The treatment process for bath salts addiction varies depending on individual needs and circumstances. It often includes detoxification to safely manage withdrawal symptoms, followed by comprehensive therapy such as cognitive-behavioral therapy (CBT), individual counseling, group therapy, and support from addiction support groups. Seeking treatment is crucial, and individuals can start by reaching out to addiction treatment centers, healthcare providers, or addiction specialists who can provide guidance and support throughout the recovery journey. Writing a relapse prevention plan can also help. While there is ongoing research and exploration into effective treatments for bath salt addiction, there is not yet a unanimous understanding of what treatments are most effective for bath salt-specific treatment.
Treatment options for bath salt addiction include:
Rehab
Rehab programs for bath salt addiction are designed to provide a structured and supportive environment for individuals to focus on their recovery. These programs typically offer a combination of detoxification, therapy, counseling, and support groups to address both the physical and psychological aspects of addiction. Rehab options for bath salts addiction are similar to other drug addictions. However, there may be some specific considerations for bath salt addiction due to the unique effects and challenges it presents.
The cost and duration of rehab for bath salt addiction can vary depending on several factors, including the type of program, location, and individual needs. Inpatient rehab programs, where individuals reside at a treatment facility, generally have higher costs and longer treatment timelines, often ranging from 30 to 90 days or more. Outpatient rehab programs, on the other hand, tend to be more flexible and less expensive, allowing individuals to attend therapy sessions and treatment while still living at home. Knowing the differences between inpatient rehab and outpatient rehab can help you decide what is right for you.
Intensive Outpatient Treatment
Intensive outpatient treatment (IOP) is a structured and comprehensive level of care for individuals who don’t require 24-hour supervision. IOP for bath salt addiction typically involves a combination of individual therapy, group therapy, psychoeducation, relapse prevention skills training, and support from addiction support groups. Treatment duration can vary depending on individual needs, but it typically spans several weeks to a few months. Sessions are scheduled multiple times a week, often for a few hours each day, allowing individuals to receive substantial therapeutic support.
The cost of IOP can vary depending on factors such as location, the specific treatment center, and any additional services provided. Generally, IOP tends to be more cost-effective than inpatient rehab programs because individuals do not require 24-hour residential care. IOP’s specific costs and insurance coverage can be determined by contacting treatment centers directly or working with insurance providers to understand the available options and associated expenses.
Therapeutic Interventions
Therapeutic interventions are an essential part of treating bath salt addiction and addressing contributing underlying factors. Various therapy options and aftercare support groups are available to those seeking recovery. The costs and timelines for therapy options can vary depending on factors such as the type of therapy, the frequency of sessions, and the location of the treatment center. Some therapy options may be covered by insurance, while others may require out-of-pocket expenses.
Finding the right therapist involves considering their expertise, experience with bath salt addiction, and compatibility with the individual seeking treatment. It can be helpful to seek referrals from healthcare providers, addiction specialists, or trusted sources, and to schedule initial consultations to ensure a good fit between the therapist and the individual.
Therapy options for addressing the effects of a bath salts addiction include:
- Cognitive-Behavioral Therapy (CBT): CBT Focuses on identifying and modifying unhealthy thought, emotional, and behavioral patterns related to addiction.
- Dialectical Behavior Therapy (DBT): DBT Helps individuals develop skills to manage emotions, improve interpersonal relationships, and cope with stress while integrating mindfulness.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a therapy often used for individuals with a history of trauma, helping to process traumatic experiences and reduce their impact on addiction and mental health.
- Group Therapy: Group Therapy offers a supportive and structured environment where individuals can share experiences, gain insights, and learn from others facing similar challenges.
- Behavioral Modification: Utilizes rewards and consequences to reinforce positive behaviors and discourage substance use.
- Motivational Interviewing: A person-centered approach that helps individuals explore and resolve their ambivalence towards substance use, enhancing motivation for change.
- Family Therapy: Involves the individual’s family members to address family dynamics, improve communication, and support recovery.
- Medication-Assisted Treatment (MAT): MAT combines the use of medications with counseling and behavioral therapies to address the physical and psychological aspects of addiction. Medications like buprenorphine or naltrexone may be prescribed to help reduce cravings, manage withdrawal symptoms, and prevent relapse. MAT can be an effective approach for individuals struggling with bath salts addiction, as it helps stabilize the individual while they engage in therapy and develop coping skills.
- Family Therapy: Bath salt addiction can impact the individual and their family members. Family therapy involves the participation of family members in the treatment process to address family dynamics, improve communication, and provide support for the individual in recovery. Strategic family therapy focuses on identifying and changing patterns of interaction within the family system that may contribute to or maintain substance abuse. This type of therapy aims to improve family relationships, build a supportive environment, and enhance the individual’s motivation for recovery.
Final Thoughts
Bath salt addiction is a serious and potentially life-threatening condition that is best treated with professional help. If you or a loved one are struggling with bath salts addiction, it’s crucial to seek immediate support and guidance from healthcare professionals and/or addiction specialists. Leaving the condition untreated can lead to severe physical and mental health consequences, including organ damage, psychosis, and even death. It’s important to remember that recovery is possible with the right treatment and support. With the help of evidence-based therapies, medication-assisted treatment, and a strong support system, individuals can overcome bath salts addiction and lead fulfilling lives in recovery. Never hesitate to reach out for help, as there are numerous resources available to assist you or your loved one on the journey to recovery.
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- National Institute on Drug Abuse (NIDA) – Bath Salts DrugFacts:
- Substance Abuse and Mental Health Services Administration (SAMHSA) – Behavioral Health Treatment Services Locator
- Partnership to End Addiction
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