'Bath Salts' Drug Trend: Expert Q&A

Medically Reviewed by Brunilda Nazario, MD on February 26, 2013

"Ivory Wave," "Purple Wave," Vanilla Sky," and "Bliss" are among the many street names of so-called designer drugs known as “bath salts,” which have sparked thousands of calls to poison centers across the U.S.

These drugs contain synthetic chemicals that are similar to amphetamines. Some, but not all, of the chemicals used to make them are illegal.

What Are Bath Salts?

"Is this what we put in our bathtubs, like Epsom salts? No," says Zane Horowitz, MD, an ER doctor and medical director of the Oregon Poison Center.

These drugs have nothing to do with real bath salts -- or "jewelry cleaner," or "plant food," or "phone screen cleaner," which they're also sometimes called, according to the National Institute on Drug Abuse.

Exactly which chemicals are in the drugs isn't known.

"The presumption is that most ‘bath salts’ are MDPV, or methylenedioxypyrovalerone, although newer... derivatives are being made by illegal street chemists," Horowitz says. "Nobody really knows, because there has been no way to test for these substances. However, that is changing, and some tests for certain of these chemicals have been developed."

What Do People Experience When They Take Bath Salts?

The effects can include agitation, paranoia, hallucinations, chest pain, increased pulse, high blood pressure, and suicidal thinking/behavior, Horowitz says.

Suicidal thinking/behavior may last "even after the stimulatory effects of the drugs have worn off," Horowitz says. "At least for MDPV, there have been a few highly publicized suicides a few days after their use."

Are Bath Salts Illegal?

In July 2012, the Synthetic Drug Abuse Prevention Act made it illegal to possess, use, or distribute many of the chemicals used to make bath salts, including Mephedrone and MDPV. Methylone, another such chemical, remains under a DEA regulatory ban. In all, the law covers 26 chemicals, all of them ingredients in synthetic drugs.

That's a "help," says DEA spokeswoman Barbara Carreno, "but we haven't controlled everything out there."

"The federal law passed [in 2012] bans a handful of the chemicals used to make them but not all of them," Horowitz says. "Those chemicals are now labeled as schedule 1 drugs, which means they have no medicinal value but a high potential for abuse."

Are Bath Salts Addictive?

"We don’t know if they are addictive. We have not had enough long-term experience with it," Horowitz says. However, he points out that many stimulant drugs do make people crave them.

The main problem is the toxic effects that these drugs have right away.

How Do People Take Bath Salts?

"They snort it, shoot it, mix it with food and drink," Horowitz says.

Where Do You See the 'Designer Drugs' Trend Going?

"Drug makers will keep creating new combinations at home and in illicit labs," Horowitz says.

"It’s almost impossible to keep up... Enforcement of the laws is difficult but it's getting better. But there's an ongoing battle between those trying to develop the technology to test for these chemicals and the street chemists who are trying to stay ahead of the law. Unfortunately, the law won't make this problem disappear. We're going to continue to see a lot of this type of thing. It will always be in the shadows."

Show Sources


Zane Horowitz, MD, emergency medicine specialist and medical director, Oregon Poison Center, Oregon Health & Science University.

Barbara Carreno, spokeswoman, U.S. Drug Enforcement Administration.

News release, U.S. Drug Enforcement Administration.

American Association of Poison Control Centers: "Bath Salts Data."

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