Bath Salt Addiction and Abuse Fort Lauderdale, FL

Cathinone is a naturally occurring stimulant drug.

When we think of stimulant drugs being abused on the streets, we think of crystal meth or prescription amphetamines, such as Adderall or Ritalin. These drugs are either illegal or highly controlled. However, there is a class of synthetic stimulants that are similar to a naturally occurring drug known as cathinone. Cathinone is a stimulant drug which is similar to amphetamine. Methcathinone is a methylated form which is similar to methamphetamine. Cathinone is sometimes known as “cat” or “crank”. The midwest has seen the use of these drugs at epidemic proportions going back at least to the 90s. The name “crank” comes from motorcycle-riding dealers and curriers carrying the drug in the crank-case of their bike. In recent years, we have seen a variety of synthetic versions of cathinone being marketed online and in gas stations and convenience stores as bath salts.

Not for human consumption.

MDPV is one ingredient that is found in bath salts. It was first synthesized in the 60s. Mephedrone is another drug sold as bath salts. MDPV, mephedrone, and other varieties of the drug are packaged as bath salts with the printed warning that they are not for human consumption. That warning, and the altered chemistry, were a way around the drug laws, and they no longer work. The DEA placed MDPV, mephedrone, and methylone under emergency control in 2011, and the Synthetic Drug Abuse Prevention Act of 2012 made MDPV and mephedrone Schedule I drugs. Florida banned them in 2011. The federal government is constantly playing a game of cat and mouse with laboratories and retailers to keep up with making new versions of the drug illegal.

Flakka was the next version, and here in Fort Lauderdale it was the drug story of 2015. Its chemical name is alpha-PVP, which is MDPV with one piece of the molecule removed, so it belongs to the same cathinone family, and it sold for a few dollars a dose as small crystals. The DEA placed it under emergency control in 2014 and later made it a permanent Schedule I drug. The Broward County wave ended after China made the drug a controlled substance in late 2015, and the local emergency rooms went quiet within months.

Bath salts can cause violent behavior, agitation, and hallucinations.

There was a well-known news story years ago about a Florida man eating another man’s face off. Since bath salts were also a big story in the news at the time, it was concluded by many people that the man must have been high on bath salts. Since it was known that bath salts could make people unstable, violent, and agitated, people who took them were known to act out unpredictably. It seemed reasonable that bath salts abuse might lead to such a face-eating incident. While police strongly suspected bath salts as a cause of the man’s cannibalistic behavior, the medical examiner ruled it out after toxicology results came back. However, experts stated that due to the nature of ingredients in bath salts varying so much, it is possible that they did not test for all possible forms of bath salts ingredients.

Flakka earned the same reputation honestly. The Broward County stories were of people running naked through traffic, convinced that someone was chasing them, and the medical picture behind them was a body temperature high enough to damage the muscles and kidneys, a racing heart, and a paranoia that can outlast the drug by days. A person in that state needs an emergency room, not a lecture, and someone needs to call 911 before the overheating does its damage.

Is bath salts addiction a concern?

Yes, bath salts, like any other amphetamine-like substance, can be highly addicting. The addiction can be long-lasting. A person who has been off the drug for months or years may find that one more use brings the cravings back quickly.

Stopping a synthetic cathinone after a binge brings a crash, a day or more of sleep, a flat mood, and a large appetite, but not the medically dangerous withdrawal that stopping a benzodiazepine or alcohol produces. So, flakka is an addiction problem and not a physical dependence problem, and there is nothing to taper. The danger is in the using, and in how hard it pulls a person back.

Treatment options for designer drugs.

The treatment of addiction to drugs such as MDPV and mephedrone is similar to treatment of any stimulant addiction. One additional concern is that some of these synthetic designer stimulants may not show up on a standard drug test. In this case, it is important to order an extended panel of drugs that are calibrated to pick up many of the newer designer drugs.

There is no medication for stimulant addiction the way buprenorphine is a medication for opioid addiction, and no detox facility can change that. What helps is slower work with a doctor or counselor who does not argue with the patient: motivational interviewing, which starts from the person’s own reasons for wanting to stop, and cognitive behavioral therapy, which works on the habits around the drug. Their track record comes from cocaine and methamphetamine, and they have not been studied on flakka itself, so they probably help and nobody knows how much. Whether Dr. Leeds can help a particular person is decided at a consultation, not from a web page.

This article is educational. It is not medical advice, and reading it does not create a doctor-patient relationship. Decisions about starting, continuing, or tapering any medication should be made with your own physician.