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"Bath Salts" - Emerging and Dangerous Products

"Bath Salts", the newest fad to hit the shelves (virtual and real), is the latest addition to a growing list of items that bath salts posteryoung people can obtain to get high. The synthetic powder is sold legally online and in drug paraphernalia stores under a variety of names, such as "Ivory Wave," "Purple Wave," "Red Dove," "Blue Silk," "Zoom," "Bloom," "Cloud Nine," "Ocean Snow," "Lunar Wave," "Vanilla Sky," "White Lightning," "Scarface," and "Hurricane Charlie." Because these products are relatively new to the drug abuse scene, our knowledge about their precise chemical composition and short- and long-term effects is limited, yet the information we do have is worrisome and warrants a proactive stance to understand and minimize any potential dangers to the health of the public.

We know, for example, that these products often contain various amphetamine-like chemicals, such as methylenedioxypyrovalerone (MPDV), mephedrone and pyrovalerone. These drugs are typically administered orally, by inhalation, or by injection, with the worst outcomes apparently associated with snorting or intravenous administration. Mephedrone is of particular concern because, according to the United Kingdom experience, it presents a high risk for overdose. These chemicals act in the brain like stimulant drugs (indeed they are sometimes touted as cocaine substitutes); thus they present a high abuse and addiction liability. Consistent with this notion, these products have been reported to trigger intense cravings not unlike those experienced by methamphetamine users, and clinical reports from other countries appear to corroborate their addictiveness. They can also confer a high risk for other medical adverse effects. Some of these may be linked to the fact that, beyond their known psychoactive ingredients, the contents of "bath salts" are largely unknown, which makes the practice of abusing them, by any route, that much more dangerous.

Unfortunately, "bath salts" have already been linked to an alarming number of ER visits across the country. Doctors and clinicians at U.S. poison centers have indicated that ingesting or snorting "bath salts" containing synthetic stimulants can cause chest pains, increased blood pressure, increased heart rate, agitation, hallucinations, extreme paranoia, and delusions. It is noteworthy that, even though we are barely two months into 2011, there have been 251 calls related to "bath salts" to poison control centers so far this year. This number already exceeds the 236 calls received by poison control centers for all of 2010. In response to this emerging threat, several states, including Hawaii, Michigan, Louisiana, Kentucky, and North Dakota, have introduced legislation to ban these products, which are incidentally labeled as "not fit for human consumption." In addition, several counties, cities, and local municipalities have also taken action to ban these products.

We will continue to monitor the situation and promote research on the extent, pharmacology, and consequences of "bath salts" abuse. In the meantime, I would like to urge parents, teachers, and the public at large to be aware of the potential dangers associated with the use of these drugs and to exercise a judicious level of vigilance that will help us deal with this problem most effectively.


Nora D. Volkow, M.D.
National Institute on Drug Abuse


“Spice” refers to a wide variety of herbal mixtures that produce experiences similar to marijuana (cannabis) and that are marketed as “safe,” legal alternatives to that drug. Sold under many names, including K2, fake weed, Yucatan Fire, Skunk, Moon Rocks, and others—and labeled “not for human consumption”—these products contain dried, shredded plant material and chemical additives that are responsible for their psychoactive (mind-altering) effects.

False Advertising

Labels on Spice products often claim that they contain “natural” psycho-active material taken from a variety of plants. Spice products do contain dried plant material, but chemical analyses show that their active ingredients are synthetic (or designer) cannabinoid compounds.

For several years, Spice mixtures have been easy to purchase in head shops and gas stations and via the Internet. Because the chemicals used in Spice have a high potential for abuse and no medical benefit, the Drug Enforcement Administration (DEA) has designated the five active chemicals most frequently found in Spice as Schedule I controlled substances, making it illegal to sell, buy, or possess them. Manufacturers of Spice products attempt to evade these legal restrictions by substituting different chemicals in their mixtures, while the DEA continues to monitor the situation and evaluate the need for updating the list of banned cannabinoids.

Spice products are popular among young people; of the illicit drugs most used by high-school seniors, they are second only to marijuana. Easy access and the misperception that Spice products are “natural” and therefore harmless have likely contributed to their popularity. Another selling point is that the chemicals used in Spice are not easily detected in standard drug tests.


The House gave early approval today to a bill that would ban salvia divinorum, a legal hallucinogen. It would classify the plant as a controlled substance, punishable by a class A misdemeanor and a fine of up to $4,000.

The drug is being used primarily by high school students. "The problem is that we have a potent hallucinogen that's readily available," Anderson said. "And a lot of kids are being peer pressured into using it simply because it's legal."

Anderson added that the drug's danger lies in its unpredictability, as its effects last anywhere from five to 30 minutes, with hangover effects lasting several hours.

Though many municipalities in Texas have placed criminal restrictions on salvia, it is still actively distributed in some head shops and, more frequently, online.

This isn't the first go-around for salvia in the Legislature. Bans were proposed in 2007 and 2009, but the lack of public knowledge of salvia's effects has stalled legislative action, Anderson said. But he added that legislators are well-versed this session in the drug's effects and said he's hopeful the ban will pass.

The bill will be taken up for a final vote tomorrow.

More on Salvia

Salvia (Salvia divinorum) is an herb common to southern Mexico and Central and South America. The main active ingredient in Salvia, salvinorin A, is a potent activator of kappa opioid receptors in the brain.1,2 These receptors differ from those activated by the more commonly known opioids, such as heroin and morphine.

Traditionally, S. divinorum has been ingested by chewing fresh leaves or by drinking their extracted juices. The dried leaves of S. divinorum can also be smoked as a joint, consumed in water pipes, or vaporized and inhaled. Although Salvia currently is not a drug regulated by the Controlled Substances Act, several States and countries have passed legislation to regulate its use.3The Drug Enforcement Agency has listed Salvia as a drug of concern and is considering classifying it as a Schedule I drug, like LSD or marijuana.

Health/Behavioral Effects

People who abuse Salvia generally experience hallucinations or “psychotomimetic” episodes (a transient experience that mimics a psychosis).4,5 Subjective effects have been described as intense but short-lived, appearing in less than 1 minute and lasting less than 30 minutes. They include psychedelic-like changes in visual perception, mood and body sensations, emotional swings, feelings of detachment, and importantly, a highly modified perception of external reality and the self, leading to a decreased ability to interact with one’s surroundings.5 This last effect has prompted concern about the dangers of driving under the influence of salvinorin. The long-term effects of Salvia abuse have not been investigated systematically. Recent experiments in rodents demonstrated deleterious effects of salvinorin A on learning and memory.6

Extent of Use

NIDA’s Monitoring the Future Survey of 8th, 10th, and 12th graders asked about Salvia abuse for the first time in 2009—5.7 percent of high school seniors reported past-year use (greater than the percent reporting ecstasy use). And according to the latest MTF figures the use of Salvia reported by 8th, 10th, and 12th graders remained unchanged from 2010 to 2011, with 1.6 percent of 8th graders, 3.9 percent of 10th graders, and 5.9 percent of 12th graders reporting past-year abuse. Although information about this drug is limited, its abuse is likely driven by drug-related videos and information on Internet sites.3 Because of the nature of the drug’s effects, its use may be restricted to individual experimentalists, rather than as a social or party drug.5


  1. , new neoclerodane diterpenes from Salvia divinorum. Organic Letters. ttp://
  2. Roth, B.L., et al. Salvinorin A: a potent naturally occurring plant.
  3. Chavkin, C., Sud, S., Jin, W. et al. Salvinorin A, an active component of the hallucinogenic sageSalvia divinorum is a highly efficacious kappa-opioid receptor agonist: structural and functional considerations. J Pharmacol Exp Ther. 308:1197–203, 2004.
  4. Harding, W.W., et al. Salvinicins A and B
  5. Ring non-nitrogenous kappa opioid selective agonist. Proc Natl Acad Sci. 99:11934–11939, 2002.
  6. Gonzalez, D., et al. Pattern of use and subjective effects of Salvia divinorum among recreational users. Drug Alcohol Depend. 85:157–162, 2006.