Overdoses caused by “bath salts,” the latest form of designer drugs finding their way into the community, have increased since fall 2011 at Central Peninsula Hospital.
“It probably has been a couple per month,” said Dr. Robert Emmick, emergency room physician at CPH.
The drugs contain stimulants that act like methamphetamine and cocaine, but produce the added effect of hallucinations, according to the National Institutes of Health. The main stimulants are Mephedrone and Methylenedioxypyrovalerone (MDPV).
Users typically snort, inject or smoke the drugs, which come in powder and crystal forms.
People exhibiting “bath salt” symptoms continue to appear at CPH. Central Peninsula law enforcement officials are knowledgeable about the harmful drugs and monitor the problem while the state addresses regulation.
Kenai Police Chief Gus Sandahl first heard about “bath salts,” also called “plant food” and “air freshener,” last year. Officers at KPD have reported few instances of sales or use of the drugs. The chemical structures of the drugs are modified to avoid provisions of existing illegal substance laws.
Local usage of the drugs often is reported after the fact, Sandahl said.
Information regarding residents entering treatment because of the drugs’ use reaches the department. However, officers have conducted few investigations involving “bath salts,” he said.
Law enforcement officials on the Central Peninsula are not aware of local stores selling the drugs.
The drugs are legal under state law. But legislation introduced by Sen. Kevin Meyer, R-Anchorage, soon could change the legal status. The Alaska Senate passed a bill on March 6 aiming to classify the drugs as schedule IIA controlled substances. SB140 has moved to the House for consideration.
The U.S. Drug Enforcement Administration temporarily banned the drugs in October 2011. The DEA’s emergency action is in effect for a year while government agencies determine how to regulate products containing certain chemicals.
Sandahl said he believes use of the drugs on the Peninsula has remained the same or slightly reduced since the federal ban. People likely will continue to find chemicals that replicate the effects of illegal drugs, he added.
“We’re still battling that problem, and I wish there was a more comprehensive list of illegal chemicals,” he said.
When patients overdosing on the drugs enter CPH, they predominantly exhibit altered mental states, Emmick said.
“I would say they have psychotic features where they’re agitated and not aware of their surrounds,” he said. “It’s very similar to the effects of PCP.”
Doctors and clinicians at U.S. poison centers have indicated that ingesting or snorting “bath salts” containing synthetic stimulants cause chest pains, increased blood pressure, increased heart rate, agitation, hallucinations, extreme paranoia and delusions, according to the National Institutes of Health.
Patients also have associated electrolyte abnormalities and metabolic acidosis, meaning their blood is more acidic. Respiratory acidosis, a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces, in combination with a lack of blood flow may cause brain damage, Emmick said.
Knowledge about the drugs’ chemical composition and short- and long-term effects is limited.
“In my opinion, it could be assumed the long-term effects would be similar to prior designer type drugs, like ecstasy,” he said.
Many animal studies have yielded evidence that ecstasy use causes a variety of behavioral and cognitive deficiencies, as well as impairing memory. The applicability of these results to humans has been vigorously contested, according to the Western Journal of Medicine.
People who use “bath salts” may have an impression the drugs are safer, Emmick and Sandalh said. The drugs can be found on the Internet, where they are marketed under gentle names like “Vanilla Sky.”
When patients are no longer under the effects of the drugs, they have told doctors at CPH the drugs induce milder side effects, Emmick said.
“They feel that they are safe and do not expect to suffer any ill side effects or long-term problems,” he said. “There are adverse side effects in the immediate.”
The drugs gained a following because they are not detectable by standard drug screening. As a result, the Alaska Department of Health and Social Services has recommended health providers include “bath salts” in substance abuse screening discussions.
Sandahl said he has read literature about the drugs destroying families nationwide. His main concern is use without personal knowledge of its chemical components.
“People really don’t know what they’re ingesting when they buy this stuff,” he said.
Jerzy Shedlock can be reached at firstname.lastname@example.org