Bans help curb abuse of bath salts, officials say

Before Louisiana banned bath salts in January, pediatric emergency physician Corey Hebert, MD, saw one or two patients who were sick from the drugs every week. Some came to the emergency department convulsing; others were hyperaggressive or hypersexual.

None seemed the same after the effects wore off.

"They would take a hit and never come back. The drugs would change something mentally" in them, said Dr. Hebert, who works at Tulane University Medical Center in New Orleans.

Louisiana became the first state to prohibit chemicals used to make bath salts, when Gov. Bobby Jindal issued the emergency rule Jan. 6.

Since then, Dr. Hebert has not seen a patient come to the ED on the drugs.

"The ban got the people to stop selling bath salts because they knew [the state] would shut them down," he said.

More than 30 states have followed Louisiana's lead, taking steps to control or outlaw chemicals used to manufacture bath salts, according to the Drug Enforcement Administration. The chemicals most commonly banned are mephedrone, methylone and 3,4-methylenedioxypyrovalerone.

Two of the latest states to prohibit bath salts' substances are Delaware and Washington.

Delaware issued an emergency ban Sept. 30 on the three substances used to make bath salts. State authorities said a permanent ban is expected in 2012.

On Oct. 3, Washington approved a permanent ban on synthetic stimulants used to make bath salts. The permanent ban will replace a temporary one by Nov. 3.

Outlawing the critical chemicals used to manufacture bath salts is working in Florida, officials said.

Florida was the second state to prohibit the drugs when it implemented a temporary ban on the drugs in January. The state Legislature has since permanently prohibited six substances, including methylone, mephedrone and 3,4-methylenedioxypyrovalerone.

Since January, there has been a decrease in commercial sales of the drugs, which includes sales at convenience stores, said inspector David Gross of the Florida Dept. of Law Enforcement. He said arrests related to bath salts have been minimal.

Statewide data from the Florida Poison Information Center show that calls about exposure to baths salts, which include ingesting and inhaling the drugs, have decreased since the ban was implemented. Reported exposure peaked in January with 45 calls to the state. In September, the state received fewer than 10 calls on bath salts exposure.

Despite the progress, Gross said illicit sales of the drugs continue. Among the greatest challenges, he said, is that manufacturers of the products always are creating new formulas that use ingredients that have not yet been prohibited.

Gross said he has heard people say, "We can change the formula before you can change the law."

A national threat

Due to the severity of the problem, the DEA on Sept. 7 issued a notice of a temporary ban on three synthetic stimulants used to create bath salts. At this article's deadline, the agency said the ban will take effect in October.

The action will make possessing and selling the outlawed chemicals, or products that contain the substances, illegal for at least a year. During that time, the DEA and the Dept. of Health and Human Services will determine whether the chemicals should be permanently controlled.

"DEA has made it clear we will not hesitate to use our emergency scheduling authority to control these dangerous chemicals that pose a significant and growing threat to our nation," said DEA Administrator Michele M. Leonhart.

In Delaware, State Rep. Rebecca Walker and other officials are working with the attorney general's office to draft legislation permanently banning bath salts. She said users of the drugs have been treated in emergency departments throughout the state.

Bath salt users "are so out of control and violent that they've injured nurses and EMS providers, making it difficult to provide the necessary treatment," Walker said. "My biggest concern is for members of the community who may be violently attacked."

Nationwide, calls to poison control centers about exposure to bath salts have surged since 2010, when physicians began seeing patients who were under the influence of the drugs.

There have been more than 4,700 such calls to poison control centers so far this year, according to Aug. 31 data from the American Assn. of Poison Control Centers. That figure jumped from 303 such calls in 2010. Not all exposures are poisonings or overdoses, the organization said.

The American Medical Association adopted policy supporting a national ban on bath salts at its June Annual Meeting in Chicago.