The Bizarre Behaviors of Bath Salt Addicts

In the summer of 2012, a man was arrested in California for attacking an elderly woman with a shovel while claiming that he was an alien talking to Jesus. In late 2017, a group of four went on a bizarre, naked rampage in eastern Missouri, barking, breaking into buildings and showering in soda water. And in 2018, an individual was arrested in Stoke on Trent, UK for breaching the peace after “arguing with a garden gnome”.

All these stories have two things in common: seriously questionable behavior and bath salts. A lot of bath salts.

These formally-legal highs were sold as bath salts or sometimes plant food in an attempt to confuse the authorities and avoid any claim against the provider/seller that they were intended for human consumption. However, under EU and UK law, any substance sold as a “bath salt” automatically falls under the Cosmetics Regulations and if labeled “plant food”, under Horticultural Regulations and in either case must have an accurate list of ingredients on the label and available accurate safety information. In addition, any product sold must, under the Trades Descriptions Act, conform to its description. Consequently, irrespective of the drug’s legal status, sellers could be prosecuted under one or more of the above regulations. This approach  has helped the authorities in Northern Ireland tackle the problem.

Despite being banned in the US in 2011 and made illegal in the UK by 2016, both countries are still struggling to halt the spread of bath salts and the deranged damage they can cause. Police officers in the UK’s West Midlands are even warning of a growing “public health crisis” due to the cheap availability of the drugs.

So, what exactly are bath salts? And, more to the point, what kind of berserk chemicals do they contain?

Take It with A Pinch Of (Bath) Salt

Named for their visual similarity to actual bath salts, these dangerous drugs also go by PABS (psychoactive bath salts) and monkey dust, in the UK. But in the lab, they’re known as synthetic cathinones, due to their intentional similarity to the psychoactive substance.

“Cathinone itself is the primary psychoactive substance in the khat plant,” explains Dr. Brenda Gannon, Laboratory Director at Steep Hill Arkansas and published researcher of contemporary bath salts.

“But synthetic cathinones are chemical analogues of cathinone, which itself has been regulated under the Controlled Substances Act (under Schedule I) for decades.”

The khat plant that Gannon refers to is grown commercially in the Arabian Peninsula and the Horn of Africa. Commonly known as the ‘Tea of the Arabs’, users chew the plant’s bitter leaves to feel more alert. Khat supporters claim that the plant is as harmless as coffee or tea, but many government agencies warn of its amphetamine-like properties. Subsequently, sale and consumption are illegal in most European and North American countries.

But synthetic cathinones are different. While they still interact with the brain’s monoamine systems to produce the cocaine-like effects of real cathinones, the synthetic versions are often more potent and created in clandestine, unregulated labs, and so can contain chemicals hitherto unknown to a forensic investigator. Week-to-week, the substances can contain completely different, and dangerous molecules – the kind that might lead to a fight with a garden gnome.

“The chemical structure of cathinone can be altered at several distinct sites, including substitutions on the aromatic ring, on the amine, or along the carbon chain,” Gannon says.

“Because of this, there have been hundreds of synthetic analogues identified already, and more are likely to emerge. In many cases, the synthetic cathinones were specifically created to evade detection.”

Forensic Cathinones 

As demonstrated in the regularly reported ‘crazy bath salt stories’ from around the world, these novel additives can have dangerous, life-threatening effects. In July 2018, the US Food and Drug Administration even warned about the risks of consuming synthetic drugs contaminated with rat poison. Half-jokingly, many products are often labeled ‘not for human consumption’.

“In terms of identifying the specific drugs present in abused bath salt preparations, you can't detect what you're not already looking for,” says Dr. William Fantegrossi, Associate Professor of Pharmacology and Toxicology at the University of Arkansas for Medical Sciences. From bath salts to spice, hallucinogens to illegal highs, Fantegrossi and his team at Arkansas research the most unregulated drugs with a high potential for abuse.

“Obtaining pure analytical standards of new synthetic cathinones often takes time, and during that time some drugs can go undetected because we simply don’t yet have the assay conditions to find them,” he says.

“By the time we have established a method to detect a new drug, others have emerged to take its place.”

So, in this dangerous game of escalation, what can analysts do to stay ahead?

“As far as screening goes,” Fantegrossi says. “There are standard test tube methods to rapidly determine the sites of action for these compounds. But animal models are absolutely required to verify that these actions produce biological effects.”

These animal experiments usually involve assays in the brain neurons of rats and mice, followed by some intravenous methods to dissect the damage. Through these behavioral assays, Fantegrossi and his team can determine the drug’s tissue distribution and disposition, its neurotoxicity, molecular correlates of tolerance and withdrawal.

But when a drug’s molecular makeup can change from week-to-week, there’s always more to learn. And the drug-addled remains of a rat can only teach one so much.

“While we’ve learned a lot (in a relatively short amount of time) about the acute effects of the synthetic cathinones under controlled laboratory conditions, we don’t know much about how these drugs function in the settings in which they are typically used,” Fantegrossi explains.

“Out in the world, bath salt users repeatedly administer drugs over a period of hours to days, and the product they’re using may contain more than one synthetic cathinone. Moreover, the effects of drugs are often powerfully impacted by environmental variables like crowding, hot ambient temperatures, and even loud noises.”

“Many of these factors are present in the typical settings in which humans abuse these drugs, but unless we specifically design experiments to address these factors in the laboratory, we miss out on important information.”

What the Future Holds

For most, bath salts are just an amusing source of outlandish stories. Stories of bizarre capers and zombified perpetrators. But for the vulnerable users and the police and health professionals that deal with them, bath salts are anything but amusing; they’re a public health issue that needs addressing.

“New analogues of these drugs continue to emerge all over the world, and each one may have unique or unexpected pharmacological properties, including addiction potential, paranoia, hallucinations, cardiotoxicity, or even lethality,” adds Fantegrossi.

In this dangerous drugs/forensics arms race, research like Dr. Fantegrossi’s and Dr. Gannon’s is still the only way to get ahead. As bath salts are illegal in the US, UK and many other countries, any experiments with human subjects are nearly impossible to carry out.

For now, chemical- and animal-based research are analysts’ best bets. Only through these methods can scientists better understand these drugs and come closer to producing new therapies and helping habitual users recover from their substance abuse.