A new "Ivory Wave" of synthetic drugs
Video from Mitigation Journal
PumpIt!, Ivory Wave, and Bath Salts
are just a few of the label names of a synthetic drugs that are causing
intoxication similar to Ecstasy and methamphetamine. These synthetics
are often sold in convenience stores, on line, and in your neighborhood
may also be labeled as an enhanced plant food...some printed with the
warning "not for human consumption". Few, it seems, are heeding that
warning as the Centers for Disease Control (CDC) and National Institute of Health (NIH)
are calling attention to the growing numbers of emergency department
visits, hospital intensive care admissions, and deaths linked to use of
Bath Salts. As a example to their popularity, YouTube hosts hundreds of videos on this topic.
Not
unlike other drugs, these materials are being swallowed, snorted,
smoked, injected or otherwise consumed by a growing population that
crosses age, economic, and social barriers.
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| From K2Incenseonline.com |
Common chemical ingredients include:
- Cathinone - a monoamine alkaloid that is similar to ephedrine and amphetamine. Cathinone has toxic side effects of anorexia, anxiety, irritability, insomnia, hallucinations and panic attacks. This chemical is also known as Khat and is found in plant food.
- Mephedrone - a substance known to produce methamphetamine-like reactions in rats.
Patient presentation
Bath
Salts, PumpIt! and similar drugs have been compared to a combination of
Ecstacy, cocaine and methamphetamine. According to both CDC and NIH
consumption of these and similar products results in symptoms
resembling stimulant overdose. Since these drugs often lack an immediate
effect, users frequently increase their intake resulting in overdose
situations with neurological and cardiovascular dysfunction including
acute myocardial infarction (AMI). Rhabdomylysis has also been reported.
The
major psychiatric componant associated with these materials is a
psychosis that can last for days. psychotic symptoms may include:
- loss of contact with reality
- false beliefs
- hallucinations/delusions
- disorganized thinking and speech
Patients testing positive for Bath Salt use often test positive for other substances. Be on the lookout for indications and side effects of polypharmaceutical overdose!If all that's not good enough, intramuscular injection of Bath Salts is linked to aggressive cellulitis and necrotizing fasciitis or flesh eating soft tissue infections. For more on the link between cellulitis/necrotizing Fasciitis see this report from Z6Mag
Its like methamphetamine, cocaine, and Ecstasy...not exactly.
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| Image from Z6Mag |
- Like meth, Bath Salt cause a spike in dopamine levels causing users develop a craving quickly. "Dopamine burnout" is a factor in the abuse potential.
- Like Ecstasy, there is an increase in serotonin. With continued use, an eventual inability to react to serotonin develops and is related to increased use and binging.
- Like both meth and Ecstasy chronic use increases the risk of personality disorders and AMI
Treatment
Treatment is mainly supportive and based on symptoms. Sedation, benzodiazapine, and anti psychotics may be used (refer to local standards). Because of the risk of polypharmacy use, treatment and recognition may be difficult.
Scope
As reported in Morbidity and Mortality Weekly Report (MMWR), May 2011, and reported in numerous other publications, the scope and severity of this situation is increasing. According to the MMWR report, in a sampling of 35 patients who reported to a Michagan emergency department had the following findings:
- symptoms similar to stimulant intoxication
- 32 patients had neurological symptoms
- 27 patients had cardiovascular symptoms
- many tested positive for other drugs
- Hospital admits were to the ICU, medical floors, and psychiatry
Operational Considerations
There is an increased risk of multiple patients becoming intoxicated with these substance when used in groups. There may be risk for multi patient events. Be on the lookout for commonalities in patient complaints and presentations.
Further Information
The following links were helpful:
Centers for Disease Control and Prevention (CDC) www.cdc.gov
Morbidity and Mortality Weekly Report http://www.cdc.gov/mmwr/
National Institute of Health (NIH) http://www.nih.gov/
YouTube > search keywords: Bath Salt, Spice, K2, Ivory Wave, PumpIt! Power Drug
