A new drug problem in so-called "bath salts"-actually "designer stimulants," packaged and sold in ways that skirt drug laws have emerged in the last few years.
Recent high-profile incidents have drawn attention to "bath salts" as a new and potentially hazardous type of recreational drug.
Addiction medicine specialist Dr Erik W. Gunderson of University of Virginia, Charlottesville, and colleagues, review available data on the use and effects of these designer drugs.
The paper provides a timely update including implications for medical management and drug policy.
Over the last few years, products containing "substituted cathinone stimulants" have become widely available for sale on the Internet and elsewhere.
To evade legal controls, the stimulants are sold as bath salts, stain removers, or other household products.
Although packages are conspicuously labeled "not for human consumption," they are clearly intended for "use as psychoactive substances," according to Dr Gunderson and coauthors.
Initially more prominent in Europe, designer stimulants have become a problem in the United States over the last few years.
The number of calls to US poison control centers regarding substituted cathinone stimulants increased from zero in 2009, to about 300 calls in 2010, to more than 6,000 in 2011.
The chemical components of these products vary widely, and the mechanisms of their effects in humans are still unclear.
As of yet, standardized testing to detect their use is not easily accessible.
The effects are generally similar to those of cocaine, amphetamine, and other stimulants but vary with compound, dose, and route of administration.
Users may sniff or swallow the drugs, or even inject them.
Reported symptoms in patients treated for acute toxicity include agitation, fast heart rate, and combative or violent behavior, potentially accompanied by delusions or hallucinations.
A review and update on these designer drugs is published in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine.