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Parents take heed: Abuse of so-called “bath salt” products – first noted last year – appears to be on the rise.

The products – sold in small, colorful packets at retail outlets, such as gas stations and tobacco shops – are marketed as “bath salts,” but users, primarily adolescent and teen males, snort the powders to get high.

The Missouri Poison Center at SSM Cardinal Glennon Children’s Medical Center in St. Louis received 34 calls related to exposures and 11 calls from individuals simply asking questions, in the first six weeks of this year, more than all of 2010 and reflecting a national trend.

Manufacturers are adding synthetic hallucinogenic substances to the products now being marketed as bath salts, says Dr. Anthony Scalzo, medical director for the Missouri Poison Center and an emergency department physician at SSM Cardinal Glennon.

Although labeled for use in bath water, a wink-and-nod advertising campaign markets the products to users who are seeking to get high by ingesting the powders, he explains.

The products sell in small packets of about 50 milligrams for $25 to $50 each.

“It’s clear you would never pay that amount of money for a standard jar or box of bath salt. The products are intended to be abused, generally by snorting,” says Dr. Scalzo, who is also a professor at Saint Louis University School of Medicine.

One common hallucinogenic substance added is MDVP or mephedrone, a stimulant similar to the street drug “ecstasy,” Dr. Scalzo continues.

He notes that MDVP and related synthetic stimulants can cause a range of potentially harmful symptoms beyond the feeling of euphoria, including a rapid heart beat – which users requiring emergency care describe as a “pounding in the chest” – elevated blood pressure, panic attacks, hallucinations and paranoia.

Dr. Scalzo continues that unlike a prescription dug, the substances added undergo no testing for dosage or quality, so the degree of the effects – and how individual users may be affected – is uncertain.

Addiction has been documented, and Dr. Scalzo says that in worst cases he has seen in hospitalized patients, the victims suffer from severe hallucinations and paranoia.

“One 22-year-old man I saw had cuts to his hands from banging on the wall of his home; while under the influence he thought someone was inside the wall,” Dr. Scalzo adds.

While many states are reporting a significant jump in bath salt abuse, Louisiana leads the nation. The state has banned some products sold under the names “Cloud Nine” and “Bliss.”

Dr. Scalzo notes that the products are sold in colorful packets, with pleasant-sounding names related to bathing and aroma therapy or relaxation. Some use the words “safe” and “natural.”  Other recent product names on the market include “Vanilla Sky” and “Ivory Snow.”

Dr. Scalzo is consulting with officers from the DEA (Drug Enforcement Administration) and legislators in Missouri. Manufacturers often have the upper hand, Scalzo says, because the synthetic stimulants can be slightly modified quickly to circumvent regulation.

 “There are dozens of these compounds out there, so if you ban five of them – as the DEA did last year in an emergency control order (related to another abuse concern: fake marijuana known as ‘K2’), right away the makers have more in production.”

Dr. Scalzo says manufacturers boldly advertise new products on the Internet with a DEA-compliant “badge” and text that says the compounds are legal and safe. The knowledge of the “street chemistry” necessary to make the products is extensive, he continues, and he adds that production and packaging probably occurs in some home basements.

Dr. Scalzo also is working to increase education of the medical community about the products. He notes that personnel in emergency care, including paramedics and emergency room staff, may not be familiar with the symptoms. Reaching a diagnosis can be hampered because some of the stimulants may not be detected by drug screenings.

What can concerned parents do?

Dr. Scalzo urges parents to learn all they can about these substances and talk to their kids about the dangers.

Tips and signs that a youngster may be experimenting include agitation and paranoia. “If your son says, ‘Mom, is someone watching the house?’ that may be a red flag.”

Another sign: just acting out of character.  “If your son was never a touching feely kid and would never use bath salts to relax his feet, and now you’re finding these small colorful packets – obviously there’s reason for suspicion.”

Dr. Scalzo also advises parents to watch out for the youngster who is running through a lot of money. “If your kid is going through an inordinate amount of cash a week, and can’t account for it, that’s a big clue right there.”

While most users have been male – adolescents to early 20s – some teen girls and adult women have been treated for abuse as well, Dr. Scalzo adds.

 As with many challenges parents face, Dr. Scalzo urges talking to kids about risks.

“Parents know to talk to their kids about standard recreational drugs and to avoid drug dealers and to watch for dangers, but now it’s getting more sophisticated,” Scalzo says. “These dangerous compounds are being sold in mainstream places, so parents need to double up efforts to protect their kids.”

Anyone with urgent questions about a possible exposure or suspicion also can call the Poison Center. The national number – 1-800-222-1222 routes calls to the nearest regional center.

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