(Press-News.org) Philadelphia, Pa. (June 4, 2013) –The last few years have seen the emergence of a new drug problem in so-called "bath salts"—actually "designer stimulants," packaged and sold in ways that skirt drug laws. A review and update on these designer drugs is presented in the June Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
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 in this issue of JAM. The paper provides a timely update including implications for medical management and drug policy.
Rapid Rise in Abuse of 'Designer Stimulants'
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 U.S. 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. The picture is often complicated by use of other drugs and underlying mental illness.
Serious acute (short-term) toxic effects of substituted cathinone stimulants have been reported—including deaths resulting from medical complications and suicide. Chronic (long-term) toxicity has also been observed, with evidence of tolerance, withdrawal, and dependence.
More Study Needed to Guide Drug Treatment and Regulation
To illustrate the dangers, Dr Gunderson and colleagues present a case report of a patient who developed hallucinations, delusions, and potentially violent behavior after a three-week "bath salt binge." The findings suggest a possible interaction with the antihistamine diphenhydramine (Benadryl)—which users commonly take to manage insomnia caused by the drugs' stimulant effect.
Substituted cathinone products are still new, so there are no formal guidelines for medical treatment of acute toxicity. Experience suggests that physical symptoms resolve after a few days, with supportive care. However, psychotic effects such as hallucinations may persist for a longer time. Intoxicated patients need close psychiatric observation and monitoring to keep them from harming themselves or others.
Treatment following acute care, according to Dr Gunderson and coauthors, should follow guidelines for treatment of other stimulant use disorders. In theory, substituted cathinone stimulants are controlled substances under current U.S. law. However, because of Internet distribution and the "forensic challenges" in identifying these substances, they have been difficult to police and regulate.
Dr Gunderson and coauthors highlight the need for further research on the "epidemiology, behavioral pharmacology, clinical effects and management" of substituted cathinone products. They write, "It is hoped that such research and coordinated public health efforts will help prevent and mitigate the rising harm associated with designer stimulant use."
###
About Journal of Addiction Medicine
The mission of Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical specialty. Published quarterly, the Journal is designed for all physicians and other mental health professionals who need to keep up-to-date with the treatment of addiction disorders. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics.
About the American Society of Addiction Medicine
The American Society for Addiction Medicine is a professional society representing over 3,000 physicians dedicated to increasing access and improving quality of addiction treatment, educating physicians and the public, supporting research and prevention, and promoting the appropriate role of physicians in the care of patients with addictions.
About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.
LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2012 annual revenues of €3.6 billion ($4.6 billion).
END
Pebbles and sand scattered near an ancient Martian river network may present the most convincing evidence yet that the frigid deserts of the Red Planet were once a habitable environment traversed by flowing water.
Scientists with NASA's Mars Science Laboratory mission reported May 30 in the journal Science the discovery of sand grains and small stones that bear the telltale roundness of river stones and are too heavy to have been moved by wind. The researchers estimated that the sediment was produced by water that moved at a speed between ...
DURHAM, N.C. -- Using a novel genetic 'editing' technique, Duke University biomedical engineers have been able to repair a defect responsible for one of the most common inherited disorders, Duchenne muscular dystrophy, in cell samples from Duchenne patients.
Instead of the common gene therapy approach of adding new genetic material to "override" the faulty gene, the Duke scientists have developed a way to change the existing mutated gene responsible for the disorder into a normally functioning gene. The Duke researchers believe their approach could be safer and more ...
A team of researchers including members of the University of Chicago's Institute for Molecular Engineering highlight the power of emerging quantum technologies in two recent papers published in the Proceedings of the National Academy of Sciences (PNAS). These technologies exploit quantum mechanics, the physics that dominates the atomic world, to perform disparate tasks such as nanoscale temperature measurement and processing quantum information with lasers.
The two papers are both based on the manipulation of the same material, an atomic-scale defect in diamond known ...
Rosemont, Ill. - The American Academy of Orthopaedic Surgeons (AAOS) recently released its revised clinical practice guideline (CPG) on the treatment of osteoarthritis of the knee, addressing two key changes. Most of the remaining recommendations provided in the 2009 CPG go unchanged. CPGs are not meant to be stand-alone documents, but rather serve as a point of reference and educational tool for both primary care physicians and orthopaedic surgeons.
The original guideline, as well as this revised version, was developed to include only treatments which are less invasive ...
For many older adults, the aging process seems to go hand-in-hand with an annoying increase in clumsiness — difficulties dialing a phone, fumbling with keys in a lock or knocking over the occasional wine glass while reaching for a salt shaker.
While it's easy to see these failings as a normal consequence of age-related breakdowns in agility, vision and other physical abilities, new research from Washington University in St. Louis suggests that some of these day-to-day reaching-and-grasping difficulties may be be caused by changes in the mental frame of reference that ...
URBANA, Ill. – Products derived from coconuts and oil palm trees are the primary protein sources in swine diets in parts of Africa, southeast Asia, South America, and Europe. New research from the University of Illinois is helping to establish the nutritional value of these products.
"In many countries in the world, and particularly in the tropics, copra and palm kernel products are the main protein sources for livestock. You also see palm kernel products and copra products fed throughout Latin America and in some countries in Europe," said Hans H. Stein, a U of I professor ...
CORVALLIS, Ore. – Scientists in the College of Veterinary Medicine at Oregon State University have developed a new, inexpensive and precise way to detect the toxin secreted by Vibrio tubiashii, a bacterial disease that a few years ago caused millions of dollars in losses to the oyster aquaculture industry in the Pacific Northwest.
When perfected and commercialized, the new assay should give oyster growers an early warning system to tell when they have a problem with high levels of this toxin and must take quick steps to address it. Findings were just published in the ...
A flash of light from a stellar outburst has provided a rare look at the 3-D structure of material ejected by an erupting nova.
Astronomers used NASA's Hubble Space Telescope to observe the light emitted by the close double-star system T Pyxidis, or T Pyx, a recurring nova, during its latest outburst in April 2011.
A nova erupts when a white dwarf, the burned-out core of a sun-like star, has siphoned off enough hydrogen from a companion star to trigger a thermonuclear runaway. As hydrogen builds up on the surface of the white dwarf, it becomes hotter and denser until ...
PHILADELPHIA (June 4, 2013)— Living in a neighborhood that supports a healthy lifestyle can make a measurable difference in preventing obesity, according to a longitudinal study recently published in the journal Obesity.
The five-year study found that significantly fewer people became obese when living in neighborhoods with healthier food environments, compared to those who had fewer healthy food options within a mile of their homes.
Previous cross-sectional "snapshot" studies have shown that healthier, less-obese people are more likely to live in neighborhoods with ...
VIDEO:
Our understanding of what lies beneath the world's biggest ice sheet has taken another leap forward. This video strips away Antarctic ice to reveal a new, and much more detailed...
Click here for more information.
A new dataset called Bedmap2 gives a clearer picture of Antarctica from the ice surface down to the bedrock below. Bedmap2 is a significant improvement on the previous collection of Antarctic data—known as Bedmap—that was produced more than 10 years ago. ...
