“Oh yeah, me and my girlfriend have a big bag of lavender bath salts sitting at home,” was the initial reaction when I asked a fellow engineer to portray as a testimonial for our borderline inappropriate bath salts infomercial. Contrary to popular belief, this new synthetic drug is far away from producing any effects that are similar to that of a relaxing bath. Until recently, bath salts were popularized to be a “legal high.” In order to tip toe around the federal drug regulatory laws, bath salts were marked with a warning label that mentioned “not for human consumption.” In South Carolina, before the ban on October 24th 2011, bath salts could be purchased at one of the many head shops, gas stations, and even online. The appearance of the drug itself is usually in a powdered form that is sold within a package that is very aesthetically pleasing. These packages are sold under a variety of appealing names such as Ivory Wave, Vanilla Sky, Bliss, Blue Silk and etc. The composition of the synthetic drug bath salts can vary from dealer to dealer. Sometimes you may find traces of other stimulant drugs such as cocaine, amphetamines, or ecstasy, but the most important culprit in bath salts is 3,4-methylenedioxypyrovalerone (MDPV). MDPV falls under the category of phenethylamines and it is structurally related to synthetic cathinones. Synthetic cathinones are a group of drugs that are derivatives of the natural plant Catha edulis (also known khat), that contain the chemical phenylalkylamine alkaloid (Coppola, 2011). The remainder of the paper will provide some of the current available information such as pharmacokinetics, neurophysiology, and a brief discussion about MDPV as the primary active ingredient in bath salts. Pharmacokinetics
The routes of administration of bath salts are similar to that of drugs in the “salt” class. The most common method is insufflation which results in faster onset of the effects but does not have a long duration. There are also other routes of administration preferred by drug enthusiasts; these mechanisms include parietal injections, intravenously, “bombing,” and also rectal administration. The “bombing” method involves putting the salt crystals in to cigarette paper to form a capsule and then simply swallowing it. The rectal administration requires an individual to dissolve the salt crystals in a type of liquid vehicle (i.e. water) and then introduce the liquid to the rectum via the anus.
The absorption of MDPV is primarily dependent on the route of administration. The nasal route obviously has the quickest absorption. On the other hand, the oral administration is absorbed poorly because when taken orally, the rate of absorption compares to that of cocaine. The metabolism of MDPV in the human liver occurs similarly to that of other synthetic cathinone. The process involves multiple steps and the last of which is where the catechol ring of MDPV is methylated by COMT (Prosser, 2011). COMT is one of several enzymes that are involved in the degradation of catecholamines (i.e. dopamine, norepinephrine, and epinephrine). Finally, after the metabolism, the excretion of MDPV waste occurs through the urine of feces. Since there are no published, the duration of the effects of MDPV must be recorded with the word of mouth from experienced users. The drug effects start presenting themselves approximately 10-20 minutes after nasal administration and duration is close to 2.5 hours. With oral administration, users report the effect to set in between 15-45 minutes after ingestion and the duration can last anywhere from 3-4 hours (in rare cases as much as 12 hrs) (Psychonaut, 2009). Neurophysiology
As mentioned previously, due to the limited amount of available information for understanding the mechanism of physiological action of MDPV, the neurophysiology is theorized to have a similar mechanism to that of amphetamines and MDMA. This comparison is highly...