Bath salt - stimulants similar to ecstasy, are street-chemist versions of the middle eastern Khat plant, and are being associated with a new wave of extremely violent behavior, and fatal overdoses. The recent zombie-like attack in Miami galvanized public attention, when a homeless man had literally 3/4 of his face chewed off by someone high on bath salts. The assailant was shot and killed by police, because he would not stop, highlighting the dangers of these fairly new designer drugs.
These "bath salts" are chemically-related versions of Khat, which is a flowering plant native to the Horn of Africa and the Arabian Peninsula. Khat chewing has a long history as a social custom dating back thousands of years. It contains the alkaloid called cathinone, an amphetamine-like stimulant, which is said to cause excitement, loss of appetite and euphoria. The bath salt versions have been showing up all over the country (and world,) and It can be tens to hundreds of times more potent than the plant, causing extreme behaviors and serious bodily damage. The several variants of these drugs are not illegal in many places, with their chemical structure being changed rapidly as they become outlawed, and with virtually no tests for them.
HOWARD: Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions, I am Howard La Mere. The story that is on everyone's mind this week is the gruesome tale of someone high on bath salts, literally chewing the face off of someone else. So, even though we’ve talked about this recently at great length, it's worth comment because it points out the profound effects of these drugs that maybe we hadn’t previously known about So, Darryl, really…this story just is shocking people and it’s bringing more people’s attention to the fact that these new drugs are somewhat legal or not yet classified as illegal but are really, really powerful and dangerous.
DARRYL: Howard, the story out of Miami yesterday, the 29th of May, is just gruesome and horrifying and naturally will shake people to question what is going on. How can a drug affect a person in such a devilish way - it hearkens back to all of the drug era hysteria that the newspapers reported about PCP, marijuana, cocaine, and methamphetamine and there is a reality to it and it is important. I think that maybe this will galvanize a lot of more interest into how these bath salts and the synthetic marijuanas and synthetic opiates and things like that are just exploding and becoming more of the norm in terms of drugs in America than the traditional drugs that have been around for hundreds of years, smuggled and marketed on the underground. Stories like this really highlight the fact that we have very little knowledge about these drugs. At least when there were horror stories about PCP, and even the synthetic heroins during the 1970’s and 80’s, but there was more laboratory research and we had a solid scientific understanding of those things - unlike today where we know little about the plethora of today's synthetic chemicals. Most of them are cathinone derivatives from the khat plant and most are of the MDPV variety of cathinone that is sort of a copy or trying to make a new synthetic ecstasy type of chemical that we know little about - what it does and how it does it, how much of a dose it takes and what are its dangers. We continue to get reports of very bizarre, psychotic reactions including the zombie attack in Miami where an individual under the influence of bath salts ate the face off of a victim and when ordered to stop he didn't and was shot and finally killed in order to save the victim. There have been admissions in our local emergency rooms here of people on bath salts who are tremendously psychotic. On the same day the incident happened in Miami here in Southern Oregon the police had to take several officers to stop somebody who was driving erratic traffic-wise and when they stopped him, he went bizerko and it turned out he was a bath salt user as well. So, there is a clear case that these are dangerous and hopefully this will raise the awareness of those kids…those people who are interested in trying these new synthetic cocaine and synthetic methamphetamines that there are some real dangers - dangers we know little about.
HOWARD: Yes at least we know the chemical components of cocaine, methamphetamine, marijuana, heroin … as opposed to these other things. One of the stories mentioned the side effects - the fellow in Miami stripped naked before he attacked the guy - because in many cases this drug creates super heating of your internal organs to the point where the people literally are like zombies. They’re completely out of control and they’ve burnt up their internal organs. And that is really scary.
DARRYL: Well, that’s actually one of the causes of death from ecstasy and from methamphetamine - it's called morbid hyperthermia. People who go to raves and take ecstasy who are extremely sensitive are at risk of a de-regulation in the hypothalamus area that controls body temperature and their body temperature goes up very quickly, very high, so high that they actually fry internally. They end up with multiple blood clots throughout their body and their blood vessels burst because their heart is trying to pump the blood through - resulting in multiple hemorrhaging or multiple bleeds underneath, inside their body and that’s the major cause of death from overdosing on ecstasy and methamphetamine. I’m sure - by projection, that if bath salts mimic ecstasy, mimic amphetamines, mimic cocaine, then they’re probably going to have the same type of toxic effects. That is a very, very, deep concern. Right now, the drug- abusing subculture…the people who monitor the internet for what’s new, what’s available, what’s the most exotic, - glass cleaner, jewelry cleaner, plant food - because that’s how these things are being sold - or bath salts or herbal incense or potpourri or whatever…those are the real human test subjects. We have, again like the 1960’s, we are seeing probably the largest uncontrolled human experimentation in the history of pharmacology - maybe even larger than the 60's. People are taking substances that we know nothing about - human guinea pigs - they are the test subjects that will determine which drugs are toxic. The scary thing for me is this is the way things are going. As states make these substances illegal, there are legions of street chemists ready to roll out the next derivative that isn't illegal yet - they'll just introduce that and when that becomes illegal, they introduce the next thing - there are an almost infinite number of derivatives that can be introduced before we get hip to each one of them. It’s going to put a whole new face on drugs of addiction.
HOWARD: Now, I didn’t realize that it was so related to khat. .. what is khat and ….how does the body react to it.
DARRYL: Well, khat has been used for hundreds of years.
HOWARD: … it’s from the Middle East or…west…
DARRYL: East Africa, actually. Its big in Yemen - they don’t drink alcohol, but they have khat dens right in their homes. Each home has a khat chewing area, the plant leaves contain a chemical called cathinone, which is a stimulant…very much like methamphetamine is a stimulant - it causes a person to be awake, more alert, more motivated. The chemical is sensitive to the environment and once it’s cut off from its growing source - it starts to degrade quickly so the leaves must be fresh - which requires live plants from which to cut them. Because of the growing requirements it wasn’t a big drug in the United States or anywhere else in the world …until more recent times. Even now khat itself is not a real popular drug, - although people have tried to grow it in Monterey, California and other places.
HOWARD: That was my question. Does it grow here? Does it need that specific environment?
DARRYL: It does grow here, but it's illegal so if it is found growing, it is cut down. But because the active chemical found in the leaf is so unstable once it has been removed from the plant, synthetic chemists just looked at the chemical and said "oh, if we put a carbon group right here on the nitrogen, it is not cathinone, it becomes methcathinone and methcathinone is stable regardless of the environment - therefore it can be made synthetically and distributed as a drug. When that became common, some people added another methyl group making methylmethcathinone and that addition made it even stronger and more stable and right now it’s methylenedioxypyrovalerone, MDPV, which is actually sort of like methylenedioxyamphetimine or ecstasy, methylenedioxypyrovalerone is a type of ecstasy phenethylamine derivative that is very common . There are several more derivatives being made and they are all uppers. They all increase the release of catacolomines in your brain. They make you more alert, more awake, more excited and can have the same sort of tremor activity, the seizure potential, the increased heart rate, increased blood pressure, stroke potential and as you said, increase the body temperature to go out of control where you have multiple blood clots form throughout the body and death through internal bleeding.
HOWARD: Based on that definition, it sounds like something you don’t want to experiment with because it’s much more dangerous than…than most anything else.
DARRYL: Well we don’t know how much different it is than methamphetamine or ecstasy. We don’t have any dose information. If a small change is made, like you take cathinone and you add a methyl group, one carbon group to make methylcathinone, those little changes might result in doubling, to tripling to quadrupling to sometimes increasing the potency of a substance up to 100 times. So if someone determines that 5 mg of this substance is what it takes to get loaded, but there’s a derivative it could make the chemical 10 times stronger so that 5 mg dose delivers 10 times the amount and leaves the person at risk for a lot of toxic and potential lethal effects. That’s the danger … we’re not sure how these things are going to differ physiologically and emotionally and psychologically from the original substances. We’re seeing a lot of toxic reactions along with a media frenzy chronicling these very, very gruesome things that are occurring as a result of bath salts.
HOWARD: And there’s another related story about increased production of meth coming out of Southwest Asia, I guess, which includes Iran and Turkey and the area we were just talking about regarding khat. I have a question about whether or not this is going to change or short-circuit the downer cycle of drugs that we’ve been talking about. We’re seeing a lot of this kind of meth activity picking up in the rest of the world, while in America we seem to be into this downer phase.
HOWARD: How do we sort this? Or do we sort this?
DARRYL: I think you follow the money here. This is an investment into the future. People who traffic drugs know that drugs are always going to make money. If people who are vulnerable to addiction are exposed to an addictive substance, they will do whatever it takes to maintain their access to that substance. And they…the people who are the drug traffickers, big drug traffickers are smart enough to invest to cover all bases.
HOWARD: So they’re just looking ahead is what you’re saying.
DARRYL: They’re looking ahead. They know right now that there is a heroin swing - people are really into heroin, but that’s going to last only about 10 to 20 years and then there will be a big interest in uppers. And what’s happened…this is really strange because Southwest Asia, you know, Turkey, Afghanistan, Iraq… have been the cradle of heroin from the very beginning, 5000 years ago they were using opiates and they had been the source throughout the world, but what has happened is that during the "upper" cycle those regions watched as cocaine came out of South America and amphetamines out of Mexico and drug suppliers in Southwest Asia recognized that there is a huge world market for those drugs …the biggest of course is the United States and in the United States - there has been a crack down on homegrown methamphetamine manufacturing. There are restrictions here on the precursors, ephedra in pseudoephedrine, which led to more manufacturing in Mexico and places like that. But now, Mexico is cracking down on those precursors as well as Southeast Asia – China and Cambodia. Regions where versions of methamphetamine are being manufactured produce pseudoephedrine so there is no need to import it, so the big time tycoons in the drug industry are investing in the future by going to these places where there are fewer restrictions, less scrutiny and the availability of precursors because they manufacture their own - positioning themselves to become the next big supplier should the world go back to a deeper interest in methamphetamine.
HOWARD: So, is that what we’re talking about here - the availability of those precursor chemicals from legitimate sources - from labs where it’s easier to acquire the chemicals - than where it’s under more scrutiny?
DARRYL: Absolutely… here in Oregon and California and other states as well, pharmacies now restrict access to cold pills so that they won’t be used to make methamphetamine. Well, I don’t think they’re going to restrict access to cold pills in Afghanistan or Turkey - so that’s what is happening - development of meth factories in Southwest Asia and South Asia.
HOWARD: Well, I guess it is, as I am fond of saying, "follow the money." So, these people are looking ahead- so I guess we all must look ahead and keep our eyes on the road. Anyway, that’s about all the time we have for today. We hope our listeners found this interesting and encourage your comments, suggestions, and questions. Feel free to drop us a note by stopping by the website, cnsproductions.com and leave us a note there. Darryl?
DARRYL: Howard, it’s finally heating up here in Southern Oregon and it sounds like the whole bath salt thing is heating up along with it.
HOWARD: Well, we’ll keep an eye on it. Thanks. That wraps our pod for today. Please check back soon for the next in the series and visit our website, www.cnsproductions.com