Recent years have seen an unprecedented growth in number and availability of new synthetic psychoactive drugs in the US and worldwide. In 2014, 101 new psychoactive drugs were identified, worldwide. Such drugs are often sold as “legal” highs or “research chemicals” over the internet or in head shops. Among these new drugs, “bath salts” appear to be one of the more commonly used in the US. “Bath salt” use has been associated with numerous adverse cardiac, psychiatric, neurological, gastrointestinal and pulmonary outcomes. In 2011, the use of bath salts was responsible for over 20,000 emergency room visits in the US and poisonings and deaths related to use have been occurring at large dance festivals. Increases in bizarre behavior linked to use of the “bath salt” known as Flakka (alpha-PVP) has increasingly been appearing in headlines. ”Bath salt” use appears to be prevalent, yet, despite this, little is known about the epidemiology of this drug in the US.
A recent study, published in The American Journal of Addiction by Joseph J. Palamar, PhD, MPH, a CDUHR affiliated researcher and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC), is among the first nationally representative studies in the US to examine self-reported use of bath salts.
The study, “‘Bath Salt’ Use Among a Nationally Representative Sample of High School Seniors in the United States,” used data from Monitoring the Future (MTF), a nationwide ongoing annual study of the behaviors, attitudes, and values of American secondary school students. The MTF survey is administered in approximately 130 public and private schools throughout 48 states in the US. Roughly 15,000 high school seniors are assessed annually. Dr. Palamar’s study utilized MTF responses from 2012 to 2013, examining data from a total of 8,604 students who reported their sociodemographic data, alcohol and drug use.
Results suggest that 1.1% of high school seniors reported using bath salts in the last 12 months. A third (33%) of students who used bath salts reported using only once or twice, which suggests experimentation is most common among users; however, frequent use was also common among users with an alarming 18% of users reporting using 40 or more times in the last year.
Students who resided with fewer than two parents, who earned over $50 per week from sources other than a job, or who go out 4-7 nights per week for fun, were at significantly increased risk for use. Lifetime use of each of the 11 illicit drugs assessed by MTF was a robust risk factor for use. More than 90% of bath salts users reported lifetime use of alcohol or marijuana, and use of powder cocaine, LSD, crack and heroin was at least ten times more prevalent among bath salt users.
Even though use did not significantly change between the two years examined in the study, according to MTF, perceived risk associated with use increased dramatically from 25% in 2012 to 39% in 2013. While rates of use in the US prior to 2012 are unknown, numerous media reports about the dangers associated with use (e.g., prior to 2012) might have served as a deterrent against use. Dr. Palamar also pointed out that “bath salts” can wind up as adulterants in drugs such as ecstasy (MDMA, “Molly”) so it is possible that many club and festival attendees who use “Molly” may be unintentionally using these potentially dangerous drugs.
“While these results suggest bath salt use is not particularly prevalent among teens in the US, it is important that we continue to monitor new drugs such as ‘bath salts’ in order to inform prevention and quickly detect potential drug epidemics,” said Dr. Palamar.
Researcher Affiliations: Joseph J. Palamar, PhD, New York University Langone Medical Center, Department of Population Health, Center for Drug Use and HIV Research, New York University College of Nursing.
Acknowledgements: This project was funded by the NIH (K01 DA-038800, PI: Palamar). The Monitoring the Future principal investigators had no role in analysis, interpretation of results, or in the decision to submit the manuscript for publication. The author would like to thank the principal investigators of Monitoring the Future (PIs: Johnston, Bachman, O’Malley, and Schulenberg) at The University of Michigan, Institute for Social Research, Survey Research Center, and the Interuniversity Consortium for Political and Social Research for providing access to these data (http://www.icpsr.umich.edu/icpsrweb/landing.jsp). Monitoring the Future data were collected through a research grant (R01 DA-01411) from the National Institute on Drug Abuse (NIDA).
The mission of the Center for Drug Use and HIV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041). It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the New York University College of Nursing. For more information, visit www.cduhr.org.
About NYU Langone Medical Center
NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation’s premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals—Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center’s dedicated inpatient orthopaedic hospital; and Hassenfeld Children’s Hospital, a comprehensive pediatric hospital supporting a full array of children’s health services across the Medical Center—plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center’s tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to www.NYULMC.org
About New York University College of Nursing
NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit https://nursing.nyu.edu/