How Do 'Bath Salts' Drive People Crazy?

By Natalie Wolchover | LiveScience.com

On Saturday in Miami, a naked, "zombielike" man viciously attacked a homeless man, biting off and eating much of his face. Police shot and killed the 31-year-old attacker, Rudy Eugene, who, according to some news outlets, may have been high on "bath salts" at the time of his cannibalistic attack.

These soothing-sounding substances are not what they seem. Manufactured in China and sold legally online and in drug paraphernalia stores under misleading brand names like "Ivory Wave," bath salts contain a bevy of newly concocted chemicals, such as methylenedioxypyrovalerone (MDPV), which aren't yet banned by the federal government. When snorted, injected or smoked, the synthetic powders can induce a state of paranoid delirium paired with abnormal strength, a combination that often leads to horrific acts of violence.

In short, "bath salts" actually do live up to the warnings of old-school anti-drug ads, which cautioned potential users of insanity, death and murder. The salts work by putting the brain's survival instincts into overdrive, essentially causing an extreme adrenaline rush that lasts for hours rather than moments.

MDPV, the active ingredient in "bath salts," increases the body's concentration of adrenalinelike hormones that prepare the heart, muscle tissue and the brain for the "fight or flight" response, explained Thomas Penders, an associate professor in the department of psychiatric medicine at East Carolina University. It does this by stopping neurons in the brain from reabsorbing the chemicals dopamine and norepinephrine immediately after secreting them, as would normally happen. This leads to a steady buildup of these neurochemicals, which trigger a person's primal survival behaviors, Penders told Life's Little Mysteries.

"One system of circuits in our brains are wired to detect and respond to threats. Overstimulation of this circuit leads to overestimation of actions by others as threatening. When the system becomes overwhelmed, as it does [from an overdose of] 'bath salts,' a condition develops known as 'excited delirium,'" he said. [Slideshow: Scientists Analyze Drawings by an Acid-Tripping Artist]

Crack cocaine, methamphetamine, ecstasy and PCP can also induce "excited delirium." It's a state of paranoid fearfulness and rage mixed with seemingly superhuman strength, as more oxygen is delivered to muscles, increasing their power. "This, to some extent, explains the bizarre aggressive behaviors we have seen during the recent rash of 'bath salt' cases," Penders said. "[However,] I cannot imagine what the individual in Miami was perceiving to fully explain the vicious attack described there."

Even if no one else gets hurt, sufferers of "excited delirium" can wind up dead or in the emergency room, with medical complications such as cardiac arrhythmias, a spike in body and brain temperature, muscle breakdown and kidney failure.

While overdoses of crack cocaine, methamphetamine, ecstasy and PCP can also induce "excited delirium," one particular danger of "bath salts" is that there's no way to gauge how large a dose will trigger the effects, despite the product's appearance of manufactured consistency. Because the substances are not made in the U.S. or regulated for consumption, studies have found varying concentrations of the active compounds from package to package, said Patrick Kyle, director of clinical chemistry and toxicology at the University of Mississippi Medical Center. This leads to unintended overdoses.

"The user assumes that since one dose of ‘XYZ’ brand gave him/her a ‘rush’ with the last use, one dose will give the same effect," Kyle wrote in an email. "The user may unknowingly overdose on the same amount of product from the same 'brand.'"

World No Tobacco Day Highlights the Industry’s “Interference”

World No Tobacco Day will be observed this year on Thursday, May 31st. Hosted by the World Health Organization (WHO), the theme is "tobacco industry interference.” 

Tobacco Industry Interference was selected as this year’s theme for The World Health Organization (WHO) World No Tobacco Day. World No Tobacco Day is meant to encourage a 24-hour period of abstinence from all forms of tobacco consumption across the globe. The day is further intended to draw global attention to the widespread prevalence of tobacco use and to negative health effects. This year’s campaign will focus on the need to expose and counter the tobacco industry’s brazen and increasingly aggressive attempts to undermine the WHO Framework Convention on Tobacco Control (FCTC) because of the serious danger they pose to public health. 

WHO states that: The tobacco industry has historically employed a multitude of tactics to shape and influence tobacco control policy. The tobacco industry has used its economic power, lobbying and marketing machinery, and manipulation of the media to discredit scientific research and influence governments in order to propagate the sale and distribution of its deadly product. Furthermore, the tobacco industry continues to inject large philanthropic contributions into social programs worldwide to create a positive public image under the guise of corporate social responsibility.
 
Tobacco use remains the leading cause of preventable death in the United States, causing approximately 443,000 deaths each year. 

For more information on World No Tobacco Day, visit http://www.who.int/tobacco/en/. To view CADCA’s tobacco resources, visit http://www.cadca.org/ctg. Know someone who wants to quit smoking and tobacco use altogether? Free help is available by calling the Tobacco Quit Line at 1-800-QUIT-NOW.

Limit Prescriptions For Painkiller Drugs

As much as one-third of the painkiller drugs abused in the United States come from hospital emergency rooms, a national study indicates. That ought to be all the impetus East Ohio hospitals need to go along with voluntary guidelines recommended to curb the problem.

Ohio Gov. John Kasich announced the guidelines this week, after consulting with state health care associations. Emergency rooms are "one of the largest access points for opiate painkillers. We hope that will be reduced to a trickle," the governor explained.

Kasich's guidelines include a variety of steps to reduce the flow of painkillers into the hands of those who abuse them and/or provide them to others for improper use. Doctors would limit both the number and duration of painkiller prescriptions. Emergency room staffers would insist on identification from those seeking painkillers - and would check them against a computerized database.

Drug overdoses have become the leading cause of accidental death in Ohio. In 2010, overdoses killed 1,544 Buckeye State residents - including 19 people in Belmont, Jefferson and Harrison counties.

Clearly, implementing the governor's guidelines would help health care professionals comply with their primary credo, "do no harm." Again, East Ohio hospitals should embrace and enforce the limits as soon as possible.

Number of US newborns with drug withdrawal triples

CHICAGO (AP) — Less than a month old, Savannah Dannelleyscrunches her tiny face into a scowl as a nurse gently squirts a dose of methadone into her mouth.

The infant is going through drug withdrawal and is being treated with the same narcotic prescribed for her mother to fight addiction to powerful prescription painkillers.

Disturbing new research says the number of U.S. babies born with signs of opiate drug withdrawal has tripled in a decade because of a surge in pregnant women's use of legal and illegal narcotics, including Vicodin, OxyContin and heroin, researchers say. It is the first national study of the problem.

The number of newborns with withdrawal symptoms increased from a little more than 1 per 1,000 babies sent home from the hospital in 2000 to more than 3 per 1,000 in 2009, the study found. More than 13,000 U.S. infants were affected in 2009, the researchers estimated.

The newborns include babies like Savannah, whose mother stopped abusing painkillers and switched to prescription methadone early in pregnancy, and those whose mothers are still abusing legal or illegal drugs.

Weaning infants from these drugs can take weeks or months and often requires a lengthy stay in intensive care units. Hospital charges for treating these newborns soared from $190 million to $720 million between 2000 and 2009, the study found.

The study was released online Monday in the Journal of the American Medical Association.

Savannah is hooked up to heart and oxygen monitors in an Oak Lawn, Ill., newborn intensive care unit. In a pink crib, she sleeps fitfully, sometimes cries all night, and has had diarrhea and trouble feeding — typical signs of withdrawal. Some affected babies also have breathing problems, low birth weights and seizures.

It nearly breaks her young mother's heart.

"It's really hard, every day, emotionally and physically," said Aileen Dannelley, 25. "It's really hard when your daughter is born addicted."

Doctors say newborns aren't really addicted — which connotes drug-seeking behavior that babies aren't capable of — but their bodies are dependent on methadone or other opiates because of their mothers' use during pregnancy. Small methadone doses to wean them off these drugs is safer than cutting them off altogether, which can cause dangerous seizures and even death, said Dr. Mark Brown, chief of pediatrics at Eastern Maine Medical Center.

Newborn drug withdrawal is rampant in Maine, Florida, West Virginia, parts of the Midwest and other sections of the country.

Dr. Stephen Patrick, the lead author of the study and a newborn specialist at the University of Michigan health system in Ann Arbor, called the problem a "public health epidemic" that demands attention from policymakers, as well as from researchers to clarify what long-term problems these infants may face.

University of Maine scientist Marie Hayes said her research suggests some affected infants suffer developmental delays in early childhood, but whether those problems persist is uncertain.

It's the 21st century version of what was known as the "crack baby" epidemic of the 1980s. Some experts say that epidemic was overblown and that infants born to mothers using crack cocaine face no serious long-term health problems.

Some think the current problem is being overblown, too.

Carl Hart, an assistant psychiatry professor at Columbia University and a substance abuse researcher at the New York Psychiatric Institute, noted that only a tiny portion of the estimated 4 million U.S. infants born each year are affected.

Hart also said the study probably includes women who weren't abusing drugs during pregnancy, but were taking prescribed painkillers for legitimate reasons. He said he worries that the study will unfairly stigmatize pregnant women who are "doing the right thing" by taking methadone to fight their addiction.

Doctors pushing powerful painkillers "like candy" contribute to the problem, said Arturo Valdez, who runs the Chicago substance abuse program that Aileen Dannelley attends. Patients at his West Side clinic include men and women who are prescribed opiate painkillers for legitimate reasons, such as car accident injuries, and find themselves addicted when the prescriptions runs out. Some turn to street drugs, which can be cheaper and easier to obtain, Valdez said.

In some states, mothers of newborns with drug withdrawal are arrested and jailed, but Valdez said addiction is a brain disease that should be treated like other illnesses, not stigmatized.

Aileen Dannelley said she started abusing drugs after an adult neighbor introduced her to crack when she was 14. She said she would "never have touched it" if she had known how addictive drugs can be.

She said she has abused Vicodin, which a doctor gave her to treat back pain from sitting all day at an office job, as well as other prescription painkillers and heroin.

Dannelley was still abusing drugs early in her pregnancy but decided in December to quit, vowing: "I'm not going to go back to that lifestyle. There's a baby inside me."

Now she is trying to get her life back on track. Estranged from her husband, she is living with her parents and just signed up for nursing classes at a local junior college. She visits Savannah every day. The baby has been in the hospital since she was born in early April, and her mother hopes to take her home soon.

"I am doing so good for the first time in my life," Dannelley said.

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