Designed to Kill

When I think of the word “designer,” it brings up images of beautiful suits and slick jeans. However, when you link the word “designer” to the word “drug,” it draws up much different images in my mind as an ER doctor.

I have visions of convulsions, aggressive behavior, hallucinations and death. Designer drugs , like synthetic marijuana, bath salts and ecstasy, are the scourge of high school and college campuses. In the late 1980s, we first started to see synthetic drugs gain popularity on college campuses. Rohypnol and ecstasy were soon followed by crystal methamphetamine, synthetic marijuana and, now, the bath salt craze.

I was practicing medicine at “ground zero” for the bath salt craze, which was New Orleans, Louisiana. I’ll never forget my first patient because I’ve never seen anything quite like it. He came in disoriented, aggressive, hypersexual, combative, and paranoid. And these symptoms lasted for over 12 hours. The worst part is that all of his drug tests came back negative! We didn’t know exactly what caused this horrible reaction. We called his family members and no one could help us out. Then we called his friends and they said he had tried a new drug and started acting crazy, so they just dropped him off at home. He was found on the streets of his neighborhood running around with no clothes on and cutting himself. When we traced what he purchased at this store, we realized that it was something we had never heard of – bath salts.

Bath salts are crystalized chemicals that are snorted, swallowed or smoked. They contain two powerful stimulants: methylenedioxypyrovalerone and mephedrone, which mimic cocaine, LSD and methamphetamine. In the US, over 8,000 people this year have been treated in ERs for the harsh symptoms of this drug. The syndrome that the victims experience is sometimes called “the dark hell.”

Thirty-eight states have enacted legislation to combat this horrible drug. The science behind bath salts is pretty simple. Bath salts cause the brain to limit reuptake of dopamine, which means more of the neurochemical is available in the brain and the brain really likes that. Over time, the effect diminishes and more of the drug is required to keep the ball rolling. When your brain is hit with that much psychoactive stimulant, the nervous system overloads and all of the brain’s hardwired threat alarms go off. The predictable result is paranoia, panic attacks, mood swings, and reckless behavior.

The young man I mentioned, who was my first bath salts patient, did not die; however, he never totally came down from his high and was never back to normal. He continued to have flashbacks and his cognitive function was never back to baseline. He has not been able to maintain interpersonal relationships because of his severe mood swings, paranoia and mania.

I have always encouraged parents to talk to their children very explicitly about drugs and alcohol abuse. However, I am now begging my readers to never try any designer drugs. The active ingredients could be different every time, so you never know what you’re going to get. Obviously, the worst-case scenario is death, but for some, because they’re never the same, they’re trapped in the prison of their own mind, which theoretically could be worse than death. My advice: Don’t ever try any of these drugs, not even once – because that one time could be your last.