Our experience with MDPV or "Bath Salts"

The latest designer drug to hit the United States is the compound Methylenedioxypyrovalerone (MDPV) marketed in the United States commonly as "bath salts." It is sold under many names in the southern part of the US (where we are), including "Ivory Wave" or "Purple Wave." It is sold in drug paraphernalia stores (head shops) but is commonly available in gas station markets and adult novelty stores. It is easily obtained and extremely dangerous.

What is MDPV? MDPV belongs to a category of drugs called cathinones. One natural souce of cathinones is from the drug khat, a dried plant derivative native to tropical East Africa and the Arabian Peninsula. Although related to more benign drugs, MDPV has several alarming properties.

 

Gil Kerlikowske, the Director of National Drug Control Policy has recently issued a statement on MDPV and its dangers. Our experience clearly warns of the psychiatric and medical dangers of this drug. We have cared for multiple patients who have abused MDPV; they report intense and unpleasant visual hallucinations after a short binge. The drug feels non-toxic with its first use, but following a moderate binge users suffer mild to moderate paranoia. To date,we have not seen violence with MDPV, in contrast to PCP and related dissociative drugs such as ketamine. However, in about 10% of individuals who use higher doses, we have observed a sustained psychotic state with intense anxiety lasting 3 to 7 days. The drug produces "immediate reinforcement" like cocaine. Immediate reinforcement is a desire to use more of the drug shortly after a first dose. This leads to the consumption of the higher doses than originally planned, resulting in psychosis in some users.

The medical side effects are equally shocking. Users of high doses can develop dangerously high blood pressures, to the point of a hypertensive crisis. In two patients, we have observed a condition known as rhabdomyolosis - the body's skeletal muscles break down risking the development of kidney failure. 

In short, MDPV is very dangerous. Just because it is available over the counter in most states, do not be fooled into thinking that it is anything but a very toxic drug.

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