Bath Salts in the Emergency Department. Issue 2 (March 2015)

• Record Type: Journal Article
• Authors: Vazirian, Mohsen; Jerry, Jason M.; James, Jeffrey; Dale, Roman M.
• Is Part Of: Journal of addiction medicine. Volume 9:Issue 2(2015:Mar./Apr.)
• Publication Date: 2015-03
• Subjects: Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86005
• DOI: 10.1097/ADM.0000000000000094
• Languages: English
• ISSNs: 1932-0620

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objectives:</title> <p>Several novel synthetic amphetamines have been marketed worldwide as "bath salts." The use of bath salts is associated with severe medical consequences resulting in a US federal ban over the last 3 years on the more common substances found in this group. Bath salts intoxication has a relatively nonspecific presentation, and urine toxicology confirmation in emergency departments (EDs) is impractical because the turnaround time is several days. Emergency clinicians must therefore rely heavily on patients' self-reports to verify the diagnosis. We performed an online survey of emergency clinicians to determine their degree of exposure to bath salts-intoxicated patients, the clinically relevant features of such patients, and the typical emergency management.</p> </sec> <sec> <title>Methods:</title> <p>We invited 124 physicians and physician assistants in 7 Cleveland Clinic EDs to participate in an online survey.</p> </sec> <sec> <title>Results:</title> <p>From a total of 43 of the 124 respondents, 77% did not specifically ask patients about bath salts use. Sixty percent had encountered a bath salts-intoxicated individual. Most respondents reported that the majority of patients were male, were between 19 and 29 years old, and used other drugs in addition to bath salts. Agitation, aggression/violence, and hallucinations were reported to be the most common presentations, and intravenous/intramuscular tranquilization was reported as the most often used management. Most patients were discharged home from the ED.</p> </sec> <sec> <title>Conclusions:</title> <p>Despite the lack of toxicology screening in EDs, about two thirds of the surveyed emergency clinicians encountered bath salts-intoxicated individuals. Our study demonstrates the need for increased screening of bath salts intoxication in EDs, especially in agitated patients.</p> </sec> </abstract>