ICE participates in nationwide synthetic drug takedown


ICE participates in nationwide synthetic drug takedown

 

WASHINGTON – More than 90 individuals were arrested and approximately five million packets of finished designer synthetic drugs were seized in the first-ever nationwide law enforcement action against the synthetic designer drug industry responsible for the production and sale of synthetic drugs that are often marketed as bath salts, Spice, incense, or plant food. More than $36 million in cash was also seized.

As of today, more than 4.8 million packets of synthetic cannabinoids (K2, Spice) and the products to produce nearly 13.6 million more, as well as 167,000 packets of synthetic cathinones (bath salts), and the products to produce an additional 392,000 were seized.

Operation Log Jam was conducted jointly by the U.S. Drug Enforcement Administration and U.S. Immigration and Customs Enforcement (ICE), with assistance from the IRS Criminal Investigation, U.S. Postal Inspection Service, U.S. Customs and Border Protection, FBI, Food and Drug Administration’s Office of Criminal Investigations, as well as state and local law enforcement members in more than 109 U.S. cities and targeted every level of the synthetic designer drug industry, including retailers, wholesalers and manufacturers.

“Today, we struck a huge blow to the synthetic drug industry. The criminal organizations behind the importation, distribution and selling of these synthetic drugs have scant regard for human life in their reckless pursuit of illicit profits,” said Acting Director of ICE’s Office of Homeland Security Investigations James Chaparro. “ICE is committed to working with our law enforcement partners to bring this industry to its knees.”

“Although tremendous progress has been made in legislating and scheduling these dangerous substances, this enforcement action has disrupted the entire illegal industry, from manufacturers to retailers,” said DEA Administrator Michele M. Leonhart. “Together with our federal, state and local law enforcement partners, we are committed to targeting these new and emerging drugs with every scientific, legislative and investigative tool at our disposal.”

“The synthetic drug industry is an emerging area where we can leverage our financial investigative expertise to trace the path of illicit drug proceeds by identifying the financial linkages among the various co-conspirators,” said Richard Weber, chief, IRS Criminal Investigation. “We will continue working with our law enforcement partners to disrupt and ultimately dismantle the highest level drug trafficking and drug money laundering organizations that pose the greatest threat to Americans and American interests.”

“The U.S. Postal Inspection Service aggressively investigates the use of the U.S. Mail system for the distribution of illegal controlled substances and its proceeds. Our agency uses a multi-tiered approach to these crimes: protection against the use of the mail for illegal purposes and enforcement of laws against drug trafficking and money laundering. This includes collaboration with other agencies,” said Chief Postal Inspector Guy J. Cottrell.

“The mission of U.S. Customs and Border Protection is to guard our country’s borders from people and goods that could harm our way of life,” said Acting Commissioner David V. Aguilar. “We are proud to be part of an operation that disrupts the flow of synthetic drugs into the country and out of the hands of the American people.”

Over the past several years, there has been a growing use of, and interest in, synthetic cathinones (stimulants/hallucinogens) sold under the guise of “bath salts” or “plant food.” Marketed under names such as “Ivory Wave,” “Purple Wave,” “Vanilla Sky,” or “Bliss,” these products are comprised of a class of dangerous substances perceived to mimic cocaine, LSD, MDMA and/or methamphetamine. Users have reported impaired perception, reduced motor control, disorientation, extreme paranoia and violent episodes. The long-term physical and psychological effects of use are unknown but potentially severe.

These products have become increasingly popular, particularly among teens and young adults and those who mistakenly believe they can bypass the drug testing protocols that have been set up by employers and government agencies to protect public safety. They are sold at a variety of retail outlets, in head shops and over the Internet. However, they have not been approved by the Food and Drug Administration for human consumption or for medical use, and there is no oversight of the manufacturing process.

Smokable herbal blends marketed as being “legal” and providing a marijuana-like high have also become increasingly popular, particularly among teens and young adults, because they are easily available and, in many cases, they are more potent and dangerous than marijuana. These products consist of plant material that has been coated with dangerous psychoactive compounds that mimic THC, the active ingredient in marijuana. Just as with the synthetic cathinones, synthetic cannabinoids are sold at a variety of retail outlets, in head shops and over the Internet. Brands such as “Spice,” “K2,” “Blaze,” and “Red X Dawn” are labeled as incense to mask their intended purpose.

While many of the designer drugs being marketed today that were seized as part of Operation Log Jam are not specifically prohibited in the Controlled Substances Act (CSA), the Controlled Substance Analogue Enforcement Act of 1986 (AEA) allows these drugs to be treated as controlled substances if they are proven to be chemically and/or pharmacologically similar to a Schedule I or Schedule II controlled substance. A number of cases that are part of Operation Log Jam will be prosecuted federally under this analogue provision, which specifically exists to combat these new and emerging designer drugs.

DEA has used its emergency scheduling authority to combat both synthetic cathinones (the so-called bath salts like Ivory Wave, etc.) and synthetic cannabinoids (the so-called incense products like K2, Spice, etc.), temporarily placing several of these dangerous chemicals into Schedule I of the CSA. Congress has also acted, permanently placing 26 substances into Schedule I of the CSA.

In 2010, poison centers nationwide responded to about 3,200 calls related to synthetic “Spice” and “bath salts.” In 2011, that number jumped to more than 13,000 calls. Sixty percent of the cases involved patients 25 and younger

INFO FROM http://www.ice.gov/news/releases/1207/120726washingtondc.htm

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The battle against bath salts


People are inventing so many new, legal ways to get high that lawmakers can’t keep up.

So law enforcers are taking new steps to target these synthetic drugs.

Those steps include coordinated raids. The latest was Wednesday, when federal agents arrested more than 90 people in a nationwide sweep of synthetic drug producers, distributors and retailers — including a number in Pennsylvania.

Across the country, agents seized more than five million packets of finished designer synthetic drugs, including substances marketed as bath salts, spice, incense, K-2 and plant food, according to the federal Drug Enforcement Administration.

They also recovered more than $36 million in cash in the sweep, code named Operation Log Jam.

“We struck a huge blow to the synthetic drug industry,” said James Chaparro, the acting director of the Office of Homeland Security Investigations. “The criminal organizations behind the importation, distribution and selling of these synthetic drugs have scant regard for human life in their reckless pursuit of illicit profits.”

In Pennsylvania, agents searched residences, convenience stores, gas stations, smoke shops and other similar businesses in several counties, including Montgomery and Philadelphia.

They seized more than 300,000 individual doses of synthetic marijuana and illegal bath salts, with an estimated street value of $1.25 million. They also recovered more than 50,000 pieces of drug paraphernalia related to the smoking or consumption of synthetic drugs and about $250,000 in cash and assets, according to the state Attorney General’s Office.

Over the past two years, the U.S. has seen a surge in the use of synthetic drugs made of legal chemicals that mimic the dangerous effects of cocaine, amphetamines and other illegal stimulants.

The drugs are often sold at small, independent stores in misleading packaging that suggests common household items. But the substances inside are powerful, mind-altering drugs that have been linked to bizarre and violent behavior across the country.

Law enforcement officials refer to the drugs collectively as “bath salts,” though they have nothing in common with the fragrant toiletries used to moisturize skin.

President Barack Obama signed a bill into law earlier this month that bans the sale, production and possession of more than two dozen of the most common bath salt drugs. But health professionals say that there are so many varieties of the drugs that U.S. lawmakers are always playing catch up.

“The moment you start to regulate one of them, they’ll come out with a variant that sometimes is even more potent,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse.

Emergencies related to the drugs have surged: The American Association of Poison Control Centers received more than 6,100 calls about bath salt drugs in 2011 — up from just 304 the year before — and more than 1,700 calls in the first half of 2012.

In Montgomery County, coroner Dr. Walter Hoffman said four deaths have been attributed to the use of bath salt drugs — including a 28-year-old man and 15-year-old girl from Pottstown who were killed in a motor vehicle accident. All four people who died from the drugs were under 30 years old, he said. Bucks County Coroner Dr. Joseph Campbell said that no deaths in Bucks County have been directly attributed to bath salt use.

A Quakertown father has attributed his son’s suicide to mental health problems following bath salt use. And authorities said an Upper Moreland teen was severely injured when he jumped from the top level of the Willow Grove Park mall parking garage after smoking an unidentified synthetic drug.

Many states have banned some of the most common bath salt drugs. For instance, in June 2011, Pennsylvania legislators banned the possession, use and sale of synthetic “designer” drugs.

But while U.S. laws prohibit the sale or possession of all substances that mimic illegal drugs, that’s only true if federal prosecutors can show they’re intended for human consumption. People who make these drugs work around this by printing “not for human consumption” on packets.

Despite the bans, bath salts producers are constantly tweaking their recipes to come up with new drugs that aren’t covered by state or federal laws. In fact, Mark Ryan, director of the Louisiana Poison Center, says there are so many different drugs out there that it’s almost impossible to know what people have ingested, or how long the effects will last.

“Cocaine is cocaine and meth is meth. We know what these things do,” he said. “But with these new drugs, every time the chemist alters the chemical structure, all bets are off.”

These drugs include synthetic marijuana substitutes, also known as “herbal incense.”

At one Doylestown store, the packages were marked “not for human consumption.” When the owner was asked if she knew people smoked the product, she said she doesn’t know anything about what customers do with it.

A man leaving the store with a vial of the synthetic “incense” in his hand said he smokes it because he’s on probation for a DUI charge.

“Before (my DUI), I would not have tried any of this stuff,” said the man, who asked that he not be identified. “Even switching over to this stuff now that I can’t smoke weed is demeaning to me.”

The most common bath salt drugs, like MDPV and mephedrone, were first developed in pharmaceutical research laboratories, though they were never approved for medical use. During the last decade, they became popular as party drugs in Europe. As law enforcement began cracking down on the problem there, the drugs spread across the Atlantic Ocean.

The most dangerous synthetic drugs are stimulants that affect levels of both dopamine and serotonin, brain chemicals that affect mood and perception. Users, who typically smoke or snort the powder-based drugs, may experience a surge in energy, fever and delusions of invincibility.

Hospital emergency rooms, doctors and law enforcement agencies across the country have struggled to control bath salt drug users who often are feverish and paranoid. Hospitals in Bucks and Montgomery counties said they’ve had cases of suspected bath salts abuse, but they aren’t tracked separately from other drug overdoses.

Drugs Stay Legal After ‘Bath Salts’ Ban


  • bath salts.jpg
    AP Photo/The Patriot-News, Chris Knight

It’s the same old story.  People making up new ways to get high while lawmakers attempt to catch up to the ever-changing, ever-growing drug culture.

Over the past two years, the U.S. has seen a surge in the use of synthetic drugs made of legal chemicals that mimic the dangerous effects of cocaine, amphetamines and other illegal stimulants.

The drugs are often sold at small, independent stores in misleading packaging that suggests common household items like bath salts, incense and plant food. But the substances inside are powerful, mind-altering drugs that have been linked to bizarre and violent behavior across the country. Law enforcement officials refer to the drugs collectively as “bath salts,” though they have nothing in common with the fragrant toiletries used to moisturize skin.

President Barack Obama signed a bill into law earlier this month that bans the sale, production and possession of more than two dozen of the most common bath salt drugs. But health professionals say lawmakers cannot keep pace with bath salt producers, who constantly adjust their chemical formulations to come up with new synthetic drugs that aren’t covered by new laws. Experts who have studied the problem estimate there are more than 100 different bath salt chemicals in circulation.

“The moment you start to regulate one of them, they’ll come out with a variant that sometimes is even more potent,” said Dr. Nora Volkow, director of the National Institute on Drug Abuse.

There are no back alleys or crack houses in America’s latest drug epidemic. The problem involves potent substances that amateur chemists make, package and sell in stores under brands like “Ivory Wave,” ”Vanilla Sky” and “Bliss” for as little as $15. Emergencies related to the drugs have surged: The American Association of Poison Control Centers received more than 6,100 calls about bath salt drugs in 2011 — up from just 304 the year before — and more than 1,700 calls in the first half of 2012.

The problem for lawmakers is that it’s difficult to crack down on the drugs. U.S. laws prohibit the sale or possession of all substances that mimic illegal drugs, but only if federal prosecutors can show that they are intended for human use. People who make bath salts and similar drugs work around this by printing “not for human consumption” on virtually every packet.

Barbara Carreno, a spokeswoman for the Drug Enforcement Agency, said the intended use for bath salts is clear.

“Everyone knows these are drugs to get high, including the sellers,” she said.

Many states have banned some of the most common bath salts, which are typically sold by small businesses like convenience stores, tobacco shops and adult book stores. For instance, West Virginia legislators banned the bath salt drug MDPV last year, making it a misdemeanor to sell, buy or possess the synthetic drug. Conviction means up to six months in jail and a $1,000 fine.

Stephanie Mitchell, assistant manager of The Den, a tobacco and paraphernalia shop in Morgantown, W.Va., said the store hasn’t sold bath salts in the six months that she’s worked there. But strung-out users still come in and ask for them.

“They’re pretty … cracked out, I guess would be a good word,” said Mitchell, 21, a student at West Virginia University. “They’re just kind of not all there. They’re kind of sketchy people.”

Mitchell says she wouldn’t sell bath salts even if she had them, “because it’s horrible, and I could get in trouble for it.”

Despite the bans, bath salts producers are constantly tweaking their recipes to come up with new drugs that aren’t covered by local laws. In fact, Mark Ryan, director of the Louisiana Poison Center, says there are so many different drugs out there that it’s almost impossible to know what people have ingested, or how long the effects will last.

“Cocaine is cocaine and meth is meth. We know what these things do,” he said. “But with these new drugs, every time the chemist alters the chemical structure, all bets are off.”

The Spread

The most common bath salt drugs, like MDPV and mephedrone, were first developed in pharmaceutical research laboratories, though they were never approved for medical use. During the last decade they became popular as party drugs at European raves and dance clubs. As law enforcement began cracking down on the problem there, the drugs spread across the Atlantic Ocean.

Poison control centers in the U.S. began tracking use of the drugs in 2010. The majority of the early reports of drug use were clustered in Southern states like Louisiana, Tennessee and Kentucky. But the problem soon spread across the country.

The financial lure for small-time drugmakers is enticing. The drugs can be cheaply imported from China or India, and then easily packaged under local brands. For example, bath salts sold in Louisiana carry regional names like Hurricane Charlie or Bayou.

The widespread availability of the drugs in stores is equally alluring for drug users: they can get a cheap high similar to that of illegal drugs by walking to a corner store.

The most dangerous synthetic drugs are stimulants that affect levels of both dopamine and serotonin, brain chemicals that affect mood and perception. Users, who typically smoke or snort the powder-based drugs, may experience a surge in energy, fever and delusions of invincibility.

Use of these drugs has spread across the country with reports stretching from Maine to California. There are no official federal estimates on deaths connected with the drugs, many of which do not show up on typical drug tests. But police reports have implicated the drugs in several cases.

Packets of “Lady Bubbles” bath salts, for instance, were found on Sgt. David Franklyn Stewart last April after the solider shot and killed his wife and himself during a car chase with law enforcement near Olympia, Wash.

The chase began when Stewart sped past a police patrol car at 6 a.m. The police trooper pursued for 10 miles and reported seeing the driver raise a hand to his head, then heard a shot and saw the driver slump over. The next day police found the couple’s 5-year-old son dead in their home; he had been suffocated with a plastic bag at least 24 hours earlier.

Another death involving bath salts played out in Covington, La. Police reported that Dickie Sanders, 21, shot himself in the head Nov. 11, 2010 while his parents were asleep.

His father, Dr. Richard Sanders, said his son had snorted “Cloud 9” bath salts and endured three days of intermittent delirium, at one point attempting to cut his own throat. As he continued to have visions, his physician father tried to calm him. But the elder Sanders said that as he slept, his son went into another room and shot himself.

What’s Ahead

Hospital emergency rooms, doctors and law enforcement agencies across the country have struggled to control bath salt drug users who often are feverish and paranoid that they are being attacked. Doctors say users often turn up naked because bath salts raise their body temperature so much that they strip off their clothing.

Cookeville Regional Medical Center in Tennessee has treated 160 people suspected of taking bath salts since 2010. Dr. Sullivan Smith, who works there, said people on the drugs become combative, and it can take four or five health professionals to subdue them. In some cases, he said, doctors have to use prescription sedatives that are typically reserved for surgery.

Smith recalls one man who had been running for more than 24 hours because he believed the devil was chasing him with an ax. By the time police brought him to the hospital, he was dehydrated and covered in blood from running through thorny underbrush.

“We’re seeing extreme agitation, hallucinations that are very vivid, paranoia and some really violent behavior, so it’s a real crisis for us,” Smith said. “We sedate the living daylights out of them. And we’re talking doses on the order of 10 or 20 times what you would give for a painful procedure.”

To control the spread of the problem, the Drug Enforcement Agency issued a temporary ban in October on three of the most common drugs — mephedrone, methylone and MDPV. That ban became permanent under the bill signed by Obama on July 10.

Under the law, anyone convicted of selling, making or possessing 28 synthetic drugs, including bath salts, will face penalties similar to those for dealing traditional drugs like cocaine and heroin.

Those on the front lines say the legislation is a good start. But they don’t expect new laws to dramatically curb use of bath salts in the near term.

“The problem is these drugs are changing and I’m sure they’re going to find some that are a little bit different chemically so they don’t fall under the law,” said Dr. Smith, the Tennessee doctor. “Is it adequate to name five or 10 or even 20? The answer is no, they’re changing too fast.”

Read more: http://latino.foxnews.com/latino/health/2012/07/26/drugs-stay-legal-after-bath-salts-ban/#ixzz22DSc4GkX

Middletown man high on bath salts threatens to burn down local house


MIDDLETOWN — A city man was charged with second-degree unlawful restraint after allegedly snorting bath salts and saying he would burn down a house, police report.

Daniel Ventre, 28, 64 Pearl St., was also charged with third-degree assault. He was issued a summons for the charges and police reported completing an emergency committal form to have Ventre admitted to the hospital. He is due in court July 30.

Officers were sent to the victim’s home on July 29 around 6:10 p.m. for a report of a disturbance. The victim told police she fled to her mother’s home because of an argument with an ex-boyfriend, police said. She said Ventre had come over and she let him stay the night, but on Saturday morning they had a fight.

Ventre allededly threw her cell phone against a wall, breaking it, the victim told police. She also told police Ventre had been “smoking and snorting ‘bath salts’” and she was scared of him because he was “out of control.”

 

Ventre allegedly started pulling the victim’s hair and choking her, accusing her of stealing his bath salts, police said. The victim tried to leave, but Ventre said he would call the state Department of Children and Families and have her kids taken away if she did. He also threatened to burn the house down, police said.

Police reported seeing bruises on the victim’s arms and side and scratches on her neck. She was able to get to her mother’s house a short time later to call the police.

Ventre told police he and the victim had both been “smoking and snorting the ‘bath salts’ all weekend” before they got into a fight. Ventre said he was just defending himself, according to police.

Ventre had a difficult time focusing on the conversation, would randomly start talking about different subjects and his eyes were glassy and bloodshot, police said. He was confused and changed his story several times, according to police.

While being transported to the police station, Ventre allegedly complained of stomach pain and said he would kill himself and harm others in the process, so police took him to the hospital to be evaluated. He was ordered to have no contact with the victim.

Local police ‘bracing’ for bath salts in region


WEST BRIDGEWATER —
bathsalts.jpg
AP Photo/The Patriot-News, Chris Knight

Bath salts, in this case synthetic cocaine, are part of a new and highly dangerous generation of drugs that have begun to make an appearance locally.

If East Bridgewater Detective Michael Jenkins catches a suspect in town with the dangerous synthetic drug known as “bath salts,” he can’t criminally charge the person.

Jenkins said his only recourse is to cite the suspect with a misdemeanor under Massachusetts public health law, and issue a fine of $50 to $100.

This is despite a federal law signed by President Barack Obama on July 9 that outlaws synthetic drugs, including some chemicals found in bath salts.

“Our hands are kind of tied,” Jenkins said Monday. “Even though there’s a federal ban, state and local authorities have no jurisdiction over federal law. We’re not federal law enforcement officers.”

State lawmakers are hoping to change that.

For several months, lawmakers including state Sen. John Keenan, D-Quincy, and state Rep. George Ross, R-Attleboro, have been pushing for a state ban of bath salts. Keenan said he wants to make bath salts illegal in Massachusetts to avoid any ambiguities that may arise from different interpretations of the federal law.

“We need the same course of action here at the state level, that it’s made clear that in Massachusetts these substances are banned, that they’re not on the shelves,” Keenan said.

The ban was tacked on to another Senate bill co-authored by Keenan to monitor prescriptions for opiate painkillers. Ross first sponsored the bill to make bath salts a controlled substance after several constituents approached him.

Ross and Keenan are among state lawmakers who hope the bill passes before the end of the legislative session tonight.

“It’s very important,” Ross said. “I had a lot of people backing me up on it, law enforcement, health officials, parents of kids who were addicted.”

Bath salts, which are synthetic psychoactive drugs, have grown tremendously in popularity in recent years, sold under names such as “Spice” or “Vanilla Sky” in head shops, smoke shops and convenience stores.

On Thursday, the federal Drug Enforcement Administration announced it had seized more than $36 million in cash and arrested 91 people in a nationwide crackdown on synthetic drugs including bath salts and fake marijuana. Five million packets of synthetic drugs were seized.

Jenkins said that without a state ban “it is almost impossible” to enforce the new federal law in Massachusetts, unless it’s a collaborative effort with federal authorities on larger drug cases.

And local police expect to see more of it.

“We’re kind of bracing ourselves for it. It’s almost like the calm before the storm,” said West Bridgewater police Sgt. Tim Nixon, also a member of the WEB Major Crimes and Drug Task Force.

The drugs are considered so dangerous that in December, Abington police charged a local man with attempted manslaughter for selling them.

Jenkins, of East Bridgewater police, also said the federal law is a good start, but it “will not dramatically curb use of bath salts.”

“These drugs are constantly changing and the manufacturers will make a small chemical alteration to their formulas and they won’t fall under the law,” Jenkins said.

For hospital workers, bath salts problems grow


443499 Bath Salts main.jpg

Police remove boxes of evidence from Tebb’s Headshop on North Salina Street in Syracuse, N.Y., part of a statewide effort to target shops suspected of selling illegal synthetic drugs like bath salts, Wednesday, July 25, 2012. Federal, state and local law enforcement fanned out across the state today to raid shops suspected of selling illegal synthetic drugs, including “bath salts,” authorities said. (AP Photo/The Post-Standard, Lauren Long) NO SALES MAGS OUT, TV OUT, NO INTERNET

 

 

Hornell, N.Y. —

Emergency room workers say the patients can be scary when they come in. They exhibit strong hallucinations, psychosis and paranoia and, full of adrenaline, they are strong.

The number of patients who use bath salts jumped this year, St. James Mercy Hospital officials said. Since January, there have been eight cases; In June alone, there were four.

“It’s a very scary and unpredictable drug,” said Shannon Work, director of patient care services.

Bath salts are synthetic substances that often contain amphetamine-like chemicals, according to the National Institute on Drug Abuse. Stimulants, they have a “high abuse and addiction liability,” and have a high risk for side effects, the NIDA said.

Bath salts have made headlines around the country and the state over the last year, noted for the strange behavior they cause.

In June, a Utica woman, reportedly on bath salts, lunged at a police officer and screamed she wanted to “kill someone and eat them,” according to reports from The Associated Press.

Local medical professionals said bath salts cause users to become paranoid and sometimes psychotic.

“We had a few, they felt like they were being chased or they wanted to hide in a small room,” Work said.

Ann Domingos, director of Mercycare Addiction and Treatment Center of Hornell, said she had a patient, who had used bath salts, break all the mirrors in his house “because he was paranoid and he couldn’t look at himself.”

For emergency room staff, it is often not immediately clear what is wrong with a patient who comes in after using bath salts. Unless the patient or a family member tells staff bath salts were used, medical staff must treat the symptoms they see.

“Often folks are admitted psychiatrically thinking they’re psychotic when after a few days or even a week or so of treatment you find out, once they start to clear up and stabilize, that there was bath salt use,” said Lisa Hooker, manager of psychiatric nursing services. “And originally, that might just present as a psychotic processing and you wouldn’t necessarily pick that up.”

Bath salts are difficult to test for because one brand may differ chemically from another, said Alexander Garrard, a clinical toxicologist for Upstate New York Poison Control.

“This is a synthetic substance, unlike meth or Ecstasy. When you say ‘bath salts,’ there are a number of different chemicals under that name,” he said.

“In order to detect something, you have to know what you’re looking for.”

Poison Control advises medical care providers how to deal with bath salts exposures, he said. So far this year, Poison Control has had 313 calls on bath salts; last year, it only had 118.

But medical professionals don’t necessarily need to know someone is on bath salts in order to give them treatment, Garrard said.

Work said doctors first stabilize patients’ vitals and then try to calm them using sedation.

“It’s a poison control nightmare … even after doses of sedation in an emergency setting, oftentimes it’s just enough to get them where we need them to be,” Work said.

At the same time, emergency room workers are also trying to deal with patients who are also paranoid or combative.

“The biggest problem is that these patients are very difficult to manage. They can be violent and unpredictable,” Garrard said.

Patients are sedated and sometimes restrained in order to minimize the harm they could cause, both to others and themselves.

“The real risk is self-harm because of the paranoia. Running out into traffic, jumping out a window,” Hooker said. “It kind of triggers that fight or flight for people and I think that’s a lot of where you see aggressive or assaultive behaviors.”

The drug can be ingested, smoked, snorted or injected. Work said some users develop cysts, necrosis or infections at injection sites.

Symptoms also seem to last longer with bath salts than other substances.

“Typically with some other drugs, like cocaine, you see the patient start to come down after several hours, and with bath salts we’re seeing it’s a period of days or even weeks before you start to see the psychosis and the side effect start to clear out,” Hooker said.

Treatment for bath salts addiction is similar to treatment for any other addiction, Domingos said.

She said bath salts users typically have problems with other controlled substances.

“I believe it’s generally the same population. If you’re going to try bath salts, you have tried other things,” Domingos said. “It would be rare, I think, for somebody to start out (and use bath salts).”

Long term consequences from bath salts are still unclear, perhaps because one brand of the drug can differ chemically from another. Work said she’s seen high blood pressure and Domingos has had patients in treatment report difficulties with their vision.

“One went two weeks in treatment closing one eye because he couldn’t see,” she said.

Laws banning the sale of bath salts were added nationally and on the state level this year. Part of the problem is that legislation isn’t addressing possession, said Norman McCumiskey, Steuben County Drug Free Communities coordinator.

“Laws are banning the sale of bath salts in stores throughout New York State,” he said. “In spite of that, they suspect a lot of these stores are still selling (bath salts).”

Last week, police raided head shops across upstate and central New York, including a store near Elmira, in a series of raids connected to bath salts, reports from The Associated Press said.

Earlier this month, New York Attorney General Eric Schneiderman’s office filed lawsuits in 12 counties accusing 16 stores of violating state labelling laws.

“People that want it can still get it,” McCumiskey said.

For bath salt users, it can be a slippery slope into addiction.

“Patients report things like, ‘That was horrible, that was awful. I can’t wait to go do it again,'” Hooker said. “They get such vivid hallucinations, paranoia, but you can’t explain the process of ‘That was horrible, I can’t wait to go do it again,’ and get your head around that process.”

One time is enough to see serious medical consequences.

“It’s really crack on speed, so to speak. It’s another level,” Domingos said.