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Substituted Cathinone Products: A New Trend in “Bath Salts” and Other Designer Stimulant Drug Use

Gunderson, Erik W. MD; Kirkpatrick, Matthew G. PhD; Willing, Laura M. BS; Holstege, Christopher P. MD

doi: 10.1097/ADM.0b013e31829084b7

There is a growing concern about the availability of a new generation of “designer drug” stimulants that are marketed as “bath salts” and other household products. The products are not true bath salts and contain substituted cathinone stimulant substances, such as methylenedioxypyrovalerone (MDPV) and mephedrone. Calls to the American Association of Poison Control Centers regarding “bath salts” consumption began in 2010 and have continued since that time. Few reports of systematic epidemiologic surveillance or definitive clinical effects of toxicity specifically associated with “bath salts” consumption have been reported in the medical literature. The current narrative review describes the growing trend of designer substituted cathinone use, pharmacology, clinical effects, and recent regulatory changes. It is hoped that a greater understanding of the clinical effects and use patterns will help inform policy and practice.

From the University of Virginia School of Medicine (EWG and CPH), Charlottesville VA; Center for Wellness and Change (EWG), Charlottesville, VA; Columbia University College of Physicians and Surgeons (EWG), New York, NY; University of Chicago (MGK), Chicago, IL; and University of North Carolina School of Medicine, Chapel Hill (LMW).

Send correspondence and reprint requests to Erik W. Gunderson, MD, University of Virginia Health System, University of Virginia School of Medicine, Box 800623, Charlottesville, VA 22908. E-mail:

Supported by Youth-Nex, the Center to Promote Effective Youth Development, University of Virginia Curry School of Education (Dr Gunderson), and T32 DA 007255 (Dr Kirkpatrick).

Dr Gunderson provides consultation for MedicaSafe, Inc. (131 Varick St, Suite 934, New York, NY) and Orexo AB (Box 303 SE-751 05 Uppsala, Sweden).

The other authors declare no conflicts of interest.

Received June 08, 2012

Accepted March 05, 2013

© 2013 American Society of Addiction Medicine