Washing away the Bath salts Myth – Part Two

This is Part Two in a short series by our South Island manager Finn Boyle about cathinones and the importance of nuanced language when we talk about them.

We highly recommend you read Part One which explains the history of cathinones how meaningless and misleading the term ‘bath salts’ is.

Lazy Language and the Responsibilities of Media

The Local Context:

In early July 2020, a flurry of articles and news pieces told the story of a drug-crazed young person clawing their own eyes out.

Reportedly, this person had taken what was only ever described as ‘bath salts’.

It may be that this person had taken a cathinone such as N-ethylpentylone, which has caused hospitalisations in NZ and around the world. As far as we know, no one actually tested this drug and identified it properly.

It certainly wasn’t done by KnowYourStuffNZ as some media first implied (later redacted). Nor was it tested by Police. Given the rapid media releases, it probably wasn’t identified in medical toxicology screening either.

Read the Herald article
Read the Stuff article

Predictably, the sensational headlines made a splash. Reporting on events like these is not inherently bad, but the lazy and inaccurate reporting is. Our drug market is cloudy and confusing enough without media compounding that.

This media attention had two main effects as seen from the perspective of KnowYourStuffNZ:

  1. On a positive note, the stories raised awareness of the risks of taking unknown substances (the person believed they had taken MDMA). That week, we had a large influx of people using our service in Dunedin. More people being curious and informing themselves? CHOICE!
  2. The myth of ‘bath salts’ is perpetuated along with a lack of nuance and useful information. This leads to greater harms further down the track.

As discussed in Part One of this series; some cathinones such as methylone are relatively low-risk and we know a fair bit about them. Others, such as n-ethylpentylone and eutylone are very dangerous, especially if people don’t know they’ve taken it.

The International Context and how we got here

Cue: American Media Shitstorm

Florida Man takes ‘bath salts’ and proceeds to eat faces
The Miami Cannibal aka ‘the Causeway Cannibal’ is an infamous example of gratuitous headlines claiming that ‘bath salts’ are leading to sensationally violent events.

Watch the CNN news clip about the Miami Cannibal

But here’s the twist: The Miami Cannibal tested negative for Cathinones or any other drug other than Cannabis.
Read the Boston Globe article with the drug test results

International media has had a feeding frenzy on this unsubstantiated “wave of drug-related violence”. There is a severe lack of high quality journalism investigating drug use/markets internationally, but especially in Aotearoa.

Names are important

Why does this all matter, you might ask?

When you call a substance by its individual name people know what they’re dealing with. They know how much to take, whether or not to take it after the kind of day they’ve had or what they might have already taken or what kind of experience they want to have.

If something is called a ‘bath salt’, and ‘bath salts’ have a presumed effect, the person runs the risk of expecting one type of reaction while getting something potentially far worse because they’ve taken a different substance.

But they’re all bath salts, amirite?

The time of Cindy:

Cindy wanted to use MDMA on the weekend. Cindy bought her MDMA from a trusted friend, but she was well aware that often even dealers don’t know exactly what they are selling. She decided to test it.
Cindy had heard that using reagent testing only to identify MDMA can be inaccurate and easily duped, so she took it to KnowYourStuffNZ to have it tested on a spectrometer.

It turns out that Cindy’s tan/brown crystal ‘MDMA’, which all her mates looked at and said “yeah, that’s good gear. I know cause its brown” was actually mephedrone.

Mephedrone: 4-MMC, 4-methyl-methcathinone aka Meow Meow, M-Cat or…’bath salts’.

Cindy learns that mephedrone is a reasonably well known drug which is part of the cathinone family. She learns about the unique profile of mephedrone, with its high intra-nasal bioavailability (very strong when snorted), short effect period (real short peak, quick come-down) and considerable neuro-toxicity (long term use = harm to your brain).

Cindy also learns how this is different from many cathinones and that each one needs to be considered individually for its effect and risk-profile. Cindy chooses to use her mephedrone because she decided that although the long-term and chronic effects are potentially harmful, she thought that experimenting with it once, after being informed about its effects and used in a safe, controlled environment, would be unlikely to cause significant harm.

The time of Jimbo:

Cindy told this story in full to her buddy Jimbo but he was playing Zelda at the time and didn’t really take it all in.

What he did remember from Cindy’s tale is that sometimes people call cathinones like Cindy’s mephedrone ‘bath salts’.

This sparked Jimbo’s memories of all those media headlines about cannibals and eye-gouging, so he thought he knew exactly what she was getting herself into.

Later that weekend Jimbo was hanging out with his other mates who also had some brown rocks they presumed to be MDMA.

They decided to test it but they hadn’t really planned ahead so KnowYourStuffNZ wasn’t open that day and they didn’t want to wait. They went to the local head-shop to buy an MDMA test kit which showed that they didn’t have MDMA either! Their kit gave various yellow/orange results which seemed to indicate their sample actually contained a cathinone.

No one had heard much about cathinones but they did recognise the little bracketed “bath salts” next to it!

But Jimbo knew that Cindy was pretty sensible and she was planning to use her ‘bath salts’ – so they can’t be that bad – right?
Plus, they had paid like $300 for a gram of this and they weren’t about to go ask for a refund from the random dude they bought it off.

So they racked up some lines.

That’s when Jimbo remembered what Cindy said about high potency when snorted. So they made the lines a little smaller than usual. Half an hour later, Jimbo and his mates were barely feeling anything. They figured that maybe their bath salts were cut or just “shit gear”.

So they racked up some bigger lines and snorted them.

This cycle continued into the wee hours of the morning. After a few lines, Jimbo and his mates started to really feel the effects. It certainly wasn’t the familiar, empathic high of MDMA, but they were wired and couldn’t stop talking about their great business plans, so it was pretty fun.

However even after they stopped snorting lines, the effects kept building and building. 6 hours later Jimbo was over it and ready for bed. But his high was not abating.

Now, as you might have guessed, Jimbo and his mates weren’t taking the same thing as Cindy.

While Cindy knew her cathinone was mephedrone and learnt about the specific effects. Jimbo and his mates just knew they had ‘bath salts’ and expected to have the same high as Cindy.

In fact, Jimbo and his mates had the novel cathinone called eutylone.

Eutylone: n-ethyl butylone, bk-EBDB or…’bath salts’

If Jimbo knew that this particular substance is actually a cathinone and not a ‘bath salt’, which includes a number of common, widely available stimulants, perhaps Jimbo would have wanted to know about the specifics of his gear:

If Jimbo had known what the unique profile of eutylone is he would have known that we don’t know much about eutylone.

It’s quite new and there’s almost zero evidence-based information available. From what we learned with the eutylone outbreak over the 2020-2021 season:

  • We now know eutylone has a slow onset and long effect-window (it keeps you awake for ages)
  • We now know eutylone, especially in high doses, causes strong stimulant effects and undesirable effects such as increased heart rate and body temperature, agitation and short-temperedness, vomiting, and seizures. In extreme cases the lack of sleep can cause psychosis
  • We now know eutylone in high doses can still make you feel sick up to 10 days after taking it

But Jimbo didn’t know this. So Jimbo endured the next 48 hours of tooth-grinding anxiety and agitation as the stimulant slowly worked its way through his system. Jimbo eventually felt overcome by the walls closing in around him as he sweated his nuts off in a shivering fever.

Jimbo considered running down the street naked, screaming about Hitler. He also considered what it would be like to eat someone’s face – cause that’s what all the news stories said about bath salts.

Thankfully, like most people who take eutylone, Jimbo didn’t do anything too regrettable and didn’t end up in hospital. Supported by his friends, Jimbo made it through his harrowing experience relatively unscathed.

Call the substance what it is

If journalists genuinely want to inform people about dangerous substances they’ll use the right names. If it’s an unknown cathinone like C86 was back in 2019, then they’ll say ‘unknown cathinone’.

If it’s a known cathinone, they’ll say ‘eutylone’ or ‘n-ethylpentalone’ or ‘alpha-pvp’ or ‘mephedrone’ or whatever the hell it’s called. Known substances have known risks. No decent journalist would use ‘opioid’ if they’re talking about oxycontin, or ‘miscellaneous white stuff’ if they’re talking about ketamine.

If the journalist is a sensationalist that wants to get everyone rarked up, they’ll use the term ‘bath salts’.

‘Bath salts’ isn’t something that requires any actual research into the story and has a history of cannibalism, self-mutilation, and basically being the monster under the bed to shock people into clutching their pearls. It’s the low-hanging fruit of headlines.

These ‘journalists’ don’t give a toss about the damage they do by being deliberately vague. Don’t give them your clicks.

Washing away the Bath salts myth – part one

This is Part One in a short series by our South Island manager Finn Boyle about cathinones and the importance of nuanced language when we talk about them.

Calling cathinones ‘bath salts’ is oversimplification

Cathinones are here to stay. We need better language to help manage their presence in our drug market.

Cathinones are a very wide and diverse family of stimulant drugs. Calling them “bath salts” is misleading. Calling a wide range of substances the same name gives the illusion that all cathinones will have the same effect.

Just as not all viruses cause the same kind of illnesses, not all cathinones cause the same kind of experience. Lumping all cathinones under the ‘bath salts’ label makes effective communication around this topic confusing and difficult.

We need to move away from the label “bath salts” and start using language that allows for the variety within the cathinone family.

Where did the ‘bath salts’ thing come from anyway?

In the early-mid 2000s a new type of stimulant emerged. Methylone, also known as bk-MDMA, the first popularised drug in the cathinone family. Methylone, it turns out, is relatively low-risk as it has a similar chemical structure and effect to MDMA.

Other chemists and legal systems soon caught onto the existence of methylone.

As has played out in every story of ‘Drug Market vs Prohibition’ since the alcohol prohibition era 100 years ago, a predictable game of cat and mouse began.

Law-makers tried to legislate against the new substances and chemists played with the structure of the molecule just enough to maintain similar user effects but different enough to avoid being classified as a controlled substance.

Throughout this cat and mouse story, chemists and distributors sold new/novel substances in a quasi-legal way. Marketing them as “not for human consumption” meant that the substances didn’t break any drug laws.

So, cathinones imported into the US began to be sold legally by being called ‘bath salts’. In the UK it was ‘plant food.’ Cathinones are neither of these things.

All this happened in the US and the UK, but New Zealand inherited the term through moral-panic based US news media around Alpha-PVP.

‘Bath salts’ could mean anything

‘Bath salts’ as a label means nothing.

Hundreds of products containing hundreds of ingredients have been sold under this moniker, including pleasant-smelling things that you put in your bath water, inert things that do absolutely nothing, mild stimulants that make you chatty for a few hours with no real ill effects, and foul-tasting things that keep you awake for days or could kill you.

Over about a decade where this was common practice, a countless number of substances were sold in packages labelled as ‘Bath salts’ or ‘Plant Food’.

The majority of these substances were cathinones. Sometimes they would be blended with synthetic cannabinoids, herbal ingredients and other more socially acceptable stimulants such as caffeine.

The Potency Effect

Also perfectly in line with that old Drug Market vs Prohibition arc is the trend known as the Potency Effect, The Alchian-Allan Theorem, or ‘the iron law of drug prohibition‘.
It states

‘Criminalisation and prohibition of a drug will induce a market effect which rewards higher-potency forms of the drug.’
E.g why import a tonne of unrefined Milk of the Poppy when you could bring in a tonne of Heroin with the same logistical challenges and 1000x the potency/profit?

Slow, unresponsive legislative systems around the globe have tried to keep up with pharmacological innovation by defining and regulating against specific compounds such as methylone. Drug producers have been incentivised to develop more varied and higher potency substances – leading to substances such as the very dangerous n-ethylpentylone.

Thanks to the innovation of drug manufacturers we now have a large family of cathinones that have varying effects, all being called ‘bath salts’.

Some drugs in this family such as methylone are relatively low-risk. Others such as n-ethylpentylone, alpha-PVP, or eutylone are high-risk.

When cathinones are sold as MDMA things go bad

Cathinones are often sold deceptively or unknowingly as MDMA. They are often cheaper and more available than MDMA or other amphetamines, especially since COVID-19 hit.

This is incredibly problematic. If people unknowingly take a cathinone in place of MDMA and have a difficult time, telling a medic that they’ve had ‘bath salts’ could mean they’ve had a miscellaneous drug, or they could have eaten something from in their Nan’s toiletries cabinet.

Using the term ‘cathinone’ lets the medics know immediately that they’re dealing with one of a particular family of drugs and need to give medical care accordingly.

We’ll talk about the main problems that arise from the press continuing to use ‘bath salts’ in Part 2.