As Florida bath salts deaths rise, drug enforcers stymied

TAMPA — When Jairious McGhee ran through a busy Tampa intersection screaming rap lyrics, when an officer's Taser barely slowed him and he fought off medics, when his heart stopped five times and he eventually died, the drug in his body was legal in most states.

It was April 2011, and bath salts had made few headlines. Attorney General Pam Bondi had just issued a temporary ban on the drug in Florida, but within three months, the U.S. Department of Justice would be calling this fine white powder an "emerging domestic threat."

Now its use is spreading, as law enforcement struggles to deal with a new designer drug that changes shape every time officials try to crack down.

More than 20 people have died in Florida from bath salts, according to a Tampa Bay Times examination of the drug's impact in Florida.

Two of the victims — both 23-year-old men — died in Tampa. One thought he was using ecstasy at a rave. The other was a caterer with no criminal record.

Both had methylone in their system, a type of "bath salts," which is the street name for this stimulant meant to mimic ecstasy or cocaine.

Methylone is now illegal in the United States, added by federal authorities to a list of banned chemicals that grows each year. But many variations are still being openly sold because every time legislators outlaw one compound, chemists simply tweak the formula to produce an unregulated drug.

Meanwhile, Florida medical examiner reports show bath salts are killing people across race, age and gender divisions.

Some die horrible deaths, like the Tampa caterer, Jairious McGhee — the first known bath salts death in the Tampa Bay area. His temperature skyrocketed, causing his muscles to break down and release toxins.

Others simply do not wake up.

And more still are committing shocking acts after using bath salts. According to their own accounts:

A California man attacked an elderly woman with a shovel.

A Pennsylvania man kicked a trooper and bit a paramedic.

A Georgia man went wild at a golf course and threatened to eat people.

Perhaps a Miami man actually did.

Authorities initially suspected bath salts when Rudy Eugene chewed off most of a homeless man's face in May. Tests confirmed the presence of marijuana, but scientists say it is possible Eugene had another drug in his system. Most toxicology labs do not have the ability to test for the newest synthetic drugs.

This summer, the U.S. Drug Enforcement Administration announced a national synthetic drug roundup — the first of its kind — called "Operation Log Jam." But unless laws are strengthened, legislators will have to ban a virtually limitless list of stimulants or face lengthy, expensive legal battles. At street level, police don't seem to have a strategy, focusing instead on traditional illegal drugs and prescription drug abuse.

Meanwhile, more people are being rushed to emergency rooms, and scientists can only guess bath salts' long-term effects.

"Who's to say that the ingestion of these drugs won't result in neurologic problems?" said University of Florida toxicology director Bruce Goldberger. "There are no studies at all."

• • •

Julia Pearson studied the drug screen results on her computer. A telltale peak in the mass spectrum told her that Jairious McGhee had a stimulant in his system when he died.

But what kind?

Pearson, the chief forensic toxicologist at the Hillsborough Medical Examiner's Office, thought the results looked similar to a case of bath salts discussed in the previous month's ToxTalk newsletter. But no one had published methods for confirming all the emerging types of this drug.

In early 2011, Pearson and the rest of the country did not know much about bath salts.

The previous year, Poison Control centers nationwide received only 304 calls about bath salts.

By the end of 2011, the number of calls would grow 20 times to more than 6,000.

Despite its name, this drug has nothing to do with relaxing crystals for the tub.

Instead, "bath salts" is the umbrella term for synthetic cathinones, a substance found naturally in a shrub called khat (pronounced "cot"). The plant has been abused and banned in the United States for decades and is native to east Africa and southern Arabia, where it is legal. Much of Yemen's agriculture is devoted to the plant.

Cathinones are similar to amphetamines, which include the popular drug methamphetamine (meth). And they are in the same drug class as ecstasy.

Their misuse is not new. One chemical variation — methcathinone — was used as an antidepressant in the Soviet Union in the 1930s and misused as a recreational drug in the 1970s and '80s.

So why the resurgence?

Some believe it is because bath salts have effects similar to ecstasy and cocaine, which are hard to get in their pure forms now. Bath salts are easy to obtain — available online or at head shops and convenience stores.

They are also cheap, selling for about $25 for a small packet. And they do not show up on common drug tests.

Despite some of the side effects, including increased heart rate and temperature, bath salts can sometimes feel exciting or empowering, users and scientists say. The drug promotes the release of the feel-good neurotransmitters dopamine, serotonin and norepinephrine.

Jessica Gillespie remembers the euphoria.

One particular strain — which came in a packet with a picture of a smiling snowman — was like pure cocaine without the cravings or comedown, she recalled.

Gillespie, a 28-year-old hairdresser from Arizona, spent a month at a Florida drug rehabilitation center this summer because, she says, she was addicted to bath salts.

Scientific studies have not confirmed that addiction is possible, but Gillespie says she felt compelled to use the drug even though it drove her to scratch at her feet until they bled.

It drove her apart from her husband and made her heart beat so rapidly, she would lie in bed and pray she would live through the night.

"I'll never do this again," she remembers pleading. "Please let me wake up in the morning."

• • •

A teenage boy convulsed on the ground at a St. Petersburg hospital, yelling garbled religious phrases — something about being a god.

Though he was only about 120 pounds, it took several people to restrain him at Bayfront Medical Center. Workers strapped him to a hospital bed and injected sedatives into his veins. Then they put him on a ventilator.

Dr. Hiten Upadhyay assumed the boy had ingested something. He had arrived at the hospital with another teen who had similar symptoms.

The young men's friend told the doctor: bath salts.

This was a year ago, and the doctor had never heard of bath salts. He typed the phrase into a search engine. Then he called Poison Control.

At Tampa General, Dr. Jacob Eastman believes he has seen about 10 cases of bath salts intoxication over the past year, but he cannot be sure. No quick test exists, so doctors and police are often left wondering.

Emergency room physicians have to rely on anecdotal information. Then, because there isn't a cure, doctors simply provide supportive care. If patients' temperatures are high, doctors give them chilled blankets and cool intravenous fluids. If they are agitated, they get sedatives.

Upadhyay says when the teenage boy he treated a year ago woke up the next day, he did not remember what happened.

Scientists do not know why some people survive and others, like Jairious McGhee, die. It could be the quantity or the type of cathinone used. Maybe it was the person's body type or metabolism. Other drug and alcohol use could play a role.

Sherri Kacinko is a toxicologist with NMS Labs — a Pennsylvania company that develops tests for new drugs — and though she studies bath salts, even she is not sure of all the drug's effects.

In presentations to scientists across the country, she often jokes that users should contact her for the sake of science:

"Please call me so I can get blood and urine samples," she says.

• • •

In December 2011, a 23-year-old St. Petersburg man was raving at an East Tampa after-hours club called Rat Soap, where dancers wave glow sticks to thumping electronic music.

At some point he used the same type of bath salts McGhee did — methylone. But records indicate Nelson Martinez thought he was using ecstasy.

Soon, clubgoers noticed Martinez "freaking out."

According to a court document filed by Tampa police, the club's manager sat Martinez down in a chair, wrapped him in plastic wrap to stop his flailing and forced a Valium in his mouth. With the help of another, the manager loaded Martinez in a van.

When Martinez's friends got a call about him, they headed to the club and found Martinez still in the van.

He was having a seizure and foaming at the mouth. His temperature was 107.

An hour later, he was dead.

• • •

A year ago, a high-ranking official with the U.S. Drug Enforcement Administration testified in front of Congress about a "new era of drug distribution."

"No longer are these substances sold in a covert manner to thwart law enforcement efforts," said Deputy Assistant Administrator Joseph Rannazzisi.

With this strategy, designer drugmakers are winning.

While Tampa Bay area law enforcement is targeting synthetic marijuana, bath salts are slipping by them.

A couple of issues are at play: Officers often do not know what they're seeing. Also, bath salts are not prescribed by doctors or dealt on the streets.

Finally, with prescription drug abuse at the epidemic level, synthetics are not always a priority — unless an agency makes it one.

Attorney General Bondi has said cracking down on synthetic drugs is of great concern, but the state's lawmakers have been bogged down by a "cat-and-mouse game."

Bondi calls the drugmakers "creative chemists" and said the manufacturers — largely based in labs in China, Pakistan and India — rebound quickly. Federal officials believe the drugs are made in large quantities, then shipped to Europe for distribution.

"It's a moneymaking business," she said.

In a recent study, Indiana toxicologists confirmed that drugmakers indeed are staying ahead of the law. Soon after the first major federal ban was announced Sept. 7, 2011, packages released into market had new chemicals.

Similar, but legal.

The Times recently purchased bath salts from an online company that promised its products were legal in Florida. The company required a direct deposit into a British bank, and the packets arrived in an envelope sent from Spain.

Each packet cost about $30.

The drug? According to a chemical analysis paid for by the Times, it was methiopropamine.

This compound is similar to the widespread — and outlawed — methamphetamine (or meth).

And it is legal in Florida.

Legal, unless authorities use a federal law called the Analog Act to assert that this compound is "substantially similar" to meth.

But the Analog Act, passed in 1986, is riddled with problems because it is vague. Prosecutors rarely use it.

In an online drug forum, "Synthetic Dave" provided his take on the country's war on bath salts:

Congress is retarded, like all of the chemists and vendors and even users say: "You keep banning them, Well keep making new ones" … I laugh when i see this because they are never going to win.

Authorities agree that, for now, they are not going to win.

"Just trying to ban as many chemicals as possible is not going to solve this problem," said DEA spokesman Rusty Payne.

Authorities say they need another tool because, in the words of Hillsborough chief toxicologist Pearson, these chemists are "relentless."

"It's a never-ending revolving door."

Times news researchers John Martin and Natalie Watson contributed to this report, which used information from the Associated Press. Jessica Vander Velde can be reached at jvandervelde@tampabay.com or (813) 226-3433.

Common effects of bath salts

• accelerated heartbeat

• agitation

• anxiety

• hyperthermia

• hallucinations

• confusion

• nausea

• chest pain

• breathlessness

• insomnia

Source: Advisory Council on the Misuse of Drugs

As Florida bath salts deaths rise, drug enforcers stymied 10/13/12 [Last modified: Saturday, October 13, 2012 8:19pm]

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