Substance-Abuse Babies in Foster Care

When you think about babies affected by substance abuse, Meth may first come to mind. A new designer drug trend is emerging–“bath salts”. This is not Calgon, take me away bath salts. This is a mixture of three synthetic stimulants — mephedrone, MDPV, and methylone.

Also known as “plant food”, it is marketed under the names “Ivory Wave,” “Purple Wave,” Vanilla Sky,” and “Bliss.” The federal government has not yet made these permanently-controlled substances, and unfortunately foster care systems are already seeing infants born prematurely to mothers who have taken this dangerous combination. It is unknown what the long-term effects on infants will be.

In Michigan, “”We’re getting a lot of substance abuse babies, we call them,” Allen said, adding for now, the substance of choice in 2011 was bath salts. Right now, the court is working with cases of four infants who were born prematurely due to their mothers’ use of bath salts while pregnant.

“They’re very hard cases,” she said.”

Poverty, bath salts linked to child abuse
[Midland Daily News 1/26/12 by Kelly Dame]

Some states did have a ban on them or had bills working their way through the legislatures. This forum tracked the state laws. Then on September 7, 2011, the Drug Enforcement Agency (DEA) invoked a one-year temporary control, using its emergency scheduling authority. See here. Excerpt: “[T]hese products are comprised of a class of chemicals perceived as mimics of 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 are sold at a variety of retail outlets, in head shops and over the Internet. However, they have not been approved by the FDA for human consumption or for medical use, and there is no oversight of the manufacturing process.

In the last six months, DEA has received an increasing number of reports from poison centers, hospitals and law enforcement regarding products containing one or more of these chemicals. Thirty-three states have already taken action to control or ban these or other synthetic stimulants. The Comprehensive Crime Control Act of 1984 amends the Controlled Substances Act (CSA) to allow the DEA Administrator to temporarily schedule an abused, harmful, non-medical substance in order to avoid an imminent hazard to public safety while the formal rule-making procedures described in the CSA are being conducted. ”

WebMD gives a good Q and A(pasted below):

“WebMD talked to Zane Horowitz, MD, an emergency room physician and medical director of the Oregon Poison Center, about what they are and why you should avoid them.

First of all, what are bath salts?

“The presumption is that most bath salts are MDPV, or methylenedioxypyrovalerone, although newer pyrovalerone derivatives are being made by illegal street chemists. Nobody really knows, because there is no way to test for these substances,” Horowitz says.

Why are they called bath salts?

“It’s confusing. Is this what we put in our bathtubs, like Epsom salts? No. But by marketing them as bath salts and labeling them ‘not for human consumption,’ they have been able to avoid them being specifically enumerated as illegal,” Horowitz says.

Are bath salts illegal?[See Temporary ban from September 7, 2011 above]

“You can find them in mini-marts and smoke shops sold as Ivory Wave, Bolivian Bath, and other names,” Horowitz says. “The people who make these things have skirted the laws that make these types of things illegal. While several states have banned the sale of bath salts, ultimately it will have to be a federal law that labels these as a schedule 1 drug, which means it has no medicinal value but a high potential for abuse, and declare them illegal.”

What do you experience when you take bath salts?

“Agitation, paranoia, hallucinations, chest pain, suicidality. It’s a very scary stimulant that is out there. We get high blood pressure and increased pulse, but there’s something more, something different that’s causing these other extreme effects. But right now, there’s no test to pick up this drug. The only way we know if someone has taken them is if they tell you they have.

The clinical presentation is similar to mephedrone [a chemical found in other designer drugs], with agitation, psychosis, and stimulatory effects. Both of these agents should be of concern, as severe agitated behavior, like an amphetamine overdose, has occurred.

A second concern is the ongoing suicidality in these patients, even after the stimulatory effects of the drugs have worn off. At least for MDPV, there have been a few highly publicized suicides a few days after their use,” Horowitz says.

Are bath salts addictive? How are they taken?

“We don’t know if they are addictive. We have not had enough long-term experience with it. Acute toxicity is the main problem. But many stimulants do cause a craving. The people who take them are very creative. They snort it, shoot it, mix it with food and drink,” Horowitz says.

Bath salts are the latest example of designer drugs. Where do you see this trend going?

“That’s right. They are part of a long line of other pills and substances that we call designer drugs. And drug makers will keep creating new combinations at home and in illicit labs,” Horowitz says. “It’s almost impossible to keep up. And the motivation for buying them is always the same: Drugs like these are new and below the radar, unlike named illegal drugs.””

REFORM Puzzle Piece

It is important to keep up with emerging trends impacting the foster care system.