Bath Salts Abuse and Addiction

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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How do health-care professionals diagnose bath salts use disorder?

As with any drug use disorder, bath salts use disorder is a condition that is characterized by a destructive pattern of using the drug(s) that leads to significant problems or distress, significant problems involving tolerance to or withdrawal from it, as well as other problems that the use of bath salts can cause for the sufferer, socially or in terms of the person's work or school performance. This pattern is manifested by at least two of the following warning signs or symptoms of use or abuse in the same one-year period:

  • Recurrent bath salts use that results in a lack of meeting important obligations at work, school, or home
  • Repeated bath salts use in situations that can be dangerous
  • Continued bath salts use despite continued or repeated social or relationship problems as due to the drug's effects
  • Tolerance, which is either significantly decreased effect of bath salts or a need to substantially increase the amount used in order to achieve the same high or other desired effects
  • Withdrawal, which is either physical or psychological signs or symptoms that characterize withdrawal from bath salts, or taking it or a substance that is chemically related in order to avoid developing symptoms of withdrawal
  • Larger amounts of bath salts are taken or for longer than intended
  • The individual experiences persistent desire to take the drug or has unsuccessful attempts to lessen or control its use
  • Substantial amounts of time are spent getting, using, or recovering from the effects of bath salts
  • The person markedly reduces or stops participating in important social, recreational, work, or school activities as a result of using bath salts. The individual continues to use bath salts despite being aware that he or she suffers from ongoing or recurring physical or psychological problems that are caused or worsened by the use of the drug.
  • Craving/a strong desire to use the substance

There is no single test that indicates someone has bath salts use disorder with complete certainty. Therefore, health-care professionals diagnose this condition by thoroughly gathering medical, family, and mental-health information. The practitioner will also either perform a physical examination or request that the individual's primary-care doctor do so. The medical assessment usually includes lab tests to assess the person's general health and to explore whether or not the individual is using other drugs, has been exposed to any environmental toxins, or has a medical condition that includes mental-health symptoms.

In asking questions about mental-health symptoms, mental-health practitioners are often trying to determine if the person suffers from depressive and/or manic symptoms, as well as whether the individual is anxious or suffers from, hallucinations, delusions, or some behavioral disorder. Health-care professionals may provide the people they evaluate with a quiz or self-test to screen for substance use disorder. Since some of the symptoms of bath salts use disorder can also occur in other mental illnesses, the mental-health screening helps determine if the individual suffers from bipolar disorder, an anxiety disorder, schizophrenia, schizoaffective disorder, or other psychotic disorder. Any disorder that is associated with sudden changes in behavior, mood, or thinking, like bipolar disorder, a psychotic disorder, borderline personality disorder, or dissociative identity disorder (DID), may be particularly challenging to distinguish from some symptoms of bath salts use disorder. In order to assess the person's current emotional state, health-care professionals perform a mental-status examination, as well.

In addition to providing treatment that is appropriate to the diagnosis and to the person in need of it, determining the presence of mental illnesses that may co-occur (co-morbid/dual diagnosis) with bath salts use disorder is important in promoting the best possible outcome. Dual diagnosis of bath salts addicted individuals indicates the need for treatment that addresses both issues in an integrated fashion by practitioners with training and experience with helping this specific population.

Medically Reviewed by a Doctor on 2/16/2016

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