Bath Salt-Induced Psychosis: Nursing Assessment, Diagnosis, Treatment, and Outcomes

Perspectives in Psychiatric Care

Volumn 52, Issue 1, 2016, Pages 68-78

  Stiles, Brandie Marie ^a   Fish, Anne F ^a   Cook, Cynthia A ^b   Silva, Victor ^c  

^a UNIVERSITY OF MISSOURI   (United States)

^b SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c St Anthony's Medical Center   (United States)

Author keywords

Bath salt induced psychosis; Bath salts; Psychosis; Synthetic cathinones

Indexed keywords

ALKALOID; CATHINONE; STREET DRUG;

ADDICTION; DELUSION; HALLUCINATION; HUMAN; NURSING ASSESSMENT; PROCEDURES; PSYCHOSES, SUBSTANCE-INDUCED; TREATMENT OUTCOME;

ALKALOIDS; BEHAVIOR, ADDICTIVE; DELUSIONS; HALLUCINATIONS; HUMANS; NURSING ASSESSMENT; PSYCHOSES, SUBSTANCE-INDUCED; STREET DRUGS; TREATMENT OUTCOME;

EID: 84956591118     PISSN: 00315990     EISSN: 17446163     Source Type: Journal    
DOI: 10.1111/ppc.12101     Document Type: Article

References (69)

1. Airuehia, E., Young-Walker, L., & Nittler, J. (2012). A review of "bath salts": Evolving designer drugs of abuse. Journal of Clinical Toxicology, 2, 1-3. doi:10.4172/2161-0495.1000125
2. Al-Kholani, A. I. (2010). Influence of khat chewing on periodontal tissues and oral hygiene status among Yemenis. Dental Research Journal, 7(1), 1-6.
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
4. Antonowicz, J. L., Metzger, A. K., & Ramanujam, S. L. (2011). Paranoid psychosis induced by consumption of methylenedioxypyrovalerone: Two cases. General Hospital Psychiatry, 33, 640.e5-640.e6. doi:10.1016/j.genhosppsych.2011.04.010
5. Benzer, T. I., Nejad, S. H., & Flood, J. G. (2013). Case 40-2013: A 36-year-old man with agitation and paranoia. New England Journal of Medicine, 369(26), 2536-2545. doi:10.1056/NEJMcpc1304051
6. Benzie, F., Hekman, K., Cameron, L., Wade, D. R., Miller, C., Smolinske, S., & Warrick, B. (2011). Emergency department visits after use of a drug sold as "bath salts"-Michigan, November 13, 2010-March 31, 2011. Morbidity and Mortality Weekly Report, 60(19), 624-627.
7. Bonano, J. S., Glennon, R. A., De Felice, L. J., Banks, M. L., & Negus, S. S. (2014). Abuse-related and abuse-limiting effects of methcathinone and the synthetic "bath salts" cathinone analogs methylenedioxypyrovalerone (MDPV), methylone and mephedrone on intracranial self-stimulation in rats. Psychopharmacology, 231, 199-207. doi:10.1007/s00213-013-3223-5
8. Bonner, G., & McLaughlin, S. (2007). The psychological impact of aggression on nursing staff. British Journal of Nursing, 16, 810-814. doi:10.12968/bjon.2007.16.13.24248
9. Borek, H. A., & Holstege, C. P. (2012). Hyperthermia and multiorgan failure after abuse of "bath salts" containing 3, 4 methylenedioxypyrovalerone. Annals of Emergency Medicine, 60(1), 103-105. doi:10.1016/j.annemergmed.2012.01.005
10. Boulanger-Gobeil, C., St-Onge, M., Laliberte, M., & Auger, P. L. (2012). Seizures and hyponatremia related ethcathinone and methylone poisoning. Journal of Medical Toxicology, 8, 59-61. doi:10.1007/s13181-011-0159-1
11. Cherpitel, C. J., & Ye, Y. (2012). Trends in alcohol- and drug-related emergency department and primary care visits: Data from four U.S. national surveys (1995-2010). Journal of Studies on Alcohol and Drugs, 73, 454-458.
12. Crisis Prevention Institute. (2014). Nonviolent crisis intervention training program. Retrieved from http://www.crisisprevention.com/About-CPI
13. Dargan, P. I., Sedefov, R., Gallegos, A., & Wood, D. M. (2011). The pharmacology and toxicology of the synthetic cathinone mephedrone (4-methylmethcathione). Drug Testing and Analysis, 3, 454-463. doi:10.1002/dta.312
14. Darke, S., Degenhardt, L., & Mattick, R. (2007). Mortality amongst illicit drug users: Epidemiology, causes and intervention. Cambridge: Cambridge University Press.
15. Darke, S., Kaye, S., McKetin, R., & Duflou, J. (2008). Major physical and psychological harms of methamphetamine use. Drug and Alcohol Review, 27, 253-262. doi:10.1080/09595230801923702
16. Darke, S., Torok, M., Kaye, S., & Duflou, J. (2010). Cardiovascular disease risk factors and symptoms among regular psychostimulant users. Drug and Alcohol Review, 29, 371-377. doi:10.1111/j.1465-3362.2009.00158.x
17. Derungs, A., Schietzer, S., Meyer, M. R., Maurer, H. H., Krähenbühl, S., & Liechti, M. E. (2011). Sympathomimetic toxicity in a case of analytically confirmed recreational use of naphyrone (naphthylpyrovalerone). Clinical Toxicology, 49, 691-693. doi:10.3109/15563650.2011.592838
18. Donnelly, M. T. (2011). Acute toxicities in persons exposed to substances marketed as "bath salts." Missouri DHSS, Health Advisory.
19. Falgiani, M., Desai, B., & Ryan, M. (2012). "Bath salts" intoxication: A case report. Case Reports in Emergency Medicine, 49, 1-2. doi:10.1155/2012/976314
20. Forrester, M. B. (2013). Adolescent synthetic cathinone exposures reported to Texas poison centers. Pediatric Emergency Care, 29(2), 151-155. doi:10.1097/PEC.0b013e3182808ae2
21. German, C. L., Fleckenstein, A. E., & Hanson, G. R. (2014). Bath salts and synthetic cathinones: An emerging designer drug phenomenon. Life Sciences, 97(1), 2-8. doi:10.1016/j.lfs.2013.07.023
22. Goshgarian, A. M., Benford, D. M., & Caplan, J. P. (2011). Bath salt abuse: Neuropsychiatric effects of cathinone derivatives. Psychosomatics, 52, 593-596. doi:10.1016/j.psym.2011.03.003
23. Hahn, S., Hantikainen, V., Needham, I., Kok, G., Dassen, T., & Halfens, R. J. G. (2012). Patient and visitor violence in the general hospital, occurrence, staff interventions and consequences: A cross-sectional survey. Journal of Advanced Nursing, 68, 2685-2699. doi:10.1111/j.1365-2648.2012.05967.x
24. Imam, S. F., Patel, H., Mahmoud, M., Prakash, N. A., King, M. S., & Fremont, R. D. (2013). Bath salts intoxication: A case series. Journal of Emergency Medicine, 45(3), 361-365. doi:10.1016/j.jemermed.2013.04.017
25. Israel, H. (2011). Patterns and trends in drug abuse in St. Louis, Missouri: 2010. Proceedings of the Community Epidemiology Work Group, 256-265.
26. James, D., Adams, R. D., Spears, R., Cooper, G., Lupton, D. J., Thompson, J. P., & National Poisons Information Service. (2011). Clinical characteristics of mephedrone toxicity reported to the U.K. National Poisons Information Service. Emergency Medical Journal, 28, 686-689. doi:10.1136/emj.2010.096636
27. Jerry, J., Collins, G., & Streem, D. (2012). Synthetic legal intoxicating drugs: The emerging "incense" and "bath salt" phenomenon. Cleveland Clinic Journal of Medicine, 79, 258-264. doi:10.3949/ccjm.79a.11147
28. Jordan, J., & Harrison, B. E. (2013). Bath salts ingestion: Diagnosis and treatment of substance-induced disorders. Journal for Nurse Practitioners, 9(7), 403-410. doi:10.1016/j.nurpra.2013.04.018
29. Kasick, D. P., McKnight, C. A., & Klisovic, E. (2012). "Bath salt" ingestion leading to severe intoxication delirium: Two cases and a brief review of the emergence of mephedrone use. American Journal of Drug and Alcohol Abuse, 38, 176-180. doi:10.3109/00952990.2011.643999
30. Kelly, J. P. (2011). Cathinone derivatives: A review of their chemistry, pharmacology and toxicology. Drug Testing and Analysis, 3, 439-453. doi:10.1002/dta.313
31. Kesha, K., Boggs, C. L., Ripple, M. G., Allan, C. H., Levine, B., Jufer-Phipps, R., & Fowler, D. R. (2013). Methylenedioxypyrovalerone ("bath salts"), related death: Case report and review of the literature. Journal of Forensic Sciences, 58(6), 1654-1659. doi:10.1111/1556-4029.12202
32. Khan, M. D., Shaheen, F., Sarwar, H., Molina, J., & Mushtag, S. (2013). "Bath salts"-induced psychosis in a young woman. Primary Care Companion CNS Disorders, 15(1). doi:10.4088/PCC.12l01417
33. Lajoie, T. M., & Rich, A. (2012). "Bath salts": A new drug epidemic-a case report. American Journal of Addictions, 21, 572-573. doi:10.1111/j.1521-0391.2012.00286.x
34. Lancaster, G. A., Whittington, R., Lane, S., Riley, D., & Meehan, C. (2008). Does the position of restraint of disturbed psychiatric patients have any association with staff and patient injuries? Journal of Psychiatric and Mental Health Nursing, 15, 306-312. doi:10.1111/j.1365-2850.2007.01226.x
35. Lusthof, K. J., Oosting, R., Maes, A., Verschraagen, M., Dijkhuizen, A., & Sprong, A. G. A. (2011). A case of extreme agitation and death after the use of mephedrone in The Netherlands. Forensic Science International, 206, e93-e95. doi:10.1016/j.forsciint.2010.12.014
36. Macher, A. (2011). Drug abuse: Methylenedioxypyrovalerone (MDPV) and toxic psychosis. American Jails, 25(3), 63-66.
37. Mansbacher, J. (2011). Dangerous methods: New ways kids get high. Pediatrics for Parents, 27, 25-27.
38. Martin, G., & Copeland, J. (2010). Brief intervention for regular ecstasy (MDMA) user: Pilot randomized trial of a Check-Up model. Journal of Substance Use, 15, 131-142. doi:10.3109/14659890903075074
39. Maskell, P. D., DePaoli, G., Seneviratne, C., & Pounder, D. J. (2011). Mephedrone (4-methylmethcathinone)-related deaths. Journal of Analytical Toxicology, 35, 188-191. doi:10.1093/anatox/35.3.188
40. McKetin, R., McLaren, J., Lubman, D. I., & Hides, L. (2006). The prevalence of psychotic symptoms among methamphetamine users. Addiction (Abingdon, England), 101, 1473-1478. doi:10.1111/j.1360-0443.2006.01496.x
41. Mugele, J., Nañagas, K. A., & Tormoehlen, L. M. (2012). Serotonin syndrome associated with MDPV use: A case report. Annals of Emergency Medicine, 60(1), 100-102. doi:10.1016/j.annemergmed.2011.11.033
42. Murray, B. L., Murphy, C. M., & Beuhler, M. C. (2012). Death following recreational use of designer drug "bath salts" containing 3, 4-methylenedioxypyrovalerone (MDPV). Journal of Medical Toxicology, 8, 69-75. doi:10.1007/s13181-011-0196-9
43. Nicholson, P. J., Quinn, M. J., & Dodd, J. D. (2010). Headshop heartache: Acute mephedrone "meow" myocarditis. Heart (British Cardiac Society), 96(24), 2051-2052. doi:10.1136/hrt.2010.209338
44. NMS Labs. (2014). Bath salts and stimulant designer drugs-expanded, urine test. Retrieved from http://www.nmslabs.com
45. Orford, J., Velleman, R., Copello, A., Templeton, L., & Ibanga, A. (2010). The experiences of affected family members: A summary of two decades of qualitative research. Drugs: Education, Prevention and Policy, 17(Suppl. 1), 44-62. doi:10.3109/09687637.2010.514192
46. Pearson, J. M., Hargraves, T. L., Hair, L. S., Massucci, C. J., Frazee, C. C., III, Garg, U., & Pietak, B. R. (2012). Three fatal intoxications due to methylone. Journal of Analytical Toxicology, 36, 444-451. doi:10.1093/jat/bks043
47. Penders, T. M. (2012). How to recognize a patient who's high on bath salts. Journal of Family Practice, 61, 210-212.
48. Penders, T. M., & Gestring, R. (2011). Hallucinatory delirium following use of MDPV ("bath salts"). General Hospital Psychiatry, 33, 525-526. doi:10.1016/j.genhosppsych.2011.05.014
49. Phillips, J., Stinson, K., & Strickler, J. (2014). Avoiding eruptions: De-escalating agitated patients. Nursing, 44(4), 60-63. doi:10.1097/01.NURSE.0000443316.43113.73
50. Prosser, J. M., & Nelson, L. S. (2012). The toxicology of bath salts: A review of synthetic cathinones. Journal of Medical Toxicology, 8, 33-42. doi:10.1007/s13181-011-0193-z
51. Rainier, N. C. (2014). Reducing physical restraint use in alcohol withdrawal patients: A literature review. Dimensions of Critical Care Nursing, 33(4), 201-206. doi:10.1097/DCC.0000000000000059
52. Regunath, H., Ariyamuthu, V. K., Dalal, P., & Misra, M. (2012). Bath salt intoxication causing acute kidney injury requiring hemodialysis. Hemodialysis International, 16, S47-S49. doi:10.1111/j.1542-4758.2012.00750.x
53. Rosenbaum, C. D., Carreiro, S. P., & Babu, K. M. (2012). Here today, gone tomorrow ... and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines. Journal of Medical Toxicology, 8, 15-32. doi:10.1007/s13181-011-0202-2
54. Sacco, L., & Finklea, K. (2013). Synthetic Drugs: Overview and Issues for Congress, Congressional Research Service, Editor. 2011 CRS Report for Congress, pp. 1-18.
55. Shimizu, E., Watanabe, H., Kojima, T., Hagiwara, H., Fujisaki, M., Miyatake, R., & Iyo, M. (2007). Combined intoxication with methylone and 5-MeO-MIPT. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 31, 288-291. doi:10.1016/j.pnpbp.2006.06.012
56. Spiller, H. A., Ryan, M. L., Weston, R. G., & Jansen, J. (2011). Clinical experience with analytical confirmation of "bath salts" and "legal highs" (synthetic cathinones) in the United States. Clinical Toxicology, 49, 499-505. doi:10.3109/15563650.2011.590812
57. Stoica, M. V., & Felthous, A. R. (2013). Acute psychosis induced by bath salts: A case report with clinical and forensic implications. Journal of Forensic Sciences, 58(2), 530-533. doi:10.1111/1556-4029.12038
58. Striebel, J. M., & Pierre, J. M. (2011). Acute psychotic sequelae of "bath salts. Schizophrenia Research, 133, 259-260. doi:10.1016/j.schres.2011.09.001
59. The PRISMA Statement. (2014). PRISMA: Transparent reporting of systemic reviews and meta-analyses. Retrieved from http://www.prisma-statement.org/statement.htm
60. Thornton, S. L., Gerona, R. R., & Tomaszewski, C. A. (2012). Psychosis from a bath salt product containing flephedrone and MDPV with serum, urine, and product quantification. Journal of Medical Toxicology, 8, 310-313. doi:10.1007/s13181-012-0232-4
61. Valente, M. J., de Pinho, P. G., de Lourdes Bastos, M., Carvalho, F., & Carvalho, M. (2014). Khat and synthetic cathinones: A review. Archives of Toxicology, 88(1), 15-45. doi:10.1007/s00204-013-1163-9
62. Vardakou, I., Pistos, C., & Spiliopoulou, C. (2011). Drugs for youth via internet and the example of mephedrone. Toxicology Letters, 201, 191-195. doi:10.1016/j.toxlet.2010.12.014
63. Walsh, J. M., Verstraete, A. G., Huestis, M. A., & Morland, J. (2008). Guidelines for research on drugged driving. Addiction (Abingdon, England), 103, 1258-1268. doi:10.1111/j.1360-0443.2008.02277.x
64. Warrick, B. J., Wilson, J., Hedge, M., Freeman, S., Leonard, K., & Aaron, C. (2012). Lethal serotonin syndrome after methylone and butylone ingestion. Journal of Medical Toxicology, 8, 65-68. doi:10.1007/s13181-011-0199-6
65. Winder, G. S., Stern, B. A., & Hosanagar, A. (2013). Are "bath salts" the next generation of stimulant abuse? Journal of Substance Abuse Treatment, 44, 42-45. doi:10.1016/j.jsat.2012.02.00
66. Winstock, A. R., Marsden, J., & Mitcheson, L. (2010). What should be done about mephedrone? British Medical Journal, 340, c1605. doi:10.1136/bmj.c1605
67. Wong, M. L., & Holt, R. I. G. (2011). The potential dangers of mephedrone in people with diabetes: A case report. Drug Testing and Analysis, 3, 464-465. doi:10.1002/dta.316
68. Young, A. C., Schwarz, E. S., Vlez, L. I., & Gardner, M. (2013). Two cases of disseminated intravascular coagulation due to "bath salts" resulting in fatalities, with laboratory confirmation. American Journal of Emergency Medicine, 31, 445.e3-445.e5. doi:10.1016/j.ajem.2012.05.03
69. Young, M. M., Stevens, A., Galipeau, J., Pirie, T., Garritty, C., Singh, K., & Moher, D. (2014). Effectiveness of brief interventions as part of the Screening, Brief Intervention and Referral to Treatment (SBIRT) model for reducing the nonmedical use of psychoactive substances: A systematic review. Systematic Reviews, 3(1), 1-18. doi:10.1186/2046-4053-3-50