title: A 9-state analysis of designer stimulant, "bath salt," hospital visits reported to poison control centers.
abstract: OBJECTIVE
  A new generation of designer stimulants marketed as "bath salts" emerged in late 2010. The goal is to describe the epidemiologic emergence of designer stimulants in 9 states in the Midwest.
  
  
  METHODS
  A retrospective review of the National Poison Data System was performed between November 1, 2010, and November 30, 2011. Inclusion criteria were health care-evaluated bath salts or other synthetic stimulants exposures. Cases were excluded if the exposure was unrelated to a designer stimulant. Demographic and clinical characteristics of cases were calculated and differences in outcome and exposure by generation were examined.
  
  
  RESULTS
  One thousand six hundred thirty-three patients met the inclusion criteria. Age ranged from 1 day to 61 years (mean=29.2 years), with 67.9% male patients. The most common clinical features were agitation (62.2%), tachycardia (55.2%), and hallucinations (32.7%). In addition to 15.5% of patients having a major medical effect, 0.6% died. Reason for use was primarily intentional abuse (88.5%). However, 0.7% of patients reported withdrawal. Treatment involved primarily benzodiazepines (58.5%), with 8.7% of patients being intubated. Baby Boomers were more likely to have a major medical outcome (24.2%) and to report injection as the method of administration (8.6%-12.9%).
  
  
  CONCLUSIONS
  Synthetic stimulants rapidly swept across the Midwest, resulting in more than 1,600 patients seeking medical care. Serious medical effects or death was observed in 16.1% of cases. Older generations were more likely to inject and to have a major medical outcome.
authors.affiliation: Children's Hospital of Michigan Regional Poison Center, Detroit, MI, USA. brandon_warrick@hotmail.com
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Warrick
authors.forename: Meredith
authors.initials: M
authors.lastname: Hill
authors.forename: Kimberly
authors.initials: K
authors.lastname: Hekman
authors.forename: Rachelle
authors.initials: R
authors.lastname: Christensen
authors.forename: Robert
authors.initials: R
authors.lastname: Goetz
authors.forename: Marcel J
authors.initials: MJ
authors.lastname: Casavant
authors.forename: Michael
authors.initials: M
authors.lastname: Wahl
authors.forename: James B
authors.initials: JB
authors.lastname: Mowry
authors.forename: Henry
authors.initials: H
authors.lastname: Spiller
authors.forename: Deborah
authors.initials: D
authors.lastname: Anderson
authors.forename: Alfred
authors.initials: A
authors.lastname: Aleguas
authors.forename: David
authors.initials: D
authors.lastname: Gummin
authors.forename: Ronald
authors.initials: R
authors.lastname: Thomas
authors.forename: Christopher
authors.initials: C
authors.lastname: Nezlek
authors.forename: Susan
authors.initials: S
authors.lastname: Smolinske
mesh_terms: D000293:Adolescent; D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015198:Designer Drugs / Q000506:poisoning*; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States / Q000453:epidemiology; D011039:Poison Control Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology; D013610:Tachycardia / Q000139:chemically induced; D055815:Young Adult
chemical_list: D015198:Designer Drugs