title: The availability and depiction of synthetic cathinones (bath salts) on the Internet: Do online suppliers employ features to maximize purchases?
abstract: BACKGROUND
  "Bath salts", a derivative of cathinone, a naturally occurring beta-ketone amphetamine analogue found in the leaves of the khat (Catha edulis) plant, is a potent class of designer drugs associated with significant medical and psychiatric consequences. They are commonly used among 20-29 year olds, a group with easy access to the Internet and an inclination to purchase online. Therefore, the Internet has the potential to play a significant role in the distribution and associated consequences of these "legal highs".
  
  
  METHODS
  Google searches were used to determine bath salts availability on retail websites and how different search terms affected the proportion of retail websites obtained. Retail websites were reviewed by two independent raters who examined content with a focus on characteristics that increase the likelihood of online sales.
  
  
  RESULTS
  Of the 250 websites found, 31 were unique retail websites. Most retail website hits resulted when a product name was used as the search term. The top three countries hosting retail websites were registered in the United States (n=14; 45%), Germany (n=7; 23%), and the United Kingdom (n=3; 10%). These online drug suppliers provided considerable information and purchasing choice about a variety of synthetic cathinones, legitimized their sites by using recognizable images, online chat features, and mainstream payment and shipping methods, and employed characteristics that promote online purchases.
  
  
  CONCLUSIONS
  Online designer drug suppliers use sophisticated methods to market unregulated products to consumers. The international community has taken diverse approaches to address designer drugs: legislative bans, harm reduction approaches, an interim regulated legal market. Multifaceted efforts that target bath salt users, suppliers, and emergency/poison control entities are critical to comprehensively address bath salt ingestion and its consequences.
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States. Electronic address: kmeyers@tresearch.org.
authors: Kathleen
authors: K
authors: Meyers
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States.
authors: Övgü
authors: Ö
authors: Kaynak
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States.
authors: Elena
authors: E
authors: Bresani
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States; University of Pennsylvania School of Medicine, 3900 Chestnut Street, Philadelphia, PA 19104, United States.
authors: Brenda
authors: B
authors: Curtis
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States.
authors: Ashley
authors: A
authors: McNamara
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States.
authors: Kristine
authors: K
authors: Brownfield
authors: Treatment Research Institute, 600 Public Ledger Building, 150 South Independence Mall West, Philadelphia, PA 19106, United States; University of Pennsylvania School of Medicine, 3900 Chestnut Street, Philadelphia, PA 19104, United States.
authors: Kimberly C
authors: KC
authors: Kirby
mesh_terms: D000470:Alkaloids / Q000009:adverse effects / Q000191:economics / Q000600:supply & distribution*; D003132:Commerce / Q000706:statistics & numerical data; D015198:Designer Drugs / Q000009:adverse effects / Q000191:economics / Q000600:supply & distribution*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects / Q000191:economics / Q000600:supply & distribution*; D020407:Internet / Q000191:economics / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000191:economics / Q000453:epidemiology
chemical_list: D000470:Alkaloids; D015198:Designer Drugs; D013287:Illicit Drugs; C023665:cathinone
keywords: Bath salts; Designer drugs; Online designer drug suppliers
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