Bath salts, a designer drug that has been gaining in popularity over recent years, became a household term when a Florida man named Rudy Eugene bit off parts of another man's face. Because of Eugene's behavior, many speculated that he was on bath salts.
Though the unique and grotesque details of the story mesmerized the public and the media, the medical community pondered another angle: Eugene did not test positive for bath salts or any other type of designer drug; the only illegal substance found in his toxicology report was marijuana.1 Although it has only been speculated that Eugene was taking a stimulant like bath salts, there are other reasons why the drug might not have been found, even if it was in his system.
"It's really very obvious -- a designer drug is not a prescription drug. It's a drug that has been designed to evade either testing methodology or federal and state laws regarding illicit-type drugs," explained Bruce A. Goldberger, PhD, DABFT, professor and director of Toxicology at the University of Florida, Gainesville.
"In the past, designer drugs were often made with very easy to obtain, legal ingredients, so because these ingredients were not illegal, a test may or may not make sense. If a test were available, a lot of agencies might be provided with 'information,' but many would say 'what can I do with that information?' If it doesn't carry any consequences, does that warrant the extra cost?" asked Sherry Bender, CEO of Affiniton LLC, Williamsport, Pa. "As soon as a federal ban is placed on one substance, manufacturers simply change the ingredients, even slightly, making them undetectable again. So, as soon as a test is developed to detect one drug, it becomes obsolete if they change the recipe."
What's in a Drug and a Test?
A designer drug is one that is created to avoid drug laws and tests, hence making it difficult for scientists to create tests to detect them. Bath salts (one of its many names, along with "bliss" and "vanilla sky"), were banned for 1 year by the U.S. Drug Enforcement Administration in October 2011 (at the time of publication of this article, there has not yet been official word that the DEA will renew that ban). This ban makes it illegal to have or sell the chemicals used to make bath salts (mephedrone, methylenedioxypyrovalerone and methylone).2
This has not stopped the drug from becoming popular. People using bath salts (which, despite the misleading name, are unrelated to the Epsom salts some people soak in), a powdery substance that can be snorted, smoked, injected or taken orally, usually experience hallucinations, paranoia and agitation, chest pain and sometimes suicidal thoughts.
The Eugene case has spotlighted these drugs and the associated crimes that can come with them. Because one slight tweak in a drug's chemical structure can make it undetectable on a test and the amount of designer drugs being introduced on the street level, it's difficult for toxicology to keep up, Goldberger noted.
"The phenomenon is very different than what we saw 10 years ago with Ecstasy, where there were a limited number of analytes," he told ADVANCE. "Today, we have an infinite number of drugs. That's a tremendous analytical challenge."
Testing for designer drugs "is very frustrating for many of our clients. They will never really 'catch up,' because as soon as a testing lab is able to actually get the reference drug standards for a particular drug and develop an assay, chances are good that the illegal drug manufacturers will have already moved on to a totally different new drug compound," said Jeff Layne, PhD, HPLC product manager, Phenomenex, Torrance, Calif.
Up for the Challenge
Despite the difficulty of keeping tests for designer drugs current and reliable, many companies are producing tests to detect substances like bath salts. Even though it may be fleeting, this can be a momentary blessing for toxicology, reference and clinical laboratories.
Affiniton LLC provides urine, sweat, saliva and surface tests to detect illegal drug residue. The organization offers a urine dip test to detect another recently popular drug, a synthetic cannabinoid called K2 or Spice. Ameritox (Baltimore), United States Drug Testing Laboratories Inc. (Des Plaines, Ill.) and Utak Laboratories Inc. (Valencia, Calif.) also offer tests or controls for these emerging drugs.
Phenomenex has developed a method using liquid chromatography with tandem mass spectrometry to analyze bath salts and several other designer drugs. "This uses the exact same running conditions as our general-purpose drug screening method, which can be used for drugs such as benzodiazapenes, opiates and amphetamine-related compounds," Layne explained. "Thus, it is possible to incorporate designer drug analysis into a routine drug screening protocol."
Besides staying abreast of these new assays, the laboratory community needs to stay current with the new drugs and their capabilities, and pass that detection knowledge on to clinicians, Goldberger said. "The typical immunoassays that hospital laboratories are running today would not pick up any of these new emerging drugs, so the clinicians need to know that. If there's a need for further testing, then it needs to be referred out to a good reference lab to test for it," he added.
"There are several larger laboratories that can now test for the designer drugs, including bath salts. A urine sample must be collected and submitted to the lab for special testing," Bender said. "However, clients must request this special test, which can be costly. A normal drug test typically only tests for the five hardcore drugs (including cocaine, cannabis, amphetamines, methamphetamines and opiates) and may go up to 10 drugs, but unless they directly order a test for 'designer drugs,' it will not be detected because you're simply not testing for it."
In the Spotlight
Even though many members of the public and media may have only recently been educated on bath salts because of the Eugene case, that doesn't mean the laboratory community hasn't had its sights on this emerging drug, and others, for quite some time.
"There's more interest in the media, but the problem of the emerging drugs has been evident for about three years," Goldberger noted.
"Laboratories were developing tests way before the Eugene case, and we've been conducting tests for at least 11 months now," Bender added. "I think this case just shed more light on the bath salt epidemic."
"Increasing awareness of designer drugs will drive testing labs to develop more assays for these substances," concluded Layne.
Amanda Koehler is a freelance writer.
- Laboy S. "Tests Find Only Marijuana in Face-Chewer's System." The Huffington Post. 27 June 2012. www.huffingtonpost.com/2012/06/27/tests-find-only-marijuana_n_1632852.html. Last accessed 15 September 2012.
- McMillen M. "'Bath Salts' Drug Trend: Expert Q&A." WebMD. 23 March 2012. www.webmd.com/mental-health/features/bath-salts-drug-dangers. Last accessed 15 September 2012.