Hair sampling shows unintended 'bath salt' use

The popularity of ecstasy use has increased in recent years since ecstasy became known as "Molly," short for "molecule" which is often marketed as "pure" MDMA powder. However, the ecstasy/Molly consumed is often far from pure: it is frequently adulterated with other drugs, such as synthetic cathinones, commonly known as "bath salts," or other novel psychoactive substances. Novel psychoactive substances are unregulated mind-altering drugs that have become newly available on the market and are often intended to mimic the effects of traditional illegal drugs.

"Given the sharp rise in poisonings and recent deaths at dance festivals related to ecstasy use, research was needed to examine whether nightclub/festival attendees who use ecstasy or Molly have been unintentionally or unknowingly using "bath salts"" said Joseph J. Palamar, PhD, MPH, an affiliate of the Center for Drug Use and HIV Research (CDUHR) and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Little is known about these new drugs and some may be more dangerous than MDMA."

To this end, Dr. Palamar and his team of researchers are the first to examine whether ecstasy users are unknowingly or unintentionally using "bath salts" and/or other novel psychoactive drugs. The study, "Detection of 'Bath Salts' and Other Novel Psychoactive Substances in Hair Samples of Ecstasy/MDMA/'Molly' Users" was recently published in Drug and Alcohol Dependence.

The researchers surveyed young adults outside of nightclubs and dance festivals from July through September of 2015 about their use of ecstasy and other drugs. The survey assessed whether participants had ever knowingly used ecstasy, MDMA or "Molly." Participants were also asked whether they had ever knowingly used any of 35 listed "bath salts" or other novel drugs.

"Then, we asked the participants if we could snip a lock of their hair to test for new drugs such as "bath salts"," said Dr. Palamar. "We collected hair samples from about a quarter of the survey sample to be tested for novel drugs."

The researchers focused on the hair samples provided by 48 participants who reported ecstasy use. While half of the samples tested positive for MDMA, half tested positive for "bath salts" and/or other novel psychoactive substances. The most commonly detected "bath salts" were butylone and methylone -- common adulterants in ecstasy/Molly.

"Among those who reported no use of "bath salts" or unknown powders or pills, four out of ten tested positive for "bath salts" and/or other novel drugs," said Dr. Palamar. "One sample also tested positive for alpha-PVP -- the strong stimulant known as "Flakka" that has made headlines in the last year.

"A lot of people laughed when they gave us their hair saying things like "I don't use bath salts; I'm not a zombie who eats people's faces." Yet our findings suggest many of these people have been using "bath salts" without realizing it."

"Ecstasy wasn't always such a dangerous drug, but it is becoming increasingly risky because it has become so adulterated with new drugs that users and the scientific community alike know very little about," said Dr. Palamar. "Users need to be aware that what they are taking may not be MDMA.

"As Molly is becoming a much riskier substance, I really hope that those who decide to use educate themselves about what they're doing. While it is safest to avoid use, test kits are available online for those who decide to use, and want to ensure that they're taking real MDMA and not a new synthetic stimulant such as Flakka."