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A New Orleans woman recently lost an arm to necrotizing fasciitis — the so-called “flesh-eating bacteria” — after injecting a drug called “bath salts,” according to a case study report in the medical journal Orthopedics . She presented with cellulitis, a skin infection, two days after attending a party at which she injected the drug. The infection initially responded to administered antibiotics, but then worsened. The woman lost not only her arm, but her breast and a large portion of her chest wall to amputation. The significant removal of tissue was necessary to prevent the spread of the bacteria.
Hand on the floor with syringe image via Shutterstock
“Bath salts” are a relatively new recreational drug. Unlike LSD or heroin, the “bath salt” drug isn’t a single compound. Instead, it consists of a mixture of amphetamine-like substances, including compounds similar to MDMA (ecstasy) and cocaine, explains the National Institute on Drug Abuse (NIDA). Until relatively recently, the drug — marketed under names like “Red Dove” and “Bloom” — was legally sold online and in stores. Components of “bath salts” are dangerous because they’re highly addictive; they also carry a significant potential for overdose. Additionally, because there’s very little information currently available on the chemicals used in the drug, there is little known about short- and long-term effects of use. The NIDA warns that “bath salts” have been responsible for a large number of ER visits, and in October of 2011, the U.S. Drug Enforcement Administration (DEA) acted to control the drug pending further investigation.
While necrotizing fasciitis is rare in the general population, the risk of infection increases astronomically with injection of a recreational substance under non-sterile conditions. That, combined with the potential for serious adverse effects and the ever-present risk of overdose, is good reason to steer clear of “bath salts.”
This case underscores the significant danger of recreational compounds that are sold legally; just because the DEA hasn’t yet banned a substance isn’t testament to its safety. In fact, recreational drug designers work hard to stay ahead of the DEA, meaning that dangerous compounds will often be available for months before they’re declared illegal. Many consumers assume that if something is available for purchase — particularly if it’s available in a physical store — it’s safe to use (or is at least a safer alternative to street drugs). Nothing could be further from the truth. In reality, the drugs that are so young they haven’t yet been declared illegal are extremely dangerous, both intrinsically and because they’re new and are poorly understood.
Russo et al. Life-threatening Necrotizing Fasciitis Due to ‘Bath Salts’ Injection. Orthopedics. 2012 Jan 16;35(1):e124-7. doi: 10.3928/01477447-20111122-36.