Bath salts are recreational drugs that belong to a group of lab-made chemicals called “synthetic cathinones” because they resemble a naturally occurring mild stimulant, cathinone, found in the African khat shrub. Unlike the naturally occurring compound, synthetic cathinones are powerful psychoactive compounds that are associated with a high risk for abuse, dependence and addiction.

Bath salts have been shown to affect the brain’s dopamine signaling pathway, which underlies the development of addiction. The chemical methylenedioxypyrovalerone (MDPV) is up to ten times more potent than cocaine, underscoring the substantial risks associated with its use. Other dangerous chemicals that have been used in bath salts include mephedrone and methylone.

While some of the most dangerous chemicals that are used to make bath salts, including MDPV, mephedrone and methylone, have been banned, other types of bath salts that are consumed to get high can be purchased in novelty stores, paraphernalia shops and even some gas stations. Bath salts packaging frequently carries warning like, ‘Not for human consumption’ and are often identified as ‘herbal highs,’ ‘legal highs’ or ‘research chemicals.’ Synthetic cathinone bath salts are unrelated to Epsom salts and other salts that are actually used for bathing purposes.

Bath salts are used recreationally for their ability to produce euphoria, energy and a sense of increased sociability. However, bath salts side effects can be very dangerous, even lethal, and often have profound psychological adverse effects that can cause people who use them to behave erratically and violently. There are some characteristic symptoms, signs and side effects that people who use bath salts often display.

Bath Salts Abuse Symptoms

Because bath salts are often chemically distinct from one another, different brands or even batches of the drugs are likely to have unpredictable effects on people who use them. However, because they are all based on the chemical structure of naturally occurring cathinone, there are stereotypical symptoms and signs that are hallmarks of bath salts abuse.

Physical Symptoms

Symptoms are subjectively experienced by the person who took the bath salts (versus signs, which are objectively measurable by other people. For example, euphoria is a symptom while being abnormally talkative is a sign). Frequently reported physical symptoms associated with bath salts use include:

  • Increased alertness
  • Euphoria
  • Increased empathy
  • Increased sensory perception
  • Increased libido
  • Dehydration
  • Dizziness
  • Blurred vision
  • Muscle cramps
  • Abdominal pain
  • Chest pain
  • Shortness of breath

In contrast to physical symptoms, physical signs of bath salts abuse can be observed by others. Physical signs that someone has taken bath salts may include:

  • Unusually talkative
  • Increased energy level
  • Increased sociability
  • Rapid heart rate
  • Elevated blood pressure
  • Poor motor control
  • Sudden, explosive bursts of activity
  • Unfocused movements
  • Unusual head movement (circling or bobbing)
  • Trembling
  • Muscle twitches
  • Clenched jaw and grinding teeth
  • Fever
  • Irregular breathing

Psychological Symptoms

Notorious cases of cannibalism that have been associated with bath salts use underscore the potential for bath salts to cause incredibly disturbing and very dangerous psychological signs and symptoms. Although bath salts have been ruled out as a direct cause of some of these violent and lethal attacks (for example, bath salts were officially ruled out as a possible cause for the astonishing violence and psychosis exhibited by Miami’s infamous “Causeway Killer”), other cases are still thought to be related to bath salts use.

Frequently reported psychological symptoms that are linked to the use of bath salts may include:

  • Anxiousness
  • Depression
  • Panic attacks
  • Paranoia and paranoid delusions
  • Visual hallucinations
  • Auditory hallucinations
  • Anhedonia (inability to experience pleasure)
  • Dysphoria (a general sense of dissatisfaction or unease)
  • Depersonalization (loss of touch with reality)

Commonly observed psychological signs that are displayed by people who have taken bath salts include:

  • Erratic behavior
  • Aggression and violence
  • Self-harm
  • Suicidal behavior
  • Confusion
  • Delirium
  • Disorientation

Bath Salts Side Effects

Side effects of bath salts use are different from signs and symptoms in that they are secondary effects that are generally undesirable. For example, someone who takes bath salts is expecting to experience objective, observable signs like increased energy and subjective symptoms like euphoria, but they are also likely to experience unwanted secondary side effects like nausea, vomiting and appetite loss.

Side effects can be difficult to fully differentiate from signs and symptoms, and there is often some overlap. Even among medical professionals, these terms are frequently used interchangeably.

Common side effects associated with bath salts use include:

  • Headache
  • Nausea/vomiting
  • Loss of appetite/anorexia
  • Insomnia
  • Dry eyes
  • Bloodshot eyes
  • Skin rash

Adverse events are another concern for people who use bath salts. Unlike signs, symptoms and side effects, adverse events are undesired effects that may or may not occur when someone takes bath salts. Some adverse events are dose-dependent and may be predictable (hyperthermia) while others do not seem to be dose-dependent and are unpredictable (destruction of muscle tissue or skin cells).

Serious adverse events that may be associated with acute or chronic bath salts intoxication include:

  • Kidney damage or failure
  • Liver damage or failure
  • Respiratory depression or failure
  • Destruction of red blood cells (disseminated intravascular coagulation)
  • Destruction of muscle tissue (rhabdomyolysis)
  • Destruction of skin cells (necrotizing fasciitis)
  • Serotonin syndrome (dangerously elevated serotonin levels)
  • Altered neural signaling and brain function
  • Psychosis
  • Stroke
  • Heart attack
  • Seizures
  • Shock (dangerously low blood pressure)
  • Coma
  • Death

Long Term Side Effects of Bath Salts

Bath salts are a relatively new drug of abuse. Consequently, there is little known about the long term side effects associated with chronic bath salts use. What is known is that even a single episode of bath salts use can result in severe health, social and legal ramifications. Bath salts have caused fatalities among people who use them as well as causing people who are high on them to commit astonishing acts of violence that may result in the death of people who are in close proximity.

Further complicating a holistic understanding of long term side effects associated with bath salts use is the chemical variation between different types of bath salts. Slight modifications of a chemical structure can have substantial consequences on how a drug affects someone in the short and long term. Thus, what may hold true for one version of bath salts may not apply to another version.

It is clear that at least some chemicals used in bath salts are associated with long term cognitive impairments and other negative effects, including alterations in levels of the neurotransmitters dopamine and serotonin. To date, much of the data obtained on the long term effects of bath salts have come from rodent studies, which have provided compelling evidence that regular binge use of bath salts can cause cognitive dysfunction and neurodegeneration.

Bath Salts Overdose Symptoms

It is possible to overdose on bath salts. Signs and symptoms of bath salts overdose may include:

  • Profuse sweating
  • Fever
  • Nausea/vomiting
  • Chest and/or abdominal pain
  • Confusion
  • Delirium
  • Hallucinations
  • Stroke
  • Seizures
  • Heart attack
  • Coma

Many fatalities associated with bath salts use are due to severe hyperthermia (dangerously elevated body temperature) and dehydration. Some evidence suggests that when bath salts are used in conjunction with other drugs, they can increase the toxicity of certain drugs. For example, co-administration of bath salts with other stimulants like cocaine, MDMA or an amphetamine is thought to increase the risk for a potentially fatal overdose.

Bath salts overdoses are medical emergencies. If you suspect an overdose, call 911 immediately.

The use of bath salts can be very dangerous, even lethal. If you or someone you know is facing a bath salts addiction, help is available. Contact The Orlando Recovery Center today to learn how professional rehab can help you get your life back on track.


Colon-Perez, Luis M.; et al. “Functional connectivity, behavioral and […]enedioxypyrovalerone.” Neuropharmacology, March 2019. Accessed November 9, 2019.

Klega, Ann E. “Stimulant and Designer Drug Use: Primary Care Management.” American Family Physician, July 2018. Accessed November 8, 2019.

Palamar, Joseph J. ““Bath Salt” Use and Beliefs about Us[…]nce Music Attendees.” Journal of Psychoactive Drugs, November 2018. Accessed November 8, 2019.

Karila, Laurent; et al. “Synthetic cathinones: a new public health problem.” Current Neuropharmacology, January 2015. Accessed November 8, 2019.

Swalve, Natashia; DeFoster, Ruth. “Framing the Danger of Designer Drugs: Ma[…]Miami Zombie Attack.” Contemporary Drug Problems, March 2016. Accessed November 9, 2019.

CBS News. “Surprising drug test results in Fla. face-biting attack case.“ November 23, 2016, 2016. Accessed November 8, 2019.

German, Christopher L.; et al. “Bath salts and synthetic cathinones: an […]gner drug phenomenon.” Life Sciences, February 2015. Accessed November 10, 2019.

Sewalia, Kaveish; et al. “Neurocognitive dysfunction following rep[…]ypyrovalerone (MDPV).” Neuropharmacology, May 2018. Accessed November 10, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.