The Drug That Never Lets Go
By Jenny Marder
Dickie Sanders was not naturally prone to depression. The 21-year-old BMX rider was known for being sweet spirited and warm -- a hugger not a hand-shaker. The kind of guy who called on holidays. Who helped his father on the family farm. Who spent countless hours perfecting complicated tricks on his bike.
Yet on Nov. 12, 2010, Sanders was found dead on the floor of his childhood bedroom. He had shot himself in the head
with a .22 caliber youth rifle.
The suicide was the culmination of five days of strange behavior that began shortly after Sanders snorted a powdery substance he bought from a friend. Instead of the brief high he was seeking, he experienced days of insomnia, along with waves of terror and frightening delusions, including an incident where he “saw” 25 police cars outside his parents' kitchen window and then slit his own throat with a butcher knife. That incident landed Sanders in the hospital with stitches. For a few hours, the hallucinations subsided.
“I don't like the way this is making me feel," Sanders told his stepmother, Julie, as the two awaited his release from the hospital. "I promise I won't do anything again. I'm done.”
But the paranoia flared up with a vengeance that night, and back home, Dickie's father lay in bed with his son, arms wrapped around him, until he finally nodded off. It's unclear when Dickie woke up, made his way downstairs to his bedroom and found the rifle he had won in a shooting contest years before. No one heard the gunshot.
An autopsy revealed a powerful stimulant in his system: methylenedioxypyrovalerone, also known as MDPV.
MDPV is a common ingredient in a street drug known as "bath salts." Sanders' death occurred the month after Mark Ryan, director of the Louisiana Poison Center, began to receive the first string of calls from emergency rooms around the state about patients taking the drug. For such a benign name, the symptoms were dangerous and bizarre. People were showing up just like Sanders had -- paranoid, agitated, violent and hallucinating.
“These guys were seeing things like monsters, demons and aliens, and those were consistent terms,” Ryan said. “We didn't ask, ‘Are you seeing monsters and aliens?' They were telling us that.”
Soon after Dickie Sanders died, Ryan teamed with Kentucky's poison control center and began to build a database of every bath salts case recorded in the two states. In the report, they listed behaviors brought on by the drugs. One patient high on the substance repeatedly fired guns out of the house at strangers. Another broke all the windows in a house and then wandered barefoot through the broken glass. A third left her 2-year-old daughter in the middle of a highway because she “had demons.”
Cathleen Clancy is associate medical director at the National Capital Poison Center in Washington D.C., where they catalog the effects of bath salts on the area's emergency room cases. Users are often hyper-agitated, hot and sweating, she said. Their heart rate is dangerously high, their blood pressure is up, and seizures are common.
Often even high doses of common sedatives don't help them. Doctors instead must turn to antipsychotics or other powerful medications.
Early on, doctors began noticing something else that was strange. Compared with other drugs, bath salts didn't follow a normal dose-response pattern. With cocaine or methamphetamine, the drug entered the bloodstream, and, within hours, began to wear off. Not so for bath salts.
“Some patients were in the hospital for 5 days, 10 days, 14 days,” Ryan said. “In some cases, they were under heavy sedation. As you try to taper off the sedation, the paranoia came back and the delusions."
Also troubling is how little is known about what these drugs do to the brain long term. Understanding how bath salts work, DeFelice said, will not only help to explain the extreme length and potency of a bath salts high, it also will reveal the extent of cell death and damage to the brain. This could help researchers design better tests, treatment, even antidotes.
"MDPV is irreversible, it won't let go," De Felice said. "I don't know of any other drug that has that same feature of not allowing you to escape from it."