State officials in Maine are blaming a sharp rise in the number of children entering state custody on the street drug known as bath salts.
An additional 200 children entered the state's foster care system due to neglect in the past 11 months, and Therese Cahill-Low, director of the state's Office of Child and Family Services, estimates that about half of the cases are linked to bath salts use. Her department is requesting $4.2 million in additional funding to tackle the growing problem.
The stories are disturbing. Drug-using parents wielding knives. A young mom hallucinating in a tree while her infant child wanders the street. In late 2011, six infant deaths in a three-month period were blamed on neglect, Low said.
The term "bath salts" describes a collection of drugs that usually contain synthetic versions of amphetamine-like stimulants called cathinones, which occur naturally in a leafy Middle Eastern plant called khat. The most common type of cathinone detected in bath salts is called Methylenedioxypyrovalerone, or MDPV. (More in our story, The Drug that Never Lets Go.)
Read our interactive feature on the science of bath salts here.
The drugs are often camouflaged as household items. Bath salts is a common example -- hence, their nickname -- but they've also been marketed as plant food, insect repellant and toilet bowl cleaner.
Officials first noticed that bath salts had surfaced in eastern Maine in early 2011. "As the year progressed, it was like tentacles, it just expanded, so that there's not one pocket in the state that hasn't been affected by it," Low said.
And from April and through the summer, she said, children began entering the foster-care system in droves. Most cases involved young parents with very young children.
Of the 86 people who sought treatment for bath salts from June 2011 to November 2012, 62 percent reported having children listed as dependents, according to Guy Cousins, director of the state's Office of Substance Abuse and Mental Health Services.
"There's a lot of distortion in thinking that happens when people are using bath salts," Cousins said. "They sometimes hallucinate. There's a loss of reality, what's real. There's a number of things that go on that make them incapable of making sure that their children are safe."
With other drugs, such as opiates, which are also widely abused in the area, the neglect often stems from extreme sedation -- parents sleeping through the day, for example. With bath salts, neglect has a different face. Abusers are more likely to engage in extreme, delusional, even violent behavior.
In our past coverage of the drug, we reported on scientists at Virginia Commonwealth University who are researching how the drug interacts with the brain's dopamine system by studying its effect on frog eggs reprogrammed to act like brain cells.
At the National Institute on Drug Abuse in Baltimore, Md., a team of researchers led by Michael Baumann are taking a different approach. They are peering directly into the brains of rats who have been dosed with MDPV to untangle the neurobiology of the drug's bizarre effects.
MDPV, like cocaine, acts on the brain's dopamine system. Dopamine is a brain chemical involved in things that give us pleasure, like food, sex and gambling, but it also regulates motor control, memory and learning. And that's not all. Any time you're tuning into a conversation, focusing on a task, flirting with a potential mate, the brain is releasing tiny bursts of dopamine from the nerve cell ending, or synapse.
But just as this dopamine is naturally released, it's also naturally getting sucked back into the cell like a vacuum in a process called reuptake. Under normal circumstances, dopamine levels outside the cell are kept exquisitely low due to this vacuum effect, Baumann says. But MDPV causes excessive amounts of dopamine to remain in the synapse, the space between cells.
This is because both cocaine and MDPV work by inhibiting that reuptake of dopamine, which results in more dopamine hanging out in the brain. Cocaine slows reuptake. MDPV nearly blocks it altogether. (Click on the image above for a visual of how this works.)
So what does that do to the rats?
"What you've done is you've jacked dopamine up, and that makes them wander crazily around the cage," Baumann said. "So you're taking circuitry that's been laid down over millions of years of evolution of these animals. This circuitry, it's been laid down, it has a purpose, but when these drugs are present, you're basically pushing them into some netherworld that the normal brain never sees."
At his lab, Baumann's team surgically implants tubes into the brains of anaesthetized rats, specifically into the nucleus accumbens, a region of the brain associated with addiction. Then a week later, they insert into the tube a probe, which they use to sample the brain's extracellular fluid, after dosing them with MDPV. That allows them to see the extent of dopamine that's been blocked from reuptake by the drug, the amount of dopamine that's unable to get back into the cell. They also study their movement and behavior while on the drug.
In a separate experiment, they use a sensor to measure the animal's blood pressure and heart rate.
Researchers at VCU said the drug was as much as 10 times more powerful than cocaine. Baumann says that's a conservative estimate.
MDPV, they found was at least 10 times more potent than cocaine in every test that they used.
"It's 10-fold more potent at increasing dopamine in the brain and 10-fold more potent at increasing heart rate," Baumann said. "Because of the increased potency of the drug, it's dangerous to take it recreationally.
They also found that MDPV illicits effects that are greater in magnitude than cocaine. It led to a higher heart rate and more hyperactivity than cocaine.
While Baumann couldn't comment on its connection to child neglect, he did say the science helps explains the extreme behavior seen by its users.
"Because of the strong dopaminergic effects of this drug, you would expect it to lead to compulsive use," he said. "There's no doubt this is a powerfully addictive substance."
