Synthetic Cathinones: ‘Bath Salts’ or ‘Flakka’ Poisonings and Use in the United States 2021 to 2023

ABSTRACT Synthetic cathinones, colloquially called bath salts or flakka, are a group of psychoactive substances used recreationally, including mephedrone and eutylone. Studies examining the prevalence of bath salt use among select samples in the United States have found that approximately 1% of nightclub attendees in New York, high school seniors, and college students have used them. The purpose of this study was to examine the national prevalence of lifetime and past-12-month use of bath salts among a nationally representative sample of persons in the United States from 2021 to 2023. This study also examined nationwide poison center data to identify the number of poisonings from 2021 to 2023 in which bath salt use was intentional and not necessarily an adulterant in another illicitly obtained recreational substance. This study identified the prevalence of lifetime bath salt use among a nationally representative sample of persons 12 years and older in the U.S. to be 0.2% (n = 670,611) in 2021, 0.3% (n = 838,941) in 2022, and 0.3% (n = 836,128) in 2023. The national prevalence of past-12-month bath salt use was 0.0% (n = 111,039) in 2021, 0.1% (n = 167,815) in 2022, and 0.1% (n = 152,276) in 2023. From 2021 to 2023, there were 148 cases in which bath salt use was intentional and involved in a reported poisoning to one of the 55 poison centers in the U.S. Future studies are needed to examine risk factors associated with bath salt-related poisonings.