Southern Maine braces for spread of bath salts

WESTBROOK, Maine — Bangor may have served as ground zero in Maine’s battle against abuse of synthetic bath salts, but the dangerous drug is also seeping into southern Maine.

“It is down here,” Michael Wardrop, Maine’s resident agent in charge for the U.S. Drug Enforcement Agency, said at a Wednesday evening conference in Westbrook about the drug. “And if the wrong person gets it, it can infiltrate your community almost overnight.”

The conference, hosted by the Westbrook Public Safety Department and Mercy Hospital, attracted area health care professionals, emergency responders and law enforcement officers, who are still learning how to respond to bath salts. The powerful stimulant first appeared in Maine last year, and has since grabbed headlines as wildly erratic and sometimes violent users tangle with police, climbing into sewer pipes and running naked in the street.

Users often suffer from extreme paranoia, hallucinations and a dangerously high heart rate and body temperature.

Bath salts have been tied to at least one death in Maine.

Manufacturers produce the drug overseas and ship it to the U.S., labeling it as fertilizer, jewelry cleaner, and, though the chemical has nothing to do with bathing, bath salts, Wardrop said.

A handful of bath salts users have turned up at Mercy’s substance abuse treatment center in Westbrook, including one agitated patient who flipped over a nurse’s desk, said nurse manager Tammie Bouchard.

“They have superhuman strength, so restraints don’t even hold them,” she said before Wednesday’s conference.

Bath salts users present tricky new challenges for health care providers and police. They can be impervious to pain, which not only puts others at risk but also means ambulance and emergency room staff may not realize when a user is injured.

Dr. Anthony Ng, chief medical officer at The Acadia Hospital in Bangor, said he once saw police transport a bath salts user for psychiatric treatment, unaware that her leg was broken so badly that her femur was protruding from her thigh.

“They don’t even feel the pain and they end up with broken bones,” he said.

Bath salts patients tend to eat up emergency room resources, as multiple doctors and nurses can be needed to restrain and treat them, Ng said. Meanwhile, other patients are left waiting for services.

Some bath salts patients must be sedated, Ng said, but he cautioned health providers against resorting to medications and restraints without first trying other methods. Speaking reassuringly to an agitated or paranoid patient and moving them to quiet room with low light often works to calm them enough for a medical assessment and treatment, he said.

That approach makes for a better relationship between doctor and patient, and also avoids a sedated bath salts user lying unconscious in the ER for long stretches of time, Ng said.

Health experts are still working to develop a treatment protocol for bath salts patients, and the drug’s long-term effects remain unknown.

Ng said he fears the damage could be similar to the long-lasting effects of the chemical drug PCP. Some bath salts addicts — the drug can be snorted, shooted or smoked — relapse into hallucinations and paranoia weeks after their last dose, he said.

Bath salts’ presence in Bangor has waned, partially because the price rose recently after possession and trafficking of the drug became a felony, making cheaper drugs more attractive, Ng said. Police have cracked down on sellers and users, and the Bangor community fought back against the epidemic with partnerships among law enforcement, first responders, health professionals and schools.

That model could help to discourage the drug’s spread in southern Maine, but must be tailored to each community, Ng said.

“Something that worked for us may not work for you guys,” he said.