Public Release: 

NYU research: Hair sampling shows unintended 'bath salt' use

Four out of ten nightclub/festival attendees who use ecstasy/Molly test positive for 'bath salts' despite reporting no use

New York University

Ecstasy -- or MDMA, the active chemical ingredient--is one of the most prevalent party drugs; it is estimated to be used by at least one out of ten young adults in the United States.

The popularity of ecstasy use has increased in recent years since ecstasy became known as 'Molly', short for 'molecule' which is often marketed as "pure" MDMA powder. However, the ecstasy/Molly consumed is often far from pure: it is frequently adulterated with other drugs, such as synthetic cathinones, commonly known as "bath salts," or other novel psychoactive substances. Novel psychoactive substances are unregulated mind-altering drugs that have become newly available on the market and are often intended to mimic the effects of traditional illegal drugs.

"Given the sharp rise in poisonings and recent deaths at dance festivals related to ecstasy use, research was needed to examine whether nightclub/festival attendees who use ecstasy or Molly have been unintentionally or unknowingly using "bath salts"" said Joseph J. Palamar, PhD, MPH, an affiliate of the Center for Drug Use and HIV Research (CDUHR) and an assistant professor of Population Health at NYU Langone Medical Center (NYULMC). "Little is known about these new drugs and some may be more dangerous than MDMA."

To this end, Dr. Palamar and his team of researchers are the first to examine whether ecstasy users are unknowingly or unintentionally using "bath salts" and/or other novel psychoactive drugs. The study, "Detection of 'Bath Salts' and Other Novel Psychoactive Substances in Hair Samples of Ecstasy/MDMA/'Molly' Users" was recently published in Drug and Alcohol Dependence.

The researchers surveyed young adults outside of nightclubs and dance festivals from July through September of 2015 about their use of ecstasy and other drugs. The survey assessed whether participants had ever knowingly used ecstasy, MDMA or "Molly." Participants were also asked whether they had ever knowingly used any of 35 listed "bath salts" or other novel drugs.

"Then, we asked the participants if we could snip a lock of their hair to test for new drugs such as "bath salts"," said Dr. Palamar. "We collected hair samples from about a quarter of the survey sample to be tested for novel drugs."

The researchers focused on the hair samples provided by 48 participants who reported ecstasy use. While half of the samples tested positive for MDMA, half tested positive for "bath salts" and/or other novel psychoactive substances. The most commonly detected "bath salts" were butylone and methylone -- common adulterants in ecstasy/Molly.

"Among those who reported no use of "bath salts" or unknown powders or pills, four out of ten tested positive for "bath salts" and/or other novel drugs," said Dr. Palamar. "One sample also tested positive for alpha-PVP -- the strong stimulant known as "Flakka" that has made headlines in the last year.

"A lot of people laughed when they gave us their hair saying things like "I don't use bath salts; I'm not a zombie who eats people's faces." Yet our findings suggest many of these people have been using "bath salts" without realizing it."

"Ecstasy wasn't always such a dangerous drug, but it is becoming increasingly risky because it has become so adulterated with new drugs that users and the scientific community alike know very little about," said Dr. Palamar. "Users need to be aware that what they are taking may not be MDMA.

"As Molly is becoming a much riskier substance, I really hope that those who decide to use educate themselves about what they're doing. While it is safest to avoid use, test kits are available online for those who decide to use, and want to ensure that they're taking real MDMA and not a new synthetic stimulant such as Flakka."

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Researcher Affiliations: Joseph J. Palamar1,2* Alberto Salomone 3, Marco Vincenti 3,4, Charles M. Cleland 2,5

1 New York University Langone Medical Center, Department of Population Health,

2 Center for Drug Use and HIV Research, NYU College of Nursing, New York, NY, USA

3 Centro Regionale Antidoping e di Tossicologia "A. Bertinaria", Orbassano, Turin, Italy

4 Dipartimento di Chimica, Università di Torino, Turin, Italy

5 New York University College of Nursing, New York, NY, USA

Declaration of Interest: No conflict declared

Contributors: All authors are responsible for this reported research. J. Palamar conceptualized and designed the study, and conducted the statistical analyses. C. Cleland mentored and assisted J. Palamar with regard to study design, time-space sampling, and statistical analysis. A. Salomone and M. Vincenti conducted the hair analyses via UHPLC-MS/MS methods and quantified the biological findings. All authors drafted the initial manuscript, interpreted results, and approved the final manuscript as submitted.

Acknowledgements: This pilot study was funded by the Center for Drug Use and HIV Research (CDUHR - P30 DA011041). J. Palamar is funded by the National Institutes of Health (NIH) (NIDA K01DA-038800).

About NYU Langone Medical Center

NYU Langone Medical Center, a world-class, patient-centered, integrated academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research, and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals--Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, the Medical Center's dedicated inpatient orthopaedic hospital; and Hassenfeld Children's Hospital, a comprehensive pediatric hospital supporting a full array of children's health services across the Medical Center -- plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The Medical Center's tri-fold mission to serve, teach, and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education, and research. For more information, go to http://www.NYULMC.org, and interact with us on Facebook, Twitter, and YouTube.

About New York University College of Nursing

NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science with major in Nursing, a Master of Science and Post-Master's Certificate Programs, a Doctor of Nursing Practice degree and a Doctor of Philosophy in Research Theory and Development. For more information, visit https://nursing.nyu.edu/

About CDUHR

The mission of the Center for Drug Use and HIV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041). It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the New York University College of Nursing. For more information, visit http://www.cduhr.org.

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