Bath salts have become increasingly popular drugs of abuse. This has led to an increase in emergency department visits for patients with intoxication from these drugs. The literature indicates that bath salt intoxication can have significant physiological and psychiatric sequelae. The purpose of this article is to report data from 10 cases of bath salt intoxication that experienced severe psychiatric symptoms requiring emergency psychiatric detention (i.e. Physician Emergency Certificate). In general, our patients had mild sympathomimetic physiologic responses that resolved quickly. The psychiatric symptoms tended to be short-lived, with staff psychiatrists rescinding the majority of the Physicians Emergency Certificates prior to inpatient admission. Our cases suggest that involuntary admission to psychiatric facilities may be circumvented with additional monitoring in the emergency department. Prospective studies should be done examining the natural course of bath salt-induced psychosis to determine if emergency detention is necessary.
