The scene at Beaufort Memorial Hospital was both violent and disturbing.
Over the past four months, teens and young adults, many of them kicking, screaming and trying to bite doctors and nurses, have turned up in the emergency room, likely under the influence of synthetic drugs called "bath salts."
In each incident, the symptoms were the same: hallucinations and violent and psychotic behavior.
The patients -- some high-school age -- have torn emergency rooms apart and in some cases, had to be restrained to stop them from hurting themselves or others, Memorial emergency room director Kevin Kremer said.
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Bath salts, a crystal or powder sold without state or federal restrictions at convenience stores and tobacco shops for between $25 and $40, mimic the effects of amphetamines. They can cause anxiety, rapid heart rate, severe panic attacks, seizures and psychosis, said Julie Williams, Beaufort County EMS training officer.
Also known as "plant food," the drugs are smoked, snorted or injected and are considered highly addictive.
"Agitated delirium is what's killing people," Williams said. "Heart rate and body temperature goes way up. It's a very scary situation."
While use of the drugs has not spiked in Beaufort County as it has in other parts of the state, at least a dozen people have admitted to using the salts in the past month, Williams said.
Most of the suspected cases have occurred in northern Beaufort County, but at least two have happened in the southern part of the county, she said. Hilton Head and Coastal Carolina hospitals have not had any patients they suspect have been on the drugs, according to those hospital officials.
"No one who admitted to using them has been in critical condition, but they were scared," she said. "I don't think they expected to have the reaction they had."
That reaction might include death.
In the past few months, county EMS crews have seen a rise in suicides, unexplained deaths and calls relating to behavioral abnormalities that led them to believe bath salts were the culprit, Williams said.
"We haven't been overrun with cases in the county, but we've certainly noticed changes," Williams said. "It's difficult for us to know the specific number of cases we've had and are still having with salts because it's undetectable in the system. Some deaths we could not explain have given us sound reason to believe it was salts."
'A WHOLE NEW LEVEL'
Salts got its street name because the consistency is similar to what's used for a relaxing soak in the tub.
Across the country, at least 35 states have already taken action to block the sale of salts and other synthetic substances such as Spice, also known as K2, according to 14th Judicial Circuit Solicitor Duffie Stone. Spice is smoked to mimic the effects of marijuana.
The number of calls to the Palmetto Poison Center about bath salts jumped from two in 2010 to 135 this year, Director Jill Michels said.
Abuse of the drugs, also known as Ivory Wave, Purple Haze, Vanilla Sky and Bliss, has spiked in the Upstate and Charleston's tri-county region.
So far this year in Beaufort County, one case of spice, or synthetic cannabinoid exposure, was reported to the center, while three cases of bath salt exposure were reported, she said.
"More populated areas have seen a spike in cases," Michels said.
Two deaths in the state has been linked to bath salts, but have not been confirmed, she said.
Some school districts, municipalities and counties statewide have rushed to place emergency bans on the drug while awaiting the federal Drug Enforcement Administration to list them as Schedule 1 narcotics, a move that would ban their use as medicine and remove them from store shelves nationwide.
S.C. Department of Health and Environmental Control officials are researching an emergency action for a statewide ban until the federal listing comes, spokesman Adam Myrick said Wednesday.
Lawmakers also are concerned.
During the last legislative session, about 60 state House members rallied behind a plan to ban the salts. But the bill did not get a vote before the Legislature adjourned in late June. Lawmakers don't return to Columbia until January, and the health department can't act on its own until the federal government moves first, Myrick said.
Council members in Greenville and in Anderson and Greenville counties passed emergency ordinances Tuesday night that ban the sale or possession of bath salts and other synthetic drugs.
"It's been a long time since I've seen an issue grab people like this," Myrick said. "It's gone to a whole new level."
The substances continue to flood the Lowcountry.
During a traffic stop for speeding on S.C. 17 in northern Beaufort County Saturday, Sheriff's Office deputies discovered two large boxes containing hundreds of packages of salts and Spice.
The two Atlanta men in the car told deputies they had been making deliveries to convenience stores in Columbia and Charleston and were heading back to Georgia.
Deputies called DEA agents, who ordered them to seize the boxes, a Sheriff's Office report said.
The men were ticketed only for speeding.
Michels said hospitals are not typically set up to screen for the chemicals found in salts. She encouraged hospitals and others to report suspected exposures to the poison center.
"These are new drugs that aren't on your typical drug screen," Michels said. "But if you're looking to ban these products, we need to have a database people can use to know what's going on."
Beaufort Memorial doctor Kremer said he would "absolutely" support a ban. He said treatment is difficult because patients generally don't admit to taking the drugs. He also said it takes higher doses of sedatives to calm those agitated patients.
"We just try to flush it through their systems as quickly as possible," he said.
"I wish it was regulated. It's dangerous."
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Related content:Two stores ignore military's Spice ban, April 4, 2011
Press releases from the United States Drug Enforcement Administration about its efforts to ban synthetic cannabinoids and its effort to place a temporary ban on bath salts.