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As a paramedic, we often do see these effects (and not withstanding the valid negatives of 'excited delirium') as a first order effect of synthetic cathinone ("bath salt") abuse: - stripping down because of overheating - this also causes tachypnea (rapid breathing) as the body looks for any means, efficient or not, to try to bleed off excess heat - frank bruxism (teeth grinding) to the point of craving 'gnawing' (this is where the "trying to eat people" sensationalist stories come from - there's no homicidal intent, it's 'just' "people are chewy") - reflection fixation (often with glass). Similar to other psychoactives, reflections in glass provide a stimulant effect. With this, the most problematic thing is that some of the most common objects with glass in them are moving (i.e. cars), which heightens the effect, and causes a danger to self and others. The challenge is that many of these behaviors, in public, are... "antisocial" and rapidly lead to police involvement. Notwithstanding what I believe is cynical CYA by some "less-lethal" manufacturers to glom onto this, the small mercy in my area is that the higher levels of police command have directed that these situations be treated as the medical emergency they are, and not a law enforcement issue. Indeed, protocol here is that LE should be used for restraint both as a last resort, and for the shortest possible time before the patient can be transitioned to "chemical restraint", i.e. sedation, at least with capnography (to monitor breathing), if not active ventilation as needed. |