There is a special room in Warren General Hospital's emergency room for people on bath salts.
There is a room full of restraint systems next to it. Most patients who need them get the four-point system because the more comprehensive full-body restraint - the Gulliver - requires the cooperation of the patient.
The ER staff has seen bath salts patients. The damages to the room they've put them in stand witness.
As of Thursday, the whole staff has had the opportunity to learn what to expect.
Warren County District Attorney Ross McKeirnan and Jessica Uber, WGH drug and alcohol counselor, addressed about 70 members of the staff Thursday.
McKeirnan introduced some of the criminal problems the county has gone through with respect to bath salts.
Like many people in the community, some of the hospital staff were still not clear what the term refers to.
"It's an unfortunate name for something that has become a hideous blight on our community," McKeirnan said. Rather than something added to water for soaking feet, today's bath salts is a synthetic amphetamine that "makes people go really nuts."
They are "plentiful and available," McKeirnan said. And dealing in them can be very lucrative.
People who use the drug commit all kinds of crimes - from theft and burglary to sex crimes and homicide - he said.
Uber said the efforts of law enforcement including the Warren County Drug Task Force have created a drop in the number of bath salts cases that arrive in the hospital.
Some people who might normally try bath salts are hesitant "since the guy ate the face in Miami," Uber said.
But people still show up at the hospital under the influence of bath salts.
"That's the issue - trying to control these people when they come to your facility," McKeirnan said.
Uber talked about the effects of the drug on the body.
Some of the medical and psychological problems seen in patients who use bath salts are: chest pain, cardiac arrest, kidney failure, stroke, death, agitation, psychosis, paranoia, hallucinations, suicidal behavior, homicidal behavior, insomnia, intense cravings, delirium, increased energy, and aimless behavior, she said.
She cited examples of bizarre behavior of people on bath salts: "Their phone was off and they really thought they were text messaging." Another person repeatedly stabbed an empty laundry basket with a knife, insisting there was someone inside.
The initial effects can last for up to 72 hours. After that, the user crashes and may sleep for more than 24 hours. Unlike with some drugs, there is no danger of death during the withdrawal period, Uber said.
The long-term effects are not well known, but there is evidence of paranoid psychotic breaks, schizophrenia, and "throwing up crystals," Uber said.
"We had a person that had neurological damage to the point that they have a twitch," she said.
While some of the physical and neurological effects are know, the addictive qualities of the drug are in question. "It's so new I don't think any of us knows the effects," Uber said.
Because there are so many variations of the drug, it is difficult to determine what a patient is under the influence of. Testing is time-consuming and expensive.
"We thought this would be a good safety issue for the staff," Jim Loree, human resources generalist, said. "We encouraged all of our staff to attend for their safety and the safety of the patients."