After Rudy Eugene attacked a homeless Miami man in May -- stripping him naked, beating him up and then chewing off 50 percent of his face -- an emergency room doctor suggested it was the work of a drug that would become a new part of the national vocabulary: bath salts.
While the drug is indeed dangerous, some medical experts suggest that it is not as widely used in Miami-Dade County as the hype would have one believe.
"There's a lot of sensationalism, and [the drugs are] getting a lot of press because most cases can be dramatic," Dr. Daniel Castellanos of Florida International University told HuffPost Miami.
The amphetamine cocktails known as "bath salts" are man-made, synthetic stimulants with a chemical composition that puts them in the same category as cocaine or, on a much milder scale, caffeine, Castellanos said.
According to the American Association of Poison Control Centers, nationwide operators received 6,138 bath salts-related calls in 2011. As of May 31, there have been 1,302 calls this year. By comparison, in 2010 (the latest year for which there is data) there were almost 52,000 calls for street drugs, which include heroin, cocaine and LSD.
According to those on the local front lines, bath salt use has increased but is still less popular than other street drugs. John Springle, a certified addiction professional in private practice in Miami and at Destination Hope in Fort Lauderdale, says the number of patients seeking treatment for bath salts addiction has doubled in the last six months to as many as 10 a month. (One user told Springle that while high on bath salts, he jumped through a glass window because he thought a trash can was chasing him.)
Springle said the majority of his patients -- three times as many as those addicted to bath salts -- are suffering from opiate addiction.
Castellanos published the first study of synthetic marijuana use in teenagers last year, and is now investigating the prevalence of bath salts in South Florida.
"People are saying this is a huge epidemic. Is that true? I'm trying to go back and find out how frequent it is," he said.
Castellanos has queried area hospitals and treatment centers to find conclusive bath salt cases, meeting with directors of an addiction treatment program at South Miami Hospital, a private substance abuse treatment program and at Broward Health, which encompasses four hospitals. So far, he has turned up only four anecdotal cases.
Dr. Luis Gutierrez, medical director of the emergency department at Coral Gables Hospital, told HuffPost that only about 2 percent of the hospital's patients have been bath salts users -- but he anticipates the problem will grow.
"These patients are very hard to control, they don't look you in the eye, they present errant behavior and can't communicate," he said. "The number of patients with this condition has recently increased and will continue to increase due to the availability of these types of substances in the market."
However, as the hysteria around bath salts reached a furor, an autopsy report revealed that Eugene only tested positive for marijuana, despite a battery of tests for the most common ingredients used in synthetic drugs. Experts, however, point out that marijuana is highly unlikely to prompt such alarming behavior -- and that toxicology testing has been unable to keep pace with the constant onslaught of new synthetic substances.
"This subject is of great concern to hospitals. Some of the symptoms presented with the use of [bath salts] are similar to those of a heart attack and could be treated as such, causing a risk to the patient," Gutierrez said. "Although the protocol has not been officially changed, the practice has. We now order more toxicology tests for patients that present clinical symptoms."
Swept up in the horror of the face-eating incident, some South Florida cities have taken steps to ban the synthetic chemicals in their municipality -- despite having made not a single related arrest.
While Springle agrees with efforts to ban the drug, he fears such measures are insufficient because of how easily manufacturers can replace banned chemicals with new ones.
"The very difficult thing about bath salts is [manufacturers are] using synthetic components that don't even have names; they're numbered," Springle said. "I really believe it's a form of Russian roulette. They don't even know what they're taking, they have no idea."