A young man with hemiplegia after inhaling the bath salt “Ivory Wave”

“Legal highs,” intoxicating substances not prohibited by laws, are gaining popularity in Europe and the United States. The bath salt “Ivory wave” is one of these substances and contains methylenedioxypyrovalerone (MDPV), a synthetic cathinone. Methcathinone was originally developed in the 1930s as an antidepressant, but due to its strong addictive potential was never clinically used. Nowadays, the group of “legal highs” is sold in local shops, and even in gas stations. It can be taken orally, IV, IM, or by means of inhalation.1,2