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A notorious synthetic stimulant, known as bath salts, ravaged scores of American communities a few years back. Particularly hard-hit, was upstate New York. Hundreds there ended up in emergency rooms for hallucinations, seizures, even heart attacks. What most people didn't know then, according to a federal indictment, was that some of the drugs wreaking havoc in New York, as well as in Virginia, Texas and Southern California, were created thousands of miles away in a lab in China. NPR's Frank Langfitt has the story from Shanghai.

FRANK LANGFITT, BYLINE: There were times when the emergency room at SUNY Upstate University Hospital in Syracuse looked like a scene from a zombie movie. Ross Sullivan, a physician there, recalls one afternoon when staff wheeled in a man with dilated pupils who was covered in sweat. Sullivan spoke to us by Skype.

ROSS SULLIVAN: The patient was screaming obscenities, and anybody he would pass - he was threatening and saying that he was going to kill them.

LANGFITT: The patient, who police suspected had taken baths salts, tried to get away.

SULLIVAN: The rest of the security team showed up. I would say about 10 men were holding him down. Even with this, he was still able to occasionally break a limb free.

LANGFITT: They eventually injected him with a sedative.

SULLIVAN: We probably used about 10 times the dosage that we would've used in a non-drug-induced person.

JAMES BURNS: To be honest, this is the first case that we had really had that involved a synthetic drug that we didn't know what it was.

LANGFITT: James Burns is assistant special agent in charge for DEA operations in upstate New York.

BURNS: It wasn't testing for cocaine. It wasn't testing for heroin or any of the other known drugs at the time.

LANGFITT: And that was by design. Burns says the chemists who made the drugs were tweaking the formula so users wouldn't test positive for a controlled substance.

BURNS: It's damn clever on their part, and it's been a real challenge to keep up with this stuff.

CARLA FREEDMAN: And then we got a lucky break.

LANGFITT: Carla Freedman is an assistant U.S. attorney in Syracuse. She says the case turned after police responded to a report about a woman freaking out one night in a city neighborhood.

FREEDMAN: She was standing on the porch of her house, firing a shotgun, screaming that there were ghosts. Local police went - they went into her house, and they found seven kilograms - what they thought might be cocaine or MDMA and a shipping label from CEC Limited, Eric Chang.

LANGFITT: CEC stands for China Enriching Chemistry. It's a small company with an office in Shanghai and a factory in neighboring Jiangsu province. Eric Chang is its director. The drug police found in the woman's home wasn't cocaine but a factory made derivative of mephedrone, a dangerous hallucinogenic stimulant. The woman was part of a Syracuse drug ring, which police say had ordered more than a hundred kilos of mephedrone from Chang using his company's website and a professional courier service.

MIKE POWER: Eric was very friendly. He spoke by phone. He spoke by e-mail.

LANGFITT: Mike Power is the author of "Drugs 2.0: The Web Revolution That's Changing How the World Gets High." Back then, he was working on an expose on mephedrone for the Daily Mail on Sunday, the London newspaper.

POWER: There've been a number of deaths from methedrone in the United Kingdom, and I wanted to see if I could find the kingpin, I suppose.

LANGFITT: Posing as an online buyer, Power found Chang's contacts. A Daily Mail reporter based in Hong Kong went undercover inside Chang's Shanghai lab. The floors were squalid, covered with dirty pieces of cardboard. Cabinets were splattered with orange chemicals. Power says Chang came off as driven.

POWER: An ambitious and successful guy that was driving an expensive SUV, drinking lots of Red Bull energy drinks. He was a very busy guy living in a fancy apartment above town. He was complaining that his wife never saw him 'cause he was so busy.

LANGFITT: He also appeared to be a big producer.

POWER: We ordered a gigantic quantity of this drug. And I said that we'd want to buy about 10 kilos a month for the next two years. And he kind of dismissed that as slightly small fry, you know. He thought that that wasn't particularly impressive.

LANGFITT: Shanghai is a big, legitimate pharmaceutical industry. Power, who never actually ordered the mephedrone, says factories like Chang's branched out into recreational drugs, in response to orders from Europe.

POWER: It's much cheaper to outsource chemical synthesis work to China than it is to do the work yourself in the U.S. or the U.K. or most parts of Europe. And it does seem a logical extension, in many ways, of the outsourcing that began once China opened up to international trade in sneakers and home furnishings. Why not designer drugs?

LANGFITT: Investigators say Chang made about $30 million selling drugs to the U.S. and Europe. China banned mephedrone in 2010. Eric Chang, though, remained free, and U.S. authorities say, continued to ship drugs to central New York as recently as February, 2013. Last year, Chang was named in a federal indictment. Without an extradition treaty, though, American authorities couldn't touch him. But they did tell the Chinese. Last week I went to Chang's headquarters in a midrise office complex near Shanghai Stadium.

I'm at China Enriching Chemistry right now, and there's nobody sitting at the reception desk. Just a - a bicycle, actually, is parked there - doesn't look like anyone's sat there in a long time.

ZHANG MINGJIE: (Foreign language spoken).

LANGFITT: I met a staffer named Zhang Mingjie. He said the firm is currently selling anti-AIDS drugs to India. But a company brochure I picked up still advertised mephedrone. Next, I ran into Sienna Tang who handles exports. She told me 20 cops raided the office late last year.

SIENNA TANG: I come here about 10 o'clock. So many people in this office - I'm afraid just because so many policeman ask me.

LANGFITT: What questions did they ask?

TANG: What does Eric do? Which material you have export?

LANGFITT: Tang said her boss didn't tell her much about what she was shipping.

TANG: I just know the shipping name, but I do not know the exact material.

LANGFITT: Police arrested Chang in November. His attorney says he's in jail now, charged with producing ecstasy. Shanghai police declined to discuss the case or explain why they didn't bust Chang earlier. Back in Syracuse, the situation has improved.

MICHELE CALIVA: It was pretty impressive how everybody came together to tackle this problem.

LANGFITT: Michele Caliva runs the Upstate New York Poison Control Center, which works with hospitals in the region. She says the state health department banned stores from selling bath salts, and police cracked down head shops.

CALIVA: The accessibility was really key, and the fact that the average person could no longer just casually go in and buy it, made a difference.

LANGFITT: Caliva says the region still has serious drug problems. But by last year, emergency room admissions for bath salts and stories about crazed users had plummeted. Frank Langfitt, NPR News, Shanghai.

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