05/6/16

Fading Flakka Fad

© ARTHIT BUARAPA | 123rf.com

© ARTHIT BUARAPA | 123rf.com

In the summer of 2015 when flakka was at its zenith in Broward County Florida, police needed four or five officers to subdue one agitated person high on flakka. In The Washington Post, Todd Frankel said people high on flakka were everywhere. “Running into traffic. Zoned-out on curbs. Sometimes naked. Sometimes in the grips of a drug-fueled psychosis.” Emergency departments were overwhelmed. A drug treatment counselor in Florida said: “At the height of the flakka craze, you were almost praying for crack cocaine to come back.”

In the summer of 2015, 12 new cases of flakka-related delirium were admitted daily to South Florida hospitals. Flakka users are resistant to pain and sometimes have superman strength. Tasers were sometimes ineffective. Deputies sometimes had to wrestle users to the ground and punch them to gain control. Talking didn’t work. Reporting for The Fix, Valerie Tejeda said CNN reported there were 63 deaths attributed to using flakka in South Florida between September 2014 and December 2015. Also for The Fix, McCarton Ackerman said some Florida EMS departments were training to use ketamine to sedate flakka users who showed signs of aggression.

Then almost as quickly as flakka came onto the scene, it went away. Returning with Todd Frankel to a gas station that had been a local gathering place to buy and sell flakka, a police lieutenant in Pompano Beach Florida couldn’t find even one person. In a short period of time flakka has disappeared from South Florida. “Experts say drug epidemics almost never burn out like this.”

In March of 2015, the United Way of Broward County organized the Flakka Action Team. The task force consisted of substance abuse counselors, local police officers and others. They developed a plan “to educate the community, to teach the police how to respond and figure out how to stop flakka production.” Anti-flakka posters were put up around the county. Community forums were held. Education presentations were done at schools, jails and homeless shelters.

Traditional drug treatment didn’t work with flakka users. One of the post acute withdrawal effects with chronic users was concentration. “Even filling out paperwork was a challenge.” Some people were light sensitive, so sessions occurred in darkened rooms. Some others struggled with paranoia and insomnia.

Jim Hall, an epidemiologist at Nova Southeastern University in Fort Lauderdale, publicized the Chinese connection with flakka. You could place an online order for flakka from a Chinese manufacturer and have it delivered to your door. A kilo of flakka cost $1,500 and had a street value of $50,000. In mid–October of 2015, the U.S. Treasury imposed sanctions on one alleged synthetic drug producer in China. In November, Florida law enforcement officials and local DEA agents went to China to plead their case directly with the Chinese government.

Afterwards, China announced they had banned 116 different synthetic drugs, including flakka and fentanyl. Confusingly, the announcement said this action had been taken on October 1st. Reported hospital cases of flakka in Broward County went from 306 in October of 2015 to 54 in December. There have been no reported deaths from flakka in 2016 as of the beginning of April 2016. There were only six flakka users admitted to Florida treatment centers in January. In February the Flakka Action Team dropped “flakka” from its name.

Michael Bauman of the National Institute on Drug Abuse (NIDA) said: “History has shown that one of the unintended consequences to banning certain drugs is that it typically leads to an explosion of new replacement drugs.” Whether or not that will occur in response to the 116-drug ban remains to be seen. But there is a next step to be taken, if the recommendations of a Broward County grand jury are activated. They recommended that entire classes of drugs, such as synthetic cathinones or bath salts, which includes flakka, should be banned.

Florida Attorney General Pamela Bondi has proposed the “2016 Florida Designer Drugs Enforcement Act.” The legislation would ban synthetic cathinones, synthetic opioids and synthetic cannabinoids. It could potentially outlaw as many as 1,000 different chemical compounds, according to Jim Hall.

But what’s next? The next “designer-drug battlefield” would seem to be variations of the synthetic opioid fentanyl. Craig Mallak, the Chief Medical examiner for Broward County said: “Flakka is gone … fentanyl is the next big thing.” His office is in the process of developing a database to track the trend of fatalities with fentanyl.

For more information on flakka, read “Flack from Flakka,” “High on Flakka” and “Emerging Public Health Threat.”

05/11/15

Flack from Flakka

© Stocksnapper | stockfresh.com

© Stocksnapper | stockfresh.com

There’s a new drug in town—Flakka! A news report in January of 2015 from Broward County Florida’s WPBF 25 reported a disturbance call at a local nightclub that led to an arrest of an individual who was in possession of a bag of flakka. It looks like a cross between crack cocaine and meth. It can be snorted, smoked, ingested or shot up. And, “It has a strong odor like a sweaty sock.” Sounds inviting.

On March 13, 2015, there was a report by NBC South Florida that a fifty year-old man was trying the BREAK INTO the Fort Lauderdale Police Department because he thought 25 cars were chasing him down Broward Boulevard. He was kicking the hurricane glass with enough force that both the glass and the door were shaking. Again, he was high on flakka. Here is a security video of the man in the act of trying to break into the locked door of the department.

A thirty-four year-old man wearing only sneakers and socks was running on Broward Boulevard (again). He thought that people had stolen his clothes and were trying to kill him. He said he’d rather die than be caught by these people. He told police he was running down the middle of the street because if he was hit by a car, they would stop chasing him. You guessed it: high on flakka. Here is a video and report on the streaker.

In addition to these incidents, there was a naked man with a loaded gun on the roof of a building in Lake Worth shouting that someone was trying to kill him. When he saw the responding police officers approaching, he placed the pistol to his head and pulled the trigger. He misfired. Again, he’d smoked (vaped) flakka. And a twenty-six year-old man faces attempted murder charges after attacking an 86-year-old woman when he was high on flakka. You can access reports and videos on these two incidents here.

Now this flakka story is just too weird. Police in Melbourne Florida responded to a burglary call and discovered a naked man (of course) who claimed he was God before he got into a “tussle” with a police officer. This was after the officer hit the man TWICE with a taser. But he pulled out the probes and attacked the officer with his fists. Aleksander Chan for Gawker quoted a report by WKMG saying: “The officer punched Crowder in the face and a scrum ensued, with Crowder saying that he was Thor and trying to stab the officer with the officer’s badge, police said.”

Flakka is a new psychoactive substance (NSP) typically made from alpha-PVP, a synthetic cathinone. Cathinones are chemicals from the khat plant grown in the Middle East and Somalia. Effective February 27, 2014, the DEA listed alpha-PVP and 9 other synthetic cathinones as Schedule I controlled substances with a temporary ban. How it works (pharmacologically) is not known. It is believed to be similar to MDPV, which acts as a norepinephrine-dopamine reuptake inhibitor (NDRI). But no substantive research has been conducted yet on alpha-PVP.

In 2012, an Australian man died after injecting alpha-PVP. He stripped off his clothes, jumped a barbed wire fence into a shipping yard and smashed a window in a psychotic fit. He was restrained by several security guards inside the shipping yard and went into cardiac arrest. His girlfriend, also high on alpha-PVP, was covered in blood as she fell from their truck. She then took her top off and ran away, yelling, “Help me, help me.”

Jim Hall, an epidemiologist, said in a CBS News report that cathinones like flakka are the next—and more potent—class of drugs taking over after MDMA. They are designed to flood the brain with dopamine, and then block the pre-synaptic neuron from removing the dopamine from synapse. The result is an intense feeling of euphoria. Hall said that “snacking,” taking more flakka or other drugs while high, often leads to serious health problems, such as rapid heart rate, agitation, extreme aggression and psychosis. He said they are starting to see cases of excited delirium with flakka, as noted in the above reports.

[Excited delirium] is where the body goes into hyperthermia, generally a temperature of 105 degrees. The individual becomes psychotic, they often rip off their clothes and run out into the street violently and have an adrenaline-like strength and police are called and it takes four or five officers to restrain them. Then once they are restrained, if they don’t receive immediate medical attention they can die.

The drug’s name has several meanings. The word flaca in Spanish means skinny. But flakka is also a Hispanic colloquial word that means a “beautiful, elegant woman who charms all she meets.” It has been reported in other parts of the country, such as Ohio and Houston. Outside of Florida it’s often sold under the street name of “gravel” because it looks like the grainy pebbles or gravel in an aquarium.

Flakka and other cathinone-based drugs are produced in China and sold online to individuals and drug gangs in the US. An investment of a few thousand dollars can make a dealer as much as $75,000. These drugs aren’t always pure, meaning neither the dealer nor the customer actually knows what is in them, or how strong the dose is. Hall said: “We’re referring to these as the guinea pig drugs. Often the dealer might not even know what they’re selling.” In 2013 there were 126 reported deaths due to synthetic cathinones in Florida.

Then on April 10, 2015 the Broward Sheriff’s office were called to the scene of what appears to have been an accidental fatal shooting. A 31 year-old man was on a three-day flakka and molly (MDMA) binge when his friend came over. They added vodka and more molly to the mix. After spending the rest of Friday morning selling heroin, they decided to go to the home of the one man’s sister. When one individual was trying to unload a shotgun, it accidentally fired, ripping through the side of a car and hitting the other man in the face.  The shooter is in jail on manslaughter charges and possession of a firearm by a felon.

CBS News in Chicago did a story on April 24, 2015: “Scary new designer drug flakka hits Chicago.” And again, there was a naked man running around southwest Chicago. He had no memory of what he did while on flakka. “I went to jail, and I don’t remember anything until my third day in jail. I was completely out of my mind.” There is a whole new world of mind-altering substances and the problems associated with them out there. I don’t think we have not heard the end of flakka. And as long as there are willing guinea pigs, there are more NPSs to come.