Flakka: What You Need To Know

 
By Terence T. Gorski
August 19, 2015

Cautionary Note: Flakka is a relatively new drug that can cause extreme behavioral reactions during intoxication and immediately after using. There are also reports of long-lasting neurological effects. It is definitely a dangerous drug that is rapidly entering the drug-using culture. 

It is important to be cautious not to exaggerate the incident rate (number of people using it) or the type and severity of symptoms (stripping down naked and chasing people down like a fast-moving zombie). 

The information in this blog is summarized by usually reliable news reporting sources on the Internet and corresponds with real incidents reported to me by colleagues and clients. It is important, however, to be cautious about extreme reports of new designer drugs. 

According to Jacob Sullim in his blog on reason.com, there are three designer-drugs that are closely-related to Flakka that are recently entering the United States. These are — meow-meow, krokodil, and Jenkem. 

  1. Meow meow, is a nickname for mephedrone, another synthetic cathinone sold as “bath salts.” and
  2. Krokodil, is a homemade version of the narcotic painkiller desomorphine, which was first synthesized in 1932 and marketed under the brand name Permoid. Krokodil caught on in Russia as a cheap substitute for heroin because it could be made from codeine, which was available there without a prescription. 
  3. Jenkem is fermented human waste that supposedly generates intoxicating fumes when inhaled. 

When doing internet research on any new drug or controversial issue, I strongly recommend you do a Google Search on the topic and the another on the topic plus the word “hoax.” This will give your review more balance. 

To get a balanced mind-set about Flakka it may be helpful to read this blog from Reason.com: http://reason.com/blog/2015/06/17/flakka-turns-people-into-zombies-just-li

With these cautions in mind, I hope this blog will summarize some information about Flakka that will help you to better understand the epidemic of Flakka as it emerges in the USA. 

Summary:

Starting in the Spring of 2015 a new drug of abuse called Flakka or Gravel was smuggled into South Florida and rapidly made it’s way up to Northern Florida and beyond. Its use is rapidly spreading across other states leaving a trail of victims behind.

Flakka, a variation of synthetic substances known as bath salts, is an illicit drug concocted in labs overseas and shipped into North America.

Flakka delivers a cheap, powerful high while acting as an amphetamine, according to officials. The drug can be snorted, smoked or taken by mouth and can cause violent behavior.

Flakka induces paranoia, psychosis and extreme aggression. Users high on this dangerous drug have attacked authorities, caused disruptions on the streets and in emergency rooms, engaged in self-injurious behavior, including in one case, and in one case, a man impaled himself on a spiked fence.

Detailed Information about Flakka.

What is flakka?

Flakka, which  is also called gravel because its crystals resemble small pebbles, is a stimulate drug with a chemical composition similar to bath salts. The active ingredient in Flakk is alpha-PVP, a synthetic version of cathinone, the active ingredient in the stimulant shrub qat, which is also the active ingredient in bath salts. 

What Is Flakka-induced Excited Delerium?

In high doses, Flakka induces “excited delirium” in which users’ body temperature can rise to up to 42 C, which might explain why so many users end up naked while hallucinating. People report stripping off their clothing because they feel like they are on fir or burning up. 

How is Flakka ingested?

Flakka can be taken in different ways:

  • injected,
  • swallowed,
  • smoked or
  • snorted.

Can people overdose on Flakka?

Yes! Especially when it is smoked. Vaporizing and the smoking Flakka allows the drug to very quickly enter the bloodstream and may make it particularly easy to overdose.

What is the chemical composition of Flakka?

Since Flakka in manufactured in illegal labs overseas and can be cut by other chemicals before sale in the USA, there are differences in each batch of Flakka analyzed.

According to the U.S. Drug Enforcement Agency, Flakka is essentially a stimulant hallucinogenic. The main ingredient in all batches of Flakka is alpha-PVP, which is linked to cathinone, the drug found in bath salts. 

Flakka is a stimulant drug and users often mix it methamphetamine to increase the intensity of the stimulant high.

In July 2012, the Synthetic Drug Abuse Prevention Act made it illegal to possess, use, or distribute many of the chemicals used to make bath salts, including Mephedrone and MDPV. Methylone, another such chemical, remains under a DEA regulatory ban. Alpha-PVP, the active ingredient in Flakka, has not yet been banned. 

What are the behavioral effects of Flakka?

Alpha-PVP is a stimulant, so its users encounter:

  • alertness,
  • wakefulness,
  • tremors,
  • agitation,
  • irrational rage,
  • violence

Flakka, when taken in high doses, induces “excited delirium” in which the users’ body temperature can rise to up to 42 C, which might explain why so many users end up naked while hallucinating and panicking because they feel like they are on fire or “burning up.”

What does Flakka look like?

According to the National Institute on Drug Abuse, Flakka “takes the form of a white or pink, foul-smelling crystal,”

Dr. James N. Hall, an epidemiologist and co-director of the U.S. Center for the Study and Prevention of Substance Abuse at Nova Southeastern University, told NBC News.

“Some [users] get high, some get very sick, and many become addicted. Some go crazy and even a few die. But they don’t know what they are taking or what’s going to happen to them,” he said.

Some people experience heart problems, muscle breakdown or even kidney failure. The NIH says Flakka has been linked to deaths by suicide and heart attack.

Hall says flakka’s name has Spanish origins. “Flaco” means thin, while “la flaca” in rough translation is a party term for pretty, thin girl.

“They give [synthetic drugs] names that are hip and cool and making it great for sales,” he told NBC.

What is the street value of Flakka?

Flakka is relatively cheap. A single dose is about a tenth of a gram which has a street value of about $5.

What are common complications of Flakka? 

1. Flakka can make the drug user acutely agitated, making them irrational and vetberbally aggressive   This puts the Flakka patient at high risk of injuring self or others.  

2. These patients are a threat to themselves, the people around them, and the first responders (police, EMS) who are there to help them. It is common to hear reports that it takes multiple people to restrain and sedate these patients. 

3. Rescue crews and emergency department staff need to give sedatives to these patients as soon as possible to calm them and make them safe.

4. If police interventional be required to control an acutely aitate Flalka. This can result in officers using a  Taser or other methods to restrain the patient that have the potential to harm the individual. Officers need to rember that in these severe states of agitation, panic and adrenalin increase the patient’s strength while diminishing their perception of pain. Their paranoi is often focused on the first responders. 

5. Medically, the severe consequences of the agitation caused by the drug appear later. Patients who are agitated can go into a state called “excited delirium,” which is a medical emergency. 

6. In the excited delirium state, restrained patients struggle to free themselves, scream, flail, and can even have seizures. 

7. This struggling causes a high core body temperature called hyperthermia

8. The combination of a high body temperature and the extreme muscle overactivity can cause other metabolic problems to happen in the body. 

9. Muscle tissue begins to break down, releasing proteins and other cellular products into the bloodstream, in a process called rhabdomyolysis

10. The extreme struggling can also cause dehydration. 

11. The end result of the cellular products and proteins released during rhabdomyolysis and dehydration can impair the filtering function of the kidneys, leading to renal failure and death. 
Gorski Books: www.cenaps.com 

The Drudge Report Archives contains articles which historically track the introduction and growth in the use of Flakka: http://www.drudgereportarchives.com/dsp/search.htm?searchFor=flakka

Here is an article from Fusion.net that described the impact of Flakka from an “on-the-street” point of view: http://fusion.net/story/117767/a-complete-guide-to-flakka-the-horrible-street-drug-terrorizing-south-florida/ 

Flakka: Special Obstscles in Treatment: http://www.sun-sentinel.com/local/broward/fl-flakka-treatment-issues-20150813-story.html 

This blog describes the major complications that can occur when treating Flakka patients: http://www.medicinenet.com/script/main/mobileart.asp?articlekey=188097 

References:

REFERENCES:

“‘Bath Salts’ Intoxication.” N Engl J Med 365 Sept. 8, 2011: 967-968. <http://www.nejm.org/doi/full/10.1056/NEJMc1107097&gt;

Kaizaki, A., S. Tanaka, and S. Numazawa. “New recreational drug 1-phenyl-2-(1-pyrrolidinyl)-1-pentanone (alpha-PVP) activates central nervous system via dopaminergic neuron.” J Toxicol Sci 39.1 Feb. 2014: 1-6. <http://www.ncbi.nlm.nih.gov/pubmed/24418703&gt;.

“The Science of Alpha-PVP (‘Gravel’), a Second-Generation Bath Salt.” The Poison Review. Mar. 14, 2014. <http://www.thepoisonreview.com/2014/03/14/the-science-of-alpha-pvp-gravel-a-second-generation-bath-salt/&gt;.

“Violent, Impaired and/or Excited Delirium (ExDS) Patient.” Greater Broward EMS Medical Director’s Association. <http://www.gbemda.org/adult-2/2-5-adult-neurologic-emergencies/2-5-2-violent-andor-impaired-patient&gt;.

2 Responses to Flakka: What You Need To Know

  1. […] Gorski wrote an informative summary about flakka on his blog: “Flakka: What You Need to Know.” He said it can cause extreme behavioral reactions and there have been reports of long-lasting […]

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