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Flakka’s rush: Stimulating brain chemicals into fatal shutdown

he latest drug fad, flakka, is coming on with a rush. But when the thrill is gone, amputations, freak-outs and lives irrevocably altered remain in its wake..

Doctors, including Broward Health emergency room Dr. John Cunha, calls flakka “the perfect storm.”

It’s cheap. It’s easy to get. And the high is almost immediate.

Short-term, it’s disastrous, according to emergency doctors. Long-term it can be lethal.
“Some of the these people we’re seeing in the hospitals are just not normal again,” said Dr. Parham Eftekhari, a nephrologist who consults with hospitals throughout Broward County and is an assistant clinical professor of medicine for Nova Southeastern University.

Over the last month, Broward County’s largest hospital system has started seeing up to 20 emergencies a day related to the designer drug known as “flakka,” “gravel” or by its shortened chemical name, alpha-PVP, according to North Broward Hospital District’s CEO, Dr. Nabil El Sanadi, director of the system’s emergency services.
Jim Hall, a drug epidemiologist at Nova, said he hasn’t seen a recreational drug emerge on the scene with this much intensity since crack cocaine in the 1980s.

“It’s producing really severe issues than most any other drug we’ve seen in the last 30 years,” Hall said.

The drug’s extreme effects have been thrust into the public’s consciousness through autopsy reports, in headlines about users stripping naked and confronting passers-by with superhuman strength or, in one case, becoming impaled on a spiked fence around the Fort Lauderdale police department.Flakka is similar to cocaine in the way it stimulates the brain, but its chemical composition makes it the second generation of bath salts, synthetic compounds related to the natural stimulant drug khat. Illicit drug laboratories altered bath salts’ chemical composition slightly to get around laws and, in the process, made it 30 times more potent, according to Eftekari.

“It’s not meant for human consumption,” he said.

Because it’s traded on the street and combined with other drugs, it’s difficult to gauge what a safe flakka dosage would be. But studies say reactions to flakka range from enhanced alertness to an excited delirium and hallucinations that can cascade into a wholesale shutdown of the body’s critical functions.

Eftekari said he’s seen a flakka injection poison the blood to the point it required an arm amputation. He’s seen suicides. He’s also seen depression.

Flakka’s chemical composition prevents the brain’s neurons from metabolizing the excitement hormones. That, in turn, forces the body to endure extended “fight or flight” impulses that can turn someone into the “Incredible Hulk,” Eftekhari said.

“These people are so hyped up on these hormones, they will do anything,” he said. “The body can’t regulate.”
With hours of sustained hormone escalation, the body temperature spikes as much as 10 degrees, leading to the sensation of being on fire — explaining why flakka users often tear off their clothes. Sustained temperatures like that can lead to internal bleeding and multi-organ failure.

Eftekari said he’s seen users, oblivious to the limits of their own bodies, twitching and moving in such an prolonged, excitable state that muscles break down and deteriorate. This, in turns, produces an effect like pouring Drano into the kidneys. Some flakka users must then go on dialysis for the rest of their lives, he said.

Flakka has come onto the scene too recently to gauge its long-term effects among those who survive the high. There is some indication that neurons are permanently damaged in their ability to regulate the excitement hormones, said epidemiologist Hall.

Schizophrenia has also been observed among flakka users, Eftekhari said. More immediately, though, it’s highly addictive, as proven in laboratory rats that keep pressing the bar for more of the drug, and patients who come in swearing over how unpleasant flakka’s high is, Dr. Cunha said.

But then he sees them again.

“People who are taking it say they don’t want to take it again, but it’s so highly addictive, they do,” he said.


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