sunsentinel

By Anne Geggis Sun Sentinel

Beyond the unprecedented levels of bizarre behavior it’s causing on the streets, South Florida’s new drug plague, flakka, is propelling local addiction treatment experts into uncharted territory.

The intensity and duration of flakka’s effects can cause users to believe they are afire and tear off clothing, or have superhuman strength that, in one case, led to an impaling on a security fence.

For those who survive the drug’s initial extended “fight or flight” surge, clinicians aren’t sure about what comes next — or how to treat the addiction. For some reason, flakka, also known as gravel, hijacks the brain in ways that stand apart from other addictive drugs. Worse, its most intense effects have recurred long after the initial high, they say.

“Flakka is whole different animal,” said Paul Faulk, director of the Broward Addiction and Recovery Center, a county-run treatment facility. “What we’re seeing when these individuals come in (for treatment), cognitively something has changed in them.”

Most troubling: Weeks and months after taking the drug, psychosis, anxiety and aggression can attack again, they say.

“Paranoia, anxiety and aggression comes out of nowhere,” Faulk said. “They are fine, having a great day, and then they have a wave come over them.”

In an effort to better understand how flakka, also known by its chemical name, alpha-PVP, affects the brain, the Broward County Medical Examiner’s Office is teaming up with a brain researcher at the University of Miami. Relatives of those who die and test positive for flakka will be asked to donate the deceased’s brain for research there.

On anther note. “In an effort to better understand how flakka, also known by its chemical name, alpha-PVP, affects the brain, the Broward County Medical Examiner’s Office is teaming up with a brain researcher at the University of Miami. Relatives of those who die and of those who die and test positive for flakka will be asked to donate the deceased’s brain for research there.

Dr. Deborah Nash, a professor of neurology and cellular pharmacology at UM’s Miller School of Medicine, is studying which brain receptors are most affected by flakka and what drugs would be most effective in counteracting those effects, according to the medical examiner’s office.

Controlled studies can’t be done on flakka for one simple reason: It’s deadly. From September until now, the medical examiner’s office logged 30 flakka-related fatalities.

Apart from research issues, physicians must develop strategies for more immediate concerns: How to deal with someone in flakka’s grip.

To stave off flakka’s immediate danger, a patient undergoing a drug-induced panic attack or psychotic episode will be brought to a hospital emergency room for either a dose of anti-anxiety or anti-psychotic medicine, said Dr. Nabil El Sanadi, CEO of North Broward Hospital District.

That treatment helps lower blood pressure, reduce agitation and limit psychosis immediately following flakka ingestion. But so far, no drug has emerged to treat the long-term effects of flakka addiction the way methadone and suboxone are used to help patients suffering from opioid addiction.

Unlike opioids, heroin or alcohol, flakka addicts don’t need the traditional, 30-day detox usually associated with drug treatment, said Karen Corcoran-Walsh, a licensed therapist who runs Inspirations for Youth & Families and the Cove Center for Recovery in Fort Lauderdale.

Once they are stable, she said, “Flakka users don’t need to detox physically. They are detoxing mentally.”

Like all addicts, flakka addicts must come to grips with what caused them to seek the high — and that means psychological or psychiatric treatment, North Broward’s El Sanadi said.

But the stimulant’s effects make it more difficult for addicts to grasp the consequences of their actions.

“Many of them don’t have recollection of what happened when they were in that high,” Broward Addiction Recovery Center’s Faulk said. He recalled the experience of one patient: “He terrorized his family for three days and had no memory of what happened.”

Trial and error at the center have revealed flakka patients do better in shorter, one-on-one sessions, rather than 60- or 90-minute group sessions, Faulk said.

And flakka poses yet another hurdle for those battling its effects. “You get a high relapse of individuals who use this drug,” Faulk said.