Tox Tuesday: Florida’s flakka problem and other drug abuse issues

Man smoking electronic cigaretteIn an official report released by Trust for American’s Health, Florida now has the 11th highest drug overdose mortality rate in the U.S. with overdose deaths doubling between 1999 and 2010. Overdose deaths in the state now also exceed motor vehicle-related deaths and have led some officials to call the current situation in their state “a serious epidemic” and “full-blown crisis.” The issues of drug abuse in Florida, like in many other states, involve a mix of drugs including synthetic designer drugs, prescription pain killers, heroin, and more. 

For example, the most recent synthetic designer drug to cause problems in the state is referred to by some as $5 insanity and is known for the bizarre incidents it causes, which have become a growing problem for police since it first appeared in Florida in 2013. Officially known as flakka, or gravel, this drug is usually sold in a crystal form and can be smoked using electronic cigarettes, snorted, injected or swallowed.

Attributing to its rapid popularity, flakka is very cheap, often only costing $5 or less and can be easily obtained in small quantities through the mail. According to a recent article, flakka’s active ingredient is a chemical compound called alpha-Pyrrolidinopentiophenone (alpha-PVP), which is also found as the active ingredient in “bath salts,” another synthetic cathinone and amphetamine-like stimulant. Synthetic cathinones have previously also made headlines for bizarre incidents that have occurred from people abusing these drugs and experiencing delirium, hallucinations and paranoia.

Alpha-PVP was first developed in the 1960s and according to the U.S. Department of Justice Drug Enforcement Administration, is considered a Schedule I drug under the Food and Drug Administration Safety and Innovation Act. Alpha-PVP contains a pyrrolidine ring, a 5-sided nitrogen-containing component that enables the molecule to effectively block reuptake of dopamine and norepinephrine, with much weaker effects at the serotonin transporter. The U.S. Drug Enforcement Administration lists alpha-PVP on the controlled substances most likely to be abused list, and is usually made overseas in countries such as China and Pakistan.

Often causing heighten awareness, increased energy, hallucinations, and “super hero strength,” flakka was responsible for one man running naked through a Florida neighborhood, trying to have sex with a tree and then telling police he was the mythical god, Thor. Other incidents have included users fearing they are being chased by packs or dogs or gangs of people, and has even caused some to break into the Fort Lauderdale Police Department in search of safety.

Judging from the evidence being seized by police around Florida, flakka use is up sharply. Submissions for testing to the Florida Department of Law Enforcement’s (FDLE) crime labs have grown from 38 in 2013 to 228 in 2014, the article states. At the Broward Sheriff’s Office laboratory, flakka submissions grew from fewer than 200 in 2014 to 275 in just the first three months of 2015.

“It’s definitely something we are watching. It’s an emerging drug,” Chad Brown, an FDLE supervisory special agent,” said in the article. He also noted that his agency is training police to better recognize the drug and the symptoms it can cause.

According to another article, one challenge for law enforcement is that flakka manufacturers make subtle changes to its chemical makeup, making it difficult test for the drug. It is also frequently mixed with other substances, such as crack cocaine or heroin resulting severe behavioral changes and quicker overdose death.

“It actually starts to rewire the brain chemistry. [Users] have no control over their thoughts and they can’t control their actions,” Don Maines, a drug treatment counselor with the Broward Sheriff’s Office in Fort Lauderdale, said in the article. “It seems to be universal that they think someone is chasing them. It’s just a dangerous, dangerous drug.”

According to the National Institute on Drug Abuse, Florida appears to be the nation’s hot spot for reports of flakka, which they believe arrived on scene just as Florida’s crackdown on prescription drugs was making progress.

Before flakka, Florida was known as the epicenter of a prescription drug abuse epidemic. In fact, doctors in Florida prescribed 10 times more oxycodone pills than every other state in the country combined and people came from all over the Southeast to visit the state’s pain clinics, a problem that continued to grow for 30 years.

One major reason pill mills proliferated in Florida was because, unlike most other states, it lacked a system for monitoring drug prescriptions until 2011. Law enforcement officials said once the database was in place, “doctor shopping” declined and no longer allowed people to get away with traveling from one clinic to another, buying hundreds of doses of prescription drugs along the way.

Along with the implementation of the drug monitoring database, police departments in Florida focused on cracking down on prescription pill mills and began shutting down as many as possible. When the source of many abusers addiction was cut off, a new search began and led some right to flakka.

Flakka was not the only substance prescription drug addicts began turning to however. At the same time, heroin began regaining popularity in the state and just as prescription opioid deaths started to decline, heroin deaths began to increase. Now, current statistics are showing that over the course of just one year, heroin-related overdoses have seen a double digit increase in almost every county in central Florida. The biggest increase is being seen in Orange and Osceola counties, where deaths have jumped 84%.

The growing issue of heroin is not only being seen in Florida, but rather is a national problem. According to the National Survey on Drug Use and Health, about 669,000 Americans reported using heroin in 2012, about double from 2007. To show just how serious this problem is, Vermont’s governor dedicated his entire annual State of the State address in January to the opiate, referring to it as a “full-blown crisis.” Also in Massachusetts, the governor declared a state of emergency after at least 185 people died from heroin overdoes since Nov 2014.

To combat this problem in Florida, state Governor Rick Scott was originally in favor of drug testing all state employees as well as all state citizens who receive government assistance. Under this legislation, state employees would have been required to submit to mandatory urinalysis without suspicion of drug abuse or wrongdoing. Those who tested positive for drugs could then face termination and would be referred to a rehabilitation clinic. A mandatory urinalysis would also be required for anyone receiving state-funded assistance and those benefits could be revoked for anyone who tested positive for drugs.

However, after facing strict opposition from worker’s rights groups who argued drug testing without suspicion was unconstitutional, Governor Scott forfeited the issues and settled with the American Federation of State, County and Municipal Employees (AFSCME). In the settlement, the two parties agreed drug testing could only be issued under reasonable suspicion. This settlement also ended Scott’s effort to require applicants of state welfare or other assistance programs to undergo drug testing as well.

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