1. Flakka The 2 Dollar Killer HPSN 2016 Eric Dotten MSL, REMT-P, NCEE

2. WHAT IS FLAKKA AKA “GRAVEL”? It is a designer drug containing the chemical compound Alpha- pyrrolidinopentiophenone, a highly ADDICTIVE synthetic stimulant

4. Where does FLAKKA Come From?  Flakka is made in labs primarily in China similar to chemical structure of crystal meth and sold to dealers over the internet  A ‘hit” from a dealer can be sold for $2 or less

5. What is the intended effect of FLAKKA?  Enhanced concentration  Mood elevation  Increased energy  Elevated libido and decreased inhibitions  Euphoria

6. What are the side effects of FLAKKA? Hallucinations Paranoia Psychosis Decreases inhibitions (unsafe sex) Anxiety Violence Self-destruction Insomnia High Temperature Excited Delirium Death (20 Broward County Deaths since September)

7. EMS Treatment Protocol Flakka

8. Epidemic  With 32 confirmed flakka-related deaths in Broward County since last September, 874 cases in so far in since 2014 reported by BSO.

9. References Gussow, L. (2015). Toxicology Rounds: Flakka: Illicit Drug Triggering Bizarre Behavior. Emergency Medicine News, 37(11), 24. Ho, J. D., Smith, S. W., Nystrom, P. C., Dawes, D. M., Orozco, B. S., Cole, J. B., & Heegaard, W. G. (2013). Successful management of excited delirium syndrome with prehospital ketamine: two case examples. Prehospital Emergency Care, 17(2), 274-279. El Sanadi,N,(2014)Illegal Stimulant Drugs & EDS Present Danger, FLAKKA, Broward Health, March 2014 @ https://www.browardhealth.org/upload/docs/Corporate/FLAKKA _final.pdf https://www.browardhealth.org/upload/docs/Corporate/FLAKKA _final.pdf