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Flakka is a highly addictive and dangerous drug, otherwise known as alpha-PVP (alpha-pyrrolidinopentiophenone.) It is an amphetamine-like stimulant that belongs to the cathinone drug class. Cathinones are man-made, or synthetic drugs containing cathinone, a naturally occurring stimulant found in the khat plant. Flakka is illegal; it is classified as a Schedule 1 synthetic drug by the U.S. Drug Enforcement Administration (DEA).
Flakka originally became popular as a new synthetic drug in South Florida with people looking for a cheap high. Flakka is the latest in a selection of synthetic drugs used in the United States. The illegal substance can sell on the streets for as little as five dollars a hit.
Flakka use has also been reported in other parts of the United States.
The designer drug flakka comes in crystal form, and it is typically pink or white. The synthetic drug may be eaten, injected, snorted, or vaporized in e-cigarettes. Vaporizing flakka sends the drug quickly into the bloodstream. This method of ingestion can make it particularly easy to overdose on flakka.
Recently, the abuse of synthetic drugs has re-emerged as a significant worldwide issue. Synthetic drugs are illicitly created to produce substances that differ slightly from legal drugs. However, they still retain their pharmacological effects. A substance produced in this way is known as a designer drug.
Other street names for flakka include:
Flakka is chemically similar to the street drug known as bath salts or MDPV.
Synthetic drugs known as bath salts are from the synthetic cathinone class of drugs, like flakka. Synthetic cathinones are central nervous system stimulants. They mimic the stimulant effects similar to those resulting from illegal drugs. These include cocaine, methamphetamine (crystal meth), and MDMA (molly or ecstasy).
Other street names for bath salts include:
When sold legally, synthetic cathinones drugs often market as the following:
Synthetic cathinones are also labeled as ‘not for human consumption.’ These labels help hide the real reason for the product's existence, so the drugs distribute easily.
Bath salts come in powder form, which is typically packaged in gelatin capsules. Bath salts are commonly ingested by sniffing or snorting. They can also be taken orally, smoked, or placed into a solution and injected into the veins.
Bath salts are produced in East Asia. They are distributed wholesale throughout Europe, North America, Australia, and other parts of the world.
The synthetic stimulants sell at the following:
Bath salts are used to achieve feelings of euphoria and alertness. Dangerous side effects are also associated with the abuse of synthetic cathinones like bath salts and flakka. Adverse effects include:
Flakka is an addictive drug that people use to obtain a cheap, quick, and euphoric high. The cathinones found in flakka stimulate the release of dopamine. The cathinones also inhibit the reuptake of epinephrine, norepinephrine, and serotonin in the central nervous system.
As cathinones are hydrophobic molecules, they can cross cell membranes and the blood-brain barrier. This allows them to interact with the monoamine transporters in the synaptic cleft between neurons.
The euphoric high from flakka abuse can last from hours to days, depending on the dosage. Sometimes the effects of flakka can linger for weeks after it has been ingested.
Although people use flakka to achieve a euphoric high, the drug's symptoms and side effects can escalate quickly.
Like other stimulants of this type, flakka can cause excited delirium, otherwise known as agitated delirium. This condition occurs when there’s an excessive influx of sympathetic activation.
Excited delirium can involve:
Flakka can also lead to various other altered mental states.
When experiencing excited delirium, some people react with violent behavior and self-injury. Flakka has been linked to several deaths by suicide, as well as heart attacks. The drug can also raise body temperature dangerously high, leading to kidney damage or failure.
Synthetic cathinones like flakka are highly addictive. Users have reported that the drug use of flakka can trigger intense and uncontrollable urges to ingest the drug again.
When someone is addicted to flakka, they can experience withdrawal symptoms without it. These withdrawal symptoms include:
As flakka is a new drug, there is still a lot to learn about the treatment of the substance. Little information is known about flakka outside what is reported from users.
However, several traditional drug treatment approaches can help someone addicted to flakka become sober.
Detox is the first treatment step for someone who is addicted to flakka. Detox refers to clearing flakka out from the body so that one’s physical and psychological health can be assessed and treated.
When someone goes through a flakka detox, they will usually experience withdrawal symptoms such as those listed above.
As little is known about flakka, detoxing in the care of medical professionals is essential.
Behavioral therapy can treat addiction to synthetic cathinones like flakka. Examples of behavioral therapy include cognitive-behavioral therapy, contingency management and motivational incentives.
Motivational incentives offer rewards to patients who remain substance-free. This type of behavioral therapy is often aimed at teens.
As with all substance abuse, those experiencing addiction to flakka should screen for co-occurring mental health conditions such as depression or anxiety.
While there are no FDA-approved medications for addiction to flakka, there are medicines available for co-occurring mental health conditions.
Flakka (alpha-PVP), United States Drug Enforcement Administration (DEA), https://www.dea.gov/factsheets/flakka-alpha-pvp
Drug alert: Flakka (alpha-PVP), Just think twice, https://www.justthinktwice.gov/drug-alert-flakka-alpha-pvp
"Flakka" (alpha-PVP), National Institute on Drug Abuse, 2015, https://archives.drugabuse.gov/emerging-trends/flakka-alpha-pvp
Drugs of abuse, United States Drug Enforcement Administration (DEA), 2017, https://www.dea.gov/sites/default/files/sites/getsmartaboutdrugs.com/files/publications/DoA_2017Ed_Updated_6.16.17.pdf#page=86
Synthetic Cathinones ("Bath Salts") DrugFacts, National Institute on Drug Abuse, 2020, https://www.drugabuse.gov/publications/drugfacts/synthetic-cathinones-bath-salts
Crespi, Craig. “Flakka-Induced Prolonged Psychosis.” Case reports in psychiatry vol. 2016, 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4933860/