Flakka Drug – Signs, Side Effects, and Dangers of This Drug

Last Updated: December 23, 2020

Authored by Isaak Stotts, LP

Reviewed by Michael Espelin APRN

Flakka is a synthetic stimulant drug. Unlike most drugs in this class which simply have an excitatory effect on the central nervous system, this one also has psychoactive effects, which is why it is sometimes referred to as the zombie drug. This combination can be dangerous, as the increased energy and psychoactive effects can cause harm to the individual or others.

This drug called flakka is commonly compared to bath salts, another synthetic substance belonging to the same class. When abused, the substance can have serious adverse effects on the individual, and there is the risk of overdose which can prove fatal. So, what is flakka? This article will answer the question of what flakka is, as well as discuss important information regarding this substance and its abuse.

What is Flakka?

Synthetic cathinones is the class of synthetic drugs flakka belongs to. This class also includes bath salts. The chemical name for this is α-pyrrolidinopentiophenone, which is sometimes shortened to α-PVP.

This substance is particularly dangerous because it can be easily obtained online, and it is rather inexpensive. This makes it a substance rather popular for use among younger people and having status as a designer drug just worsens this.

What Drug Class is Flakka in?

The active ingredient in this drug, which is α-PVP, is listed by the United States Drug Enforcement Agency to be a Schedule I drug. This means that it is a substance that has no approved medical value, yet has a high potential for being abused. The substance is illegal in the United States and several other countries, including the United Kingdom, France, Germany, Australia, and Ireland.

Is Flakka an Addictive Drug?

Similar to many other stimulants, this substance is thought to have significant addictive potential. However, there is not much information from studies done in humans to demonstrate this due to its relative novelty as a drug of abuse, according to a report by the European Monitoring Centre for Drugs and Drug Addiction. However, animal studies have been able to demonstrate that there is clear abuse liability, and there may as well be the potential for dependence in humans.

The woman in blue is seeing a psychologist.

 

In many states, the use of flakka drug rapidly rose, before crashing just as fast. From 2010, where there were no records of use in the state of Florida, to 870 instances just 4 years later. Following this, the numbers began to drop quickly. In Broward County, the state in Florida with the most prevalent use of the substance, 63 people died related to the use of the substance, but in early 2016, no deaths were recorded. This is likely due to the government ban on manufacturers in China, and the government ban on the sale and use in the United States.

Signs and Symptoms of Flakka Use

As a psychostimulant, flakka drug use tends to make the user feel symptoms related to increased activity of the central nervous system. However, unlike other stimulants like cocaine or methamphetamines, there is a psychoactive component to α-PVP.

The state it causes is known as excited delirium, which presents with the following symptoms:

  • Hallucinations
  • Paranoia
  • Frightful delusions
  • Aggression and violent behavior
  • Agitation
  • Paranoid psychosis
  • Seizures
  • Confusion
  • Elevated body temperature (hyperthermia)
  • Increased heart rate
  • Increased blood pressure
  • Excessive sweating

 

Physical and Psychological Risks

Increasing use can predispose individuals to physical and psychological risks such as:

  • Neglect of personal hygiene
  • Poor nutrition
  • Injury to self
  • Paranoia and erratic behavior
  • Financial distress
  • Risk of dependence
  • Suicidal behavior

The Difference Between Flakka and Bath Salts

These two drugs share a lot in common but are easy to differentiate. They are both synthetic drugs belonging to a class known as cathinones. They also have a relatively similar effect on the individuals who use them, though with some differences.

A team of doctors stands in the center of the room.

The table below shows some of the ways that this drug differs from bath salts:

Flakka Bath Salts
Colour White to pink White or brown
Texture Coarse crystals Crystalline powder
Active Ingredient α-Pyrrolidinopentiophenone Usually methylenedioxypyrovalerone (MDPV)
Potency More potent Less potent
Effects Causes more violent behavior

Excessive sweating

Repetitive muscle movements

Confusion

Energy boost is almost immediate

Paranoia

Bath salts do not exhibit any of these effects

What Do Bath Salts and Flakka Have in Common?

The list below shows the ways that bath salts and flakka are similar:

  • Both are synthetic cathinones
  • Both can be administered through the same routes
  • Both are crystalline substances
  • Both of these drugs will cause hyperthermia, increased alertness, euphoria, increased heart rate, increased energy, and increased libido.

Side Effects of Flakka

Using this substance comes with some unwanted effects which can be harmful to the user’s health. These can be short-term or long-term effects.

Short-Term Effects

  • Fatigue
  • Depression
  • Delirium
  • Hypertension
  • Palpitations
  • Increased heart rate
  • Aggression
  • Hyperthermia
  • Muscle breakdown (rhabdomyolysis)

Long-Term Effects

Due to the fact that flakka drug is relatively new, few long-term side effects have been recorded. However, some of them include:

  • Kidney damage and renal failure
  • Pulmonary oedema
  • Atherosclerosis
  • Cardiotoxicity
  • Muscle damage
  • Malnutrition
  • Insomnia
  • Depression
  • Coagulopathy

Potential of Overdose

Overdose is a possibility with the use of this substance, and due to its manufacturing process and administration, the exact dosage used is hard to measure.

101 deaths were reported to the European Monitoring Centre for Drugs and Drug Addiction between 2012 and mid-2015, with α-PVP detected in each of them. It was determined as the definite cause of death or a contributing factor in 23 of these cases. The remainder of the cases were yet to determine the extent of α-PVP in the fatality.

Overdose can be identified by the following signs:

  • Psychosis
  • Hallucinations
  • Extremely aggressive or violent behavior
  • Agitation
  • Heart attack
  • Cardiac arrhythmias
  • Kidney damage

Emergency services should always be immediately contacted in case of a suspected overdose. It can be dangerous to attempt deescalation without assistance.

Flakka Withdrawal

The effects that abuse and overdose of this drug can have on the health can be very serious, as it can cause the users to be aggressive and violent, and they can cause injury to themselves and others. As a result, stopping the use of the substance is very important but withdrawal symptoms arise. These include the following:

  • Depression
  • Anxiety
  • Cravings for the drug
  • Tremors
  • Insomnia
  • Paranoia
  • Lethargy
  • Difficulty finding pleasure (anhedonia)
  • Agitation
  • Hallucinations

Treatment of Flakka Abuse

For individuals trying to stop abusing flakka drugs, it can be hard to do so due to withdrawal symptoms. Luckily, with professional care and medication, this process can be made comfortable for addicts. There are three phases involved.

Rehabilitation

The drug abuser will need to be treated in a center that specializes in drug addiction. They can be treated either as an inpatient or an outpatient.

Addicts support group, a woman talking to a man.

An inpatient benefits from around-the-clock monitoring and treatment, and also keeps them away from the sources and stressors that result in drug use outside. Outpatient treatment is best for people who cannot put a stop to their everyday lives or may prefer to stay at home.

 

Therapy

This is the means by which to correct the psychosocial elements of abuse and addiction, which can be through counselling alone or in groups, cognitive behavioral therapy, and contingency management therapy.

Pharmacological Treatment

This involves using medication to reduce the burden that withdrawal symptoms have. This includes the use of benzodiazepines to prevent aggressive behavior and agitation, norepinephrine to manage cardiac symptoms, and other supportive medications.

Flakka is a very harmful substance, as it can cause danger to the user and to those who may be around them. Falling into an addiction to this drug can be a major hazard, and if abuse has started, it is important to be treated by a professional in a proper center.


Page Sources

  1. U.S. Department of Justice, Lists of Scheduling Actions, Controlled Substances, Regulated Chemicals, 2020, https://www.deadiversion.usdoj.gov/schedules/orangebook/orangebook.pdf
  2. Flakka (alpha-PVP), https://www.dea.gov/factsheets/flakka-alpha-pvp
  3. Marusich JA, Gay EA, Watson SL, Blough BE, Synthetic cathninone self-administration in female rats modulates neurotransmitter levels in addiction-related brain regions, 2019, https://www.sciencedirect.com/science/article/pii/S0166432819310824
  4. European Monitoring Centre for Drugs and Drug Addiction, Report on the risk assessment of 1-phenyl-2-(pyrrolidin-1-yl)pentan-1-one (α-pyrrolidinovalerophenone, α-PVP) in the framework of the Council Decision on new psychoactive substances, 2015, https://www.emcdda.europa.eu/system/files/publications/2934/TDAK16001ENN.pdf
  5. Palamar JJ, Rutherford C, Keyes KM, "Flakka" use among high school seniors in the United States, 2019, https://pubmed.ncbi.nlm.nih.gov/30709657/
  6. Umebachi R, Aoki H, Sugita M, Taira T, Wakai S, Saito T, Inokuchi S, Clinical characteristics of α-pyrrolidinovalerophenone (α-PVP) poisoning, 2016, https://pubmed.ncbi.nlm.nih.gov/27227375/
  7. World Health Organization, 1-Phenyl-2-(pyrrolidin-1-yl)pentan-1-one (α-PVP) Critical Review Report, 2015, https://www.who.int/medicines/access/controlled-substances/5.3_Alpha-PVP_CRev.pdf
  8. Prosser JM, Nelson LS, The toxicology of bath salts: a review of synthetic cathinones, 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550219/#Sec20title

Published on: July 17th, 2019

Updated on: December 23rd, 2020

About Author

Isaak Stotts, LP

Isaak Stotts is an in-house medical writer in AddictionResource. Isaak learned addiction psychology at Aspen University and got a Master's Degree in Arts in Psychology and Addiction Counseling. After graduation, he became a substance abuse counselor, providing individual, group, and family counseling for those who strive to achieve and maintain sobriety and recovery goals.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.