What is Flakka and How is it Abused?

Flakka is one of the names for a synthetic cathinone related to bath salts. Occasionally also called “gravel,” Flakka has become a large problem in states like Florida and Ohio. Like other synthetic cathinones, flakka is incredibly dangerous with unpredictable side effects.

It can also quickly cause an overdose because the potency is not controlled when it is created. The drugs are typically labeled “not for human consumption,” although they are shipped into the US market specifically for the purpose of getting the user high.

Flakka and Other Synthetic Cathinones

a man holding a tiny plastic bag of flakka, a white powder substance in it

Cathinones are chemically similar to cocaine or amphetamines, two famous types of stimulant drugs. This family of drugs induces a high by forcing neurons to release dopamine, serotonin, and norepinephrine; these neurotransmitters are responsible for elevated emotions.

Synthetic cathinones are manufactured in laboratories in East Asia most commonly. Although agencies like the Drug Enforcement Administration (DEA) attempt to make these dangerous substances illegal, the laboratories that manufacture the drugs can change the chemical structure slightly to stay ahead of the law. While flakka and bath salts are two synthetic cathinones that are illegal in the US, per the Controlled Substance Analogue Enforcement Act as of 2012, other synthetic cathinones are on the market.

The name for the chemical behind the drug is alpha-pyrrolidinopentiophenone, which is usually abbreviated to alpha-PVP. This is the primary intoxicating molecule often found in the more famous bath salts too. Flakka, like bath salts, is sometimes found as a white or pink finely ground crystal, which can smell rancid.

Methods of ingesting the drug include:

  • Eating it
  • Sniffing or snorting it
  • Injecting it intravenously
  • Smoking or vaporizing it

Most people who abuse flakka use a vaporizer to inhale a smoke filled with the toxic drug. This allows flakka to quickly be absorbed through the lungs and into the bloodstream. Diluting flakka in order to inject or eat the drug are both slower release methods, so the person abusing it does not experience the same intense intoxication as with smoking it. When the drug is vaped, however, it can rapidly lead to intoxication, negative side effects, and overdose.

The drug’s effects typically last for 3-4 hours, but side effects can last for several days, even after just one dose.

Who Abuses Flakka?

Flakka is sometimes called “five dollar insanity” because it is so inexpensive. In Florida, the epicenter of flakka abuse, the drug was reportedly sold in convenience stores and gas stations for $4 or $5 until recently. Psychiatric Times notes that people who abuse flakka tend to be young adults who are economically disadvantaged. Before recent law changes, the drug was legal for purchase with no age restrictions, so adolescents and teenagers were particularly at risk of abusing the drug.

While many synthetic drugs, including cathinones, are designed to be inexpensive to appeal to a wide market, flakka is cheaper than many designer drugs. This makes it a target of abuse for people who struggle with all kinds of substance abuse problems, including methamphetamine addiction or polydrug abuse. The drug is particularly appealing for those who feel a compulsion to consume intoxicating substances but do not have a lot of money. The drug is very potent, so people who have become tolerant to other drugs may take flakka to get a new level of euphoria.

Signs and Symptoms of Abuse

The primary cluster of symptoms associated with flakka is referred to as excited delirium. Symptoms of this condition include:

  • Hyperstimulation or excitement.
  • Hyperthermia.
  • Paranoia or delusions.
  • Hallucinations.
  • Acute psychosis.
  • Seizures.
  • Hypertension and arrhythmia.
  • Aggression and agitation.
  • Violence toward oneself or others.

Many people who have abused flakka have been found undressed. This is because the drug dramatically raises the body’s temperature, sometimes in excess of 106 degrees Fahrenheit, which can cause damage to the brain and cardiovascular system.

Delusions have been linked to suicide and homicide among people intoxicated on flakka. The drug has also caused heart attacks due to its intense stimulant properties. It can also damage the liver and kidneys. The extreme release of neurotransmitters can lead to the destruction of neurons, contributing to brain damage. Intoxication and overdose symptoms are typically similar, although additional overdose symptoms include organ failure.

Although the boundary between intoxication and overdose is thin, there are more distinct symptoms that require immediate medical attention if witnessed. Symptoms that define a flakka overdose include:

  • Bizarre, unusual, or aggressive behavior.
  • Severe hallucinations, especially those with violent or disturbing content.
  • Extreme paranoia.
  • Disorientation or panic.
  • Changes or disturbance in speech.
  • Unable to feel pain.
  • Inhuman or superhuman strength.
  • Profuse sweating or shedding clothes due to very elevated body temperature.


At the height of the flakka craze, emergency rooms in Florida reported seeing as many as 30 cases per day of flakka overdose. When the drug first hit stores in Broward County, Florida, there were 60 deaths directly caused by flakka between September 2014 and December 2015. The epidemic in Broward County still accounts for about 20 percent of flakka abuse and overdose cases nationally.

However, there are other areas that have been deeply affected by the drug’s spread. Most states, like Kentucky and Maryland, have sent warnings to medical professionals and law enforcement about flakka’s dangers.

Treatment for Flakka Addiction

doctor giving treatment plan to patient with flakka addictionA complete rehabilitation program will help clients through the withdrawal process, under medical supervision, and include intensive therapy. It is most important for those struggling with flakka abuse to understand the root causes of their addictive behaviors and cravings, and to develop better coping mechanisms to manage these issues in the future. In some instances, a physician may prescribe mood-stabilizing medications, such as antidepressants, as well as over-the-counter medications to manage withdrawal symptoms.

This means that they could require physical and occupational therapy in addition to ongoing psychotherapy. In some cases, inattention and cognitive impairment could last for a long time or become permanent. As a result, prompt intervention and treatment are recommended, before problems potentially become irreversible.

As the number of synthetic cathinones in the country increases, the need for high-quality rehabilitation services also increases. Most rehabilitation programs are prepared to help those struggling with flakka abuse and addiction. Programs that offer evidence-based treatments are the best option for those looking to leave substance abuse in the past and stabilize in recovery.

For some people who abuse flakka consistently, at high doses or for a long time, damage to the brain could be permanent.

Issues Affecting California

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