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Flakka is a new designer drug in the synthetic cathinone family that is chemically similar to cocaine and bath salts. However, the Drug Enforcement Administration pushed methylenedioxypyrovalerone (MDVP), mephedrone, and methylone to the Schedule I list, thanks to changes from the Synthetic Drug Prevention Act of 2012. Those chemicals were the main cathinones found in bath salts and similar drugs. Flakka is a variant that uses a new cathinone, called alpha-pyrrolidinopentiophenone (alpha-PVP). Due to its appearance, flakka is sometimes also called gravel.
According to reports from Florida and other areas that have seen a spike in flakka consumption, the drug affects the user much like bath salts do, but even more intensely. Hallucinations, paranoia, and psychosis are especially strong in individuals who take flakka, and the high lasts for hours and even sometimes days. Reportedly, it is very hard to control the dose of this drug; the difference between a small high and overdose is difficult to calculate.
Flakka appears as a white or pink crystalline substance that typically has a foul smell. People who abuse this drug take it orally, or they snort it, inject it, or vaporize it with an e-cigarette or similar device. Unlike other drugs, vaporizing flakka makes it enter the bloodstream the fastest, and it is also the easiest way to overdose on the drug because the dose is much less controlled.
Alpha-PVP, like MDVP and naturally occurring cathinones found in cocaine or crack cocaine, is a central nervous system stimulant. The effects of this compound are at least as potent as cocaine, meth, or bath salts. It is believed to be highly addictive; however, the drug has not been on the market long enough for significant scientific research to conclusively determine the addictive nature of this chemical. Alpha-PVP works by preventing neurons from absorbing dopamine and serotonin, so the brain is flooded with neurotransmitters. The drug also blocks the uptake of norepinephrine, which can spike blood pressure and heart rate.
The high can last for several hours, and it can potentially span several days.
As a synthetic drug, flakka was designed to skirt the law to get users high. The chemical structure of the drug was not specifically illegal anywhere in the US until 2014, so it was sold in convenience stores, paraphernalia shops, and online with impunity. The drug’s packets are labeled “not for human consumption,” in an attempt to get the drug around regulations in customs so it can enter the country.
Because the drug is still technically legal in many places, teenagers who are underage for alcohol or cigarette purchases often buy designer drugs like synthetic marijuana or cathinones. However, because flakka in particular is very inexpensive – a packet sells for between $3 and $5 – it has become a replacement for cocaine for many poor and even homeless individuals. According to a CNN report, dealers recruited homeless individuals to sell the drug on the streets.
A report from an emergency room doctor noted that most of the individuals abusing flakka appeared to be male, and in their 20s or 30s. He added that, due to the drug’s potency and danger, he had not seen any regular users.
Since flakka is chemically similar to cocaine or methamphetamines, the “come down” period after a dose finally wears off can lead to withdrawal symptoms like fatigue, depression, and physical pain. People who abuse flakka can descend into an addiction spiral with the substance in order to avoid the sensation after it wears off.
Flakka is very new so the addiction or dependence cycle is not well documented, but people who use this drug could quickly develop a tolerance to it, which means they will need more of the drug to achieve the same high as the first dose. With something so potent and easy to overdose on, this cycle becomes very dangerous very quickly. One study from The Scripps Research Institute (TSRI) suggested that flakka was as addictive as bath salts.
As with other synthetic cathinones, symptoms of flakka abuse can include:
The number of cases of flakka highs, overdoses, and arrests have centered around Florida, although they have also been noted in New York, Ohio, Texas, and Kentucky. In 2010, the state of Florida noted no instances of flakka use at all; in 2012, there were suddenly 85 instances of use, which spiked to 670 in 2014. However, in 2015, the number of cases began to drop just as rapidly. In Broward County, which has been hit hardest by flakka abuse, there were a reported 300 hospitalizations in June through October, which then fell to 54 in December. The county medical examiner noted 63 flakka-related deaths in September 2014, but did not see one flakka-related death between December 11, 2015 and March 4, 2016.
There are several factors that have reduced the frequency of flakka abuse and overdose, including the Chinese government’s October 2015 ban on manufacturers, and the US’s ban on alpha-PVP, particularly in Florida. It is also likely that news reports about the dangers of the drug’s side effects have reduced the frequency of use.
Flakka is an extremely dangerous drug because of the effects it has on both the mind and the body. Typical side effects of flakka include:
These side effects, along with the high, can last for as little as three hours or as long as several days. Other more serious side effects include:
Excited delirium is a very dangerous condition that can involve screaming and flailing, which can cause individuals to accidentally hurt themselves. People may also likely suffer seizures, and hyperthermia can cause them to rip their clothes off, sweat profusely, and pass out. Excited delirium is always a medical emergency.
Flakka also leads to the breaking down of organ systems very rapidly. Rhabdomyolysis is the process of muscle tissue breaking down and releasing proteins and other cell components into the bloodstream, which floods the liver and kidneys with toxins. Kidney failure is a common side effect of this condition. Dehydration is another common problem in people who abuse flakka.
Because the drug is so potent, it is very easy to overdose on flakka. Side effects and overdose symptoms are very similar, with rapid heart rate and rhabdomyolysis becoming a medical emergency very quickly. It is also possible that the mental effects can become permanent, since flakka may destroy neurons while preventing the reuptake of neurotransmitters.
Flakka overdose symptoms include:
Withdrawal can cause symptoms similar to withdrawal from other cathinones like cocaine or bath salts, including exhaustion and depression.
Many people who use flakka have ended up in the emergency room. Doctors there work to reduce the individual’s body temperature so they do not die from hyperthermia. They may also be given sedatives to calm them down, reduce aggression, and lower heartbeat. Sometimes, medications are given to prevent or stop seizures.
Although there are no specific drugs to treat flakka abuse or addiction, it is very important to get help from a rehabilitation program as soon as possible. Rehabilitation programs offer medical oversight during the detox process, as well as therapeutic treatment and support. Comprehensive treatment puts individuals in the best position to leave all substance abuse behind for good and embrace a new life in recovery.