As a stimulant, flakka gives users a feeling of invincibility and invulnerability. It also compels them to act in aggressive, unpredictable ways, usually endangering themselves and other people around them.[2] Given this, and its strong potential for addiction, it is highly illegal in the United States.
What Is Flakka?
Flakka is a strong stimulant drug, comparable in effect to other stimulants like cocaine and methamphetamine.[1]
Chemically known as alpha-Pyrrolidinopentiophenone (and given the name flakka as a nickname from the Spanish slang for “attractive woman”), flakka is a synthetic cathinone derived from the khat plant, which is in a larger category of drugs known as bath salts.[3] Flakka made headlines in the early 2010s when footage of people who had taken flakka acting in bizarre and dangerous ways circulated around the country.
Flakka is sold as small, clear crystals that can be taken orally, smoked, or snorted.[1]
People who take flakka report feeling a sense of delirium and super-human strength, often being compelled to act in ways that put themselves and those around them in danger.[1] One of flakka’s most significant dangers is in its unpredictable nature because its effects can be very different from one person to another.
How Is Flakka Manufactured?
Flakka is typically manufactured in underground laboratories in China and Pakistan, but some production has shifted to the U.S. in order to meet demand.[4]
As a highly illegal drug (it is a Schedule I controlled substance in the United States), there is no regulation or oversight into how flakka is produced. The ingredients are often cobbled together from one source to another.
Even the same producer might cut their flakka shipments with different drugs, such as ecstasy (MDMA), crystal meth (methamphetamine), or other synthetic cathinones, like MCAT (methcathinone) or MDPV (mephedrone or methylenedioxypyrovalerone).[4]
Flakka Abuse & Its Community Impact
Flakka started making the news in 2014. The epicenter was Broward County in Florida, where 60 people succumbed to flakka in a little more than a year.
NBC News wrote of how local hospitals admitted dozens of patients for flakka-related causes a day and 50% of local 911 calls were because of flakka overdoses.[5] It was worse than the crack cocaine epidemic of the 1980s, according to residents, who reported flakka users running naked into traffic or impaling themselves on fences.
The director of a recovery house had to start turning flakka users away because he had no room to admit them. Flakka is “one of the most addictive drugs we’ve ever seen,” he told NBC News, “because it’s so inexpensive ($5).”[5]
So devastating was flakka to Broward County that the recovery director called it “the devil’s drug,” and “by far worse than crack,” a sentiment echoed by a veteran narcotics officer in the Broward County Sheriff’s Office.[5,6]
How Addictive Is Flakka?
Flakka is extremely addictive, compelling people to take more of the drug even after a single dose.[7] This is because flakka releases large amounts of the dopamine neurotransmitter in the brain, making users feel rewarded and pushing them to seek out those feelings again.
While dopamine in the brain is a normal, natural part of living, drugs like flakka overwhelm the brain with dopamine, giving users a feeling unlike anything they have experienced before. This is what makes flakka as addictive as it is.[7]
What Are the Side Effects of Using Flakka?
The primary side effects of flakka include the following:[1,2,7]
- People experience drastically increased strength and a reduced sensitivity to pain. Together, this can lead to self-injury or death.
- Users feel a strong sense of well-being and euphoria, far beyond normal levels.
- Extreme agitation and restlessness are common, to the point of being unable to sleep and staying awake for days at a time.
- Hallucinations and delusions may occur, such as hearing and seeing things that aren’t there. Users may become paranoid and unable to distinguish between imagination and reality.
- Hyperthermia, a dangerous increase in body temperature, is possible. This can cause organ failure and ultimately death.
- Due to hyperthermia, hydration issues may occur. People under the influence of flakka usually experience dehydration because of their increased body temperature and aggressive physical behavior.
- Users may experience significantly increased heart rate and blood pressure. This can either cause heart problems or exacerbate them in people who have existing risks of heart attacks and arrhythmia.
What Are the Dangers of Using Flakka?
People under the influence of flakka may act in ways that put themselves in danger.[1] This is often because of the strength of the hallucinations they experience and how flakka induces aggressive behavior.
Flakka is commonly sold as a cheaper alternative to other stimulants, like cocaine or methamphetamine. But flakka is usually cut with other, unknown substances, making its end results much more unpredictable and dangerous. As much as the effects of flakka themselves are likely to cause serious harm, people who use flakka often do not know what they are actually ingesting.[1]
Frequent use of flakka can lead to physical and psychological dependence, as well as painful and distressing withdrawal symptoms when the drug is gone.[1]
Treatment Options for Addiction to Flakka
Treatment options for addiction to flakka include medical detox, behavioral therapy, counseling, medical supervision, and social support. Because of how addictive and potent flakka is, managing a psychological dependence on flakka is challenging, but possible.[8]
Here are some of the characteristics of treatment options for flakka abuse and addiction:[1,8-10]
Assessment & Detox
Individuals first start with an assessment, evaluating the nature of their addiction, any co-occurring mental health or physical issues, and goals for recovery.
Medical detox is needed for clients who are dependent on flakka. This part of the process has to be carefully supervised, as the withdrawal symptoms that come from breaking the physical hold on flakka can be very difficult and can sometimes cause their own medical complications. Relapse is also very likely during withdrawal if medical and psychological support is not available.
Therapy & Counseling
Behavioral therapy is the backbone of addiction treatment, including treatment for flakka abuse. Cognitive behavioral therapy is one of the most popular approaches to help people understand what triggered their flakka abuse, how to cope with the triggers and avoid them when possible, and how to change behaviors and thinking patterns associated with their flakka abuse.
Individual and group counseling provide supportive environments where clients can further and more deeply address the psychological damage caused by their addiction. Group counseling is especially useful for teaching people how they can remain sober and cope without flakka, and receive emotional support from people who have experienced and successfully managed their own flakka addictions.
Medication-Assisted Treatment & Co-Occurring Disorders
There are no specific medications approved to treat flakka abuse, but medication-assisted treatment (MAT) can help some people who have co-occurring disorders as well as those who are struggling with addictions to other drugs. The medications used in MAT can alleviate the distress of drug withdrawal, and this may prove helpful for someone withdrawing from flakka use.
If a person has a co-occurring mental health disorder present with their psychological dependence on flakka, an integrated form of treatment to address both the flakka dependence and the other mental health condition (like dual diagnosis treatment) is essential.
Social Support & Lifestyle Changes
Access to social support systems — such as family therapy, support groups, and peer support — is crucial for continued and consistent recovery from flakka abuse. Having a combination of social groups help people to build a strong network of encouragement and accountability to continue living and thriving without flakka. These groups are also directly helpful in relapse prevention, giving people the tools they need to manage the stressors and triggers that precipitated the initial flakka use.
Lifestyle changes are a vital component of treating and recovering from flakka use. Engaging in productive activities, taking on healthy habits, and staying away from places, people, and situations that were conducive to flakka abuse boosts overall well-being and resilience against relapse.
Flakka Abuse & Addiction FAQs
These are some of the most frequently asked questions about flakka abuse and addiction:
Flakka is chemically similar to other synthetic cathinones, such as bath salts. It is designed to mimic the effects of drugs like amphetamines and ecstasy.
Flakka represents the new generation of bath salts (synthetic cathinones), and it is the most common form.[1] The natural form of cathinones derives from the khat plant, used as a stimulant in certain regions of Africa and the Middle East.
Flakka affects the brain by acting as a powerful stimulant. It can change the levels of dopamine, serotonin, and norepinephrine, flooding the brain’s synapses and preventing their reuptake. This is what makes users feel superhuman and unnaturally powerful.[1]
The length of time that flakka stays in the body depends on many factors that will be different from one user to the next, such as individual metabolism, regularity of use, and dose size. Flakka’s effects can be felt anywhere from hours to days, or even weeks in some cases.[7]
The testing method used to detect the presence of flakka will also influence how long the drug is detectable. Urine, for example, can contain traces of flakka for up to four days, but chronic use of flakka can make it show up in urine for much longer. Hair testing can detect flakka for up to 90 days, but this is not always a reliable method of testing for flakka.
Yes, flakka abuse can quickly lead to addiction due to the potency of the drug.
- Flakka: New dangerous synthetic cathinone on the drug scene Patocka J, Zhao B, Wu W, et al., International Journal of Molecular Sciences. 2020;21(21):8185.
- DARK Classics in chemical neuroscience: α-Pyrrolidinovalerophenone (“flakka”) Kolesnikova TO, Khatsko SL, Demin KA, Shevyrin VA, Kalueff AV., ACS Chemical Neuroscience. 2018;10(1):168-174
- Flakka: New synthetic drug is more potent than predecessors NBC News. Published January 12, 2021. Accessed October 1, 2023.
- What is flakka and why is it so dangerous? Storrs C., CNN. Published May 26, 2015. Accessed October 1, 2023.
- “Devil’s drug”: Flakka is driving Florida insane NBC News. Published December 18, 2015. Accessed October 1, 2023.
- Cheap, synthetic “flakka” dethroning cocaine on Florida drug scene Reuters. Published June 10, 2015. Accessed October 1, 2023.
- Flakka-induced prolonged psychosis Crespi C., Case Reports in Psychiatry. 2016;2016:1-2.
- The explosion of a new designer drug, flakka Salani D, Albuja LD, Zdanowicz MM., Journal of Addictions Nursing. 2018;29(4):255-259.
- “Flakka”: A low cost, a dangerous high Dsouza A, Pereira L, Levounis P., Current Psychiatry. Published December 11, 2018. Accessed October 1, 2023.
- Cognitive behavioral interventions for alcohol and drug use disorders: Through the stage model and back again Carroll KM, Kiluk BD., Psychology of Addictive Behaviors. 2017;31(8):847-861.