flakka picture

Flakka has been in the news since 2002. South Florida made headlines about this drug that resulted in strange provocative behaviour, emergency room visits and fatalities due to overdosing.

flakka picture

Though exact numbers with regards to quantity of Flakka entering the US is unknown, but Broward County in Florida leads the pack in Flakka trafficking. Nearly 477 cases of Flakka were impounded by US Drug Enforcement Agency (DEA) in 2014, twice the number in comparison to other counties.

Around 526 meth seizures was also reported in the entire state of Florida in 2014. Cook County, Illinois including Chicago ranked second in apprehending Flakka with 212 cases. A study by DEA in Broward County noted an average of 27 Flakka cases per 100,000 residents.

Illegal sale of pills across Florida was at a peak before the entry of Flakka. Flakka is relatively inexpensive and extremely addictive, which is helping it to spread wings in other states such as Kentucky, Ohio, Tennessee and Texas.

Content of Flakka

Also known as “gravel,” Flakka is a Cathinone class synthetic stimulant which resembles a chunks of minute white crystal pieces. Produced from alpha-Pyrrolidinopentiophenone (a-PVP), it can be snorted, smoked, ingested or injected.

Cathinone class drugs are based on compound found in Khat plant, a native of the Middle East and East Africa. World Health Organization classified this plant as a drug of abuse plant. This plant is also the prime target of organisation such as DEA and is on the controlled substance list in countries like Canada, Germany, United Kingdom and the United States.

Countries like Ethiopia, Kenya, Uganda, Yemen and Somalia, however, allows legal sale of this plant. Leaves of Khat are consumed by Israelis in its natural state. Khat chewing is a social custom dating back to thousands of years in areas where these grow.

As with many societal customs, chewing of Khat leaves was done as it helped to create a stimulant effect on the brain. Since 1930’s, scientists have made attempts at synthetic production of the Khat plant. a-PVP is a compound which is a structural replicate of methylenedioxypyrovalerone (MDPV), a psychoactive stimulant which is very often abused for recreational purpose.

Developed in 1960s, MDPV came in vogue in 2004 on the streets as a designer drug like Flakka. This stimulant is also known on the street under different names like bath-salts, plant fertilizer, Ivory Wave and Vanilla Sky.

Though many trafficking groups have dubbed Flakka as more dangerous than bath salts, Flakka consists of active ingredient similar to Cathinone, which is a natural stimulating substance found in Khat. However, the amphetamine-like effect found in bath salts and Flakka are man-made. Both these are synthesized in China and shipped in bulk to different parts of the world.

Origin of Flakka

Though DEA permanently banned MDPV and mephedrone in July 2012, and methylone in April 2013, manufacturers of these drugs went one step ahead and slightly altered the chemical structure of their formulas. They created a new formula similar to the synthetic substance that was legal, a-PVP. This was commonly called Flakka – Spanish slang for a skinny woman (“la-flaca”). This is how Flakka came into market.

Brain chemistry is becoming more and more sophisticated over time and along with changes in lifestyle and needs of a person. Although the drugs were developed in early 20th century for helping practitioners of psychology, side effects and effects on long term use were not immediately recognised or understood.

As psychotherapeutic drugs were more addiction-prone, their use was widely restricted. Brain-altering chemicals are always on the hit-list of recreational drug users as these substances helped in creating euphoric feeling which they crave for, but at the end has high addiction rates. a-PVP is believed to remain in the brain much longer than any other mood-altering substance, with long term damaging effects as well as increased chances of overdose.

Flakka and Manufacturers’ Strategy

Synthetic drugs like bath salts and ecstasy undergo routine modifications by their manufacturers as they aim at staying one step ahead of authorities. Developers of these designer or synthetic drugs start off with developing and showing off psychotherapeutic effects of the drug and gradually exploit it. Since procurement of brain-altering substances are either banned or controlled, manufacturers tweak combination of these drugs in order to stay within the legal ambit.

Chinese drug companies are the primary source for substances like Flakka, which can procured without any hassles from the internet. Many laboratories in China dabble with chemicals present in a-PVP, a legal product in China. These laboratories readily alter the chemical structure for their clients, which is later shipped into foreign markets like the United States.

Rage about Flakka has been compared to ecstasy rage and the scariest part is that Flakka is very new and the drug dealers have more knowledge about it than medical and legal authorities. By the time experts gather enough knowledge about the product, drug manufacturers change their formula and start all over again with a new product.

Flakka rage started in Florida, but has spread to states like California, Illinois, Ohio, Kentucky, Tennessee and Texas. Flakka is so dangerous that not only it just give the users a high, but it also makes them harm themselves and others as well. People who abused Flakka were reported to become wild after its use, running on streets, attacking people and putting children and themselves in harm’s way. Flakka abusers were also reported to display uncontrollable and bizarre behaviour.

Flakka is developed from a compound called a-PVP, a chemical cousin of Cathinone (an amphetamine-like drug present in bath salts). The irony is that while active ingredient in bath salts was officially banned in 2011, its newer relative, a-PVP was spared the rod.

Flakka is inexpensive than most of drugs on the streets and thus becomes relatively easier to buy, and overdose. It has become popular in urban areas and people from low-income strata have started abusing it, thereby impacting their lives. A few years ago, crime cases reported due to or involving Flakka was zero, but entire scene was turned upside down in 2014.

Within a couple of months, the law enforcement agencies across the world started encountering Flakka-related crimes like assault, theft, teasing etc. Besides being a dangerous drug, Flakka also tags along various problems related to drug detox and rehabilitation procedures. Though Flakka is a new designer drug, National Institutes of Health (NIH) has revealed that the potency matches with Methamphetamine, yet has more addiction propensities in its users.

Popularity of Flakka

Flakka came into public awareness in 2015 after a YouTube video titled “Flocka (sic) is Destroying USA,” went viral, depicting a young woman who was dancing in the rain. Soon other videos which highlighted erratic behavior attributed to Flakka popped up on the internet, but these videos did not actually show people abusing Flakka.

Dangerous as it is, Flakka can spike your body temperature to 104 degrees, which can result in kidney damage and failure and even death. As per Mayo Clinic, this synthetic drug can elevate your blood pressure which can lead to aneurysm, stroke, heart attack or failure or even coma (g, h).

Flakka results in total loss of control among its users. People under Flakka’s influence can put themselves in situations which are risky and dangerous. Flakka-related deaths are now becoming more common, and has forced authorities to go the whole hog in getting it off the streets.

Effects of Flakka

Flakka users exhibit unusual behaviours though the stories covered by media are hyped. However, there have been instances of drug causing people to run nude in streets, attempting to break into police stations for protection from imaginary threats, perform violent acts on strangers and become violent instinctively.

flakka effects infographic
For instance, a man high on Flakka was seen running nude in order to escape from people who he thought had stolen his clothes and were attempting to kill him. Police describe these as drug craze caused by paranoia and weird behaviors like acting psychotic, hallucinating, and displaying extraordinary strength, a really scary combination. Flakka’s effects can last for nearly three to four hours or may linger for several days too.

Some short-term side effects of Flakka include hallucinations, anxiety and paranoia which can result in violent behavior in abusers. The high dose can raise body temperature which can result in breakdown of muscles and cause kidney damage. Overdose gives Flakka users high adrenaline, before they succumb to heart attack, stroke or even death.

Like other stimulants, Flakka floods the brain with dopamine, neurotransmitter that helps regulate the brain’s reward and pleasure centers. Flakka hinders the uptake of this neurotransmitter by brain cells, thereby producing an intense euphoric feeling.

Short-term effects are similar to cocaine and amphetamines and can include euphoric sensation, palpitations, rapid heart-rate, increased blood pressure, changes in alertness and frequent aggressive behavior.

Effects after Flakka leaves the body include depression and fatigue. Mood swings, behavioural issues, jerking muscles, confused thought process and profound paranoia are some of the alarming effects of Flakka. Paranoid patients pose danger to other people and also themselves. These people are usually calmed with help of sedatives.

There is intense feeling of getting rid of this effect and returning to drug which jump-starts another cycle, eventually leading to abuse. As tolerance level goes up, the addict needs increased amounts of Flakka to feel the high, risking his life with the numerous overdose effects and even fatal consequences.

Immediate and long-term effects of Flakka can compete with strongest crystal meth and cocaine, though long-term effects has not yet been properly researched as it is a new drug and effects has not been really extensive. Some research conducted has shown that this drug can be toxic and cause renal failure in the long run. Unknown effects of Flakka use and its popularity has both surprised and upset many, as no one is aware of the consequences of Flakka use on human body and brain in the long run.

Though long term effects are not really known, there are many severe side effects of Flakka that could be worse than those anticipated in the long run. Abusers first feel euphoric, then become highly sociable and stimulated in thoughts, are more focused and report increased sex drive (i), but anticipated high quickly wears off, leaving users to increase Flakka intake. The more it is consumed, the more negative feelings crop up.

National Institute on Drug Abuse reports that Flakka users feel “excited delirium,” a much-debated condition that involves paranoia; hallucinations; increased strength, and hyper-stimulation. Racing heart leads to panic attacks, plunging sex drive to new lows, which makes one more depressed and suicidal as well as psychotic and violent.

Flakka users get high easily, but once crash happens and unpleasant withdrawal symptoms kicks in, the tolerance of abusers pushes them to the other side. Flakka has the ignominy of making users feel these effects quicker than any other substance, because this goes directly into bloodstream, which can result in overdose.

So far, Flakka overdose cases has been restricted to few regions of the US, but DEA and other law-enforcing authorities may witness start of a major drug epidemic with parallel social problems sooner or later.

Common Symptoms

Most common Flakka symptom is paranoia, (thought process which is profoundly influenced by fear or anxiety, often to point of irrationality or delusion). People experiencing paranoia may feel and believe that strangers are hounding them, but in reality may be different. There is mistrust and state of suspicion all the time. Drug intoxication is one of the major cause of this symptom.

Designer Drug Dangers

Though changing the structure of Flakka makes contents legally different, the effects remain the same. Manufacturers are aware of the fact that users of this recreational drug really do not care about the name or formula, they are just addicted to the high given by the drug. No proper regulations and testing are done; if they are done, then manufacturers would realise the potency or side effects of this drug.

Dangers of such designer drugs come from chemicals used by the chemists. The structure is used as a basic framework and chemists play around for developing the mind-altering euphoria. By tweaking the formula to remain legal, they produce a drug that is marketable on streets.

Despite the sophisticated process, expensive research and involvement of pharmaceutical information, designer drugs aren’t safe at all. Since expenses are recovered by selling the developed product, manufacturers of these drugs put in huge efforts to stay within legal limits. What these drug manufacturers do is scrounge for ideas which were not successful earlier and tweak them to bring it in the market themselves to avoid the regulatory process.

These drugs are not certified by any agency or authorities and there is no control over the quality of these drugs. The side effects are only documented by users. Designer drugs do not come in a package with exact percentage of active ingredients and prescribed dosages. Even if you are paying same amount, there is no guarantee that you will get same dose each time as there are no production or dosing standards which is maintained during manufacturing process.

Designer drugs are highly addictive and since a-PVP is inexpensive and easily available, there are greater chances of a person overdosing on it. Once the addict’s brain is affected by drugs, the person tends to make wrong/bad decisions, which can often have serious consequences.


FDA is the only organization which can certify the safety and efficacy of a drug and the appropriate dosing regimen. Banned substances, illegal drugs, and medicines taken for non-medical reasons are not safe at all. Even those drugs formulated in sophisticated labs by highly experienced chemists and sold under fancy names cannot be trusted. Taking drugs sold on street, not often, but most of the times can result in tragedies.

If someone you know or your loved one is acting weirdly and you have reasons to believe he/she has taken Flakka or any other designer drug, you can be of help by getting immediate medical attention for that person. Calling an ambulance is the quick step to take, when such a situation arise. Taking that person away from any sharp and dangerous objects is always recommended and yes, getting people away from him is also necessary.

Try and gather information on what he/she has taken, how much and when. If he is not able to say it, talk to people he was with and collect unused samples for medical testing. Staying calm and acting normally can help you keep things under control. Offering ice packs and a quiet/calm place to be in till medical help arrives would be comforting to the affected person.

+ posts

Dr. Freeman completed her Doctor of Medicine (M.D.) in 2008 from UT Health San Antonio. She was a fellow at the University of Michigan and performed a surgery residency at Lahey Hospital in Burlington Massachussets. Dr. Freeman is currently a surgeon at TRACC in the Dallas Fort Worth area.