Flakka use is on the increase. In 2010, there were no reported cases; 85 cases in 2012; and under just over a thousand in 2014. According to the DEA, alpha- PVP is a listed schedule 1 drug along with other synthetic cathinones.8More recently, however, in New York City alone, 150 hospital admissions per week were related to flakka usage.9 In 2015, there was a sharp rise in the number of overdoses.5
Users often think they are purchasing a capsule of MDMA (aka molly or ecstasy), but instead they end up with flakka. This adds to the dangerous nature of the drug and serious consequences that ensue. Its low cost, easy availability, confusion with other drugs, and widespread use—these make for a lethal combination that is quickly spreading among users of illicit drugs and young “partiers” alike.
Treatment of acute intoxication is mainly supportive. It includes providing hydration by intravenous fluids, benzodiazepines to counteract agitation, and low-dose norepinephrine to normalize heart rate and blood pressure. Like treatment for other addictions, treatment for flakka abuse should address medical and psychiatric problems, along with psychosocial education, counseling, and participation in peer groups.
“Designer Drug” Use and Abuse: Implications for Psychiatrists
Flakka-Induced Prolonged Psychosis
The Backstory You Really Need to Know About Flakka And Other Synthetic Drugs
Synthetic Cathinones: Signs, Symptoms, and Treatment
Dr Anjum is a Research Associate and Dr Aggarwal is Associate Professor in the department of psychiatry at Rutgers New Jersey Medical School, Newark, New Jersey. The authors report no conflicts of interest concerning the subject matter of this article.
1. New synthetic drug ‘ﬂakka’ triggers crazed behaviors. Drugs.com. April 16, 2015. http://www.drugs.com/news/new-synthetic-ﬂakka-triggers-crazed-behaviors-56432.html. Accessed August 3, 2016.
2. Wood MR, Bernal I, Lalancette RA. The dangerous new synthetic drug α-PVP as the hydrated chloride salt α-pyrrolidinopentiophenone hydrochloride 0.786-hydrate. Acta Crystallogr C Struct Chem. 2016;72(Pt 1):48-51.
3. Katselou M, Papoutsis I, Nikolaou P, et al. a-PVP (‘‘ﬂakka’’): a new synthetic cathinone invades the drug arena. Forensic Toxicol. 2016;34(1):41-50.
4. “Flakka” (alpha-pvp). National Institute on Drug Abuse. https://www.drugabuse.gov/emerging-trends/flakka-alpha-pvp. Accessed August 3, 2016.
5. World Health Organization. Expert Peer Review No. 1. Expert Committee on Drug Dependence 37th Meeting; November 16-20, 2015; Geneva, Switzerland. http://www.who.int/medicines/access/controlled-substances/5.3_aPVP_PR1.pdf. Accessed August 3, 2016.
6. Marinetti LJ, Antonides HM. Analysis of synthetic cathinones commonly found in bath salts in human performance and postmortem toxicology: method development, drug distribution and interpretation of results. J Anal Toxicol. 2013;37:135-146.
7. Robles F. Police in Florida grapple with a cheap and dangerous new drug. New York Times. May 24, 2015. http://www.nytimes.com/2015/05/25/us/police-in-florida-grapple-with-flakka-a-cheap-and-dangerous-new-drug.html. Accessed August 3, 2016.
8. Drug Enforcement Administration. Schedules of Controlled Substances: Temporary Placement of 10 Synthetic Cathinones Into Schedule I. Regist 79:129 38- 129 93. http://www.deadiversion.usdoj.gov/fed_regs/rules/2014/fr0307_2.htm. Accessed August 3, 2016.
9. Steinberg J. Flakka: The new illegal drug you need to know about. Inc. November 8, 2015. http://www.inc.com/joseph-steinberg/flakka-the-new-illegal-drug-you-need-to-know-about.html. Accessed August 3, 2016.