Updated: 31 January 2023 & medically reviewed by Dr. Samantha Miller
Flakka is a synthetic cathinone with effects and a chemical makeup similar to bath salts. The adverse side effects of the drug include volatile psychosis, leading it to be dubbed "the zombie drug".
- Despite limited research, the common consensus is that Flakka holds a high potential for abuse, dependence, and addiction
- Even on a chemical level, bath salts and Flakka share a lot of similarities. The only core difference is the presence in bath salts of an atom cluster called the 3,4-methylenedioxy motif, which is responsible for the active ingredient in bath salts, Methylenedioxypyrovalerone (MDPV)
- Synthetic cathinones are known to have addictive properties, and the same can be said of Flakka. The drug affects the brain's pleasure and rewards neurotransmitters, effectively rewiring brain chemical impulses
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What is Flakka?
Flakka is a synthetic, amphetamine-like stimulant that is derived from cathinone found in khat plants. Also known by its chemical name alpha-Pyrrolidinopentiophenone (alpha-PVP) or the street name ‘gravel’, the synthetic drug Flakka is a relatively new designer drug that is believed to have originated in South Florida in the early 2010s and was quickly labeled as a Schedule I substance.
The drug resembles small stones, hence the nickname gravel, and is usually a dusty pink or white color. It is taken either by smoking, injecting, eating, or vaporizing.
Flakka is a DEA controlled drug. Substances in the DEA Schedule I have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse. Flakka is classified by the DEA as Designer Drugs. 
Flakka and other synthetic cathinones are known as New Psychoactive Substances (NPS). NPS drugs like synthetic cathinones began to gain prevalence in the early 2000s and were designed to mimic the effects of other drugs such as cocaine, LSD, and ecstasy. Other types of cathinones include Bupropion, Mephedrone, and Methylone.
Effects of Flakka abuse
The initial effects of taking Flakka are similar to those of bath salts and methamphetamines. This includes feelings of euphoria, heightened focus, increased sex drive, and being sociable. When Flakka is abused in high amounts it can cause users to have paranoid, violent, and bizarre behavior, again similar to bath salt abuse.
NIDA, the National Institute on Drug Abuse, has identified Flakka as causing a condition called excited delirium, characterized by hallucinations, paranoia, increased strength, and hyperstimulation. This condition can lead to psychotic episodes that include violence towards others and self-injury. In the mid-2010s, police believe a man who murdered a couple and attempted to eat the male victim's face was high on Flakka. This has led to many referring to the substance as “the zombie drug”.
As well as inducing psychotic episodes, Flakka may also cause hyperthermia, liver and renal failure, hypertension, narrowing of the blood vessels, irregular heartbeat, stroke, heart attack, suicidal ideation, coma, and death. Flakka also has a high potential for overdose, especially when vaporized as the exact amount being taken is hard to quantify. The onset of a Flakka overdose is often rapid and can cause heart problems, aggressive behavior, and psychosis.
Are bath salts and Flakka the same?
The effects of abusing bath salts and Flakka are remarkably similar. Both cause euphoria, increased sex drive, feeling sociable, and hallucinations. They also have similar negative effects when abused in high quantities such as high blood pressure, elevated heart rate, paranoia, aggression, panic attacks, and psychosis. Bath salts can also be abused in multiple ways like Flakka, including smoking, injecting, and snorting and both have a high possibility of overdose and death.
Even on a chemical level, bath salts and Flakka share a lot of similarities. The only core difference is the presence in bath salts of an atom cluster called the 3,4-methylenedioxy motif, which is responsible for the active ingredient in bath salts, Methylenedioxypyrovalerone (MDPV).
Both Flakka and bath salts are incredibly dangerous when abused, causing harmful side effects, overdose, death, and are addiction-forming.
Is Flakka dangerous?
The adverse effects of Flakka abuse, its damaging nature towards physical and psychological health, and the potential for overdose all make Flakka a highly dangerous drug.
The relatively low cost of Flakka also exacerbates its risk factor, especially amongst those in low-income areas, teens, and the homeless. On average, a gram of cocaine will cost around $80-$90 making it an expensive stimulant habit to maintain. A hit of Flakka can cost as little as $3-$5 and is readily available, much like bath salts.
Another danger of Flakka abuse is the long-term nature of the high from it. A hit of cocaine, when snorted, usually lasts around 30 minutes; a hit of Flakka can last for up to five hours. The high from Flakka can also vary depending on the chemical composition. Some Flakka abusers have reported dissociative feelings similar to those felt when abusing benzodiazepines or hallucinogens such as ketamine. Flakka is a dangerous drug but it isn't the only one. Find out more about dangerous drugs here.
Is Flakka addictive?
Owing to Flakka’s relatively new status as a substance of abuse, there are currently few studies into the addictive properties of the drug. Despite the limited research, the common consensus is that Flakka holds a high potential for abuse, dependence, and addiction. The high risk of Flakka was determined by considering the drug's properties, potency, and observed effects and comparing it to other substances with similar properties, such as bath salts. As with many similar substances, it is often difficult to judge the dosage, thereby making the drug’s effects extremely unpredictable.
Synthetic cathinones are known to have addictive properties, and the same can be said of Flakka. The drug affects the brain's pleasure and rewards neurotransmitters, effectively rewiring brain chemical impulses. This is an indicative sign that dependence can form when a substance is abused, and the negative consequences of taking the drug can lead to an addiction-forming. 
Treatment for Flakka abuse
Those who have abused Flakka to the extent that psychosis and other aggressive behaviors are present may need to have a course of medication to bring them down to a safe level. These neurological effects may be treated with benzodiazepines to counteract agitation and the physical side effects, mostly relating to cardiac issues, may be treated with low doses of norepinephrine over the course of several hours. 
Once a person who has misused Flakka is in a state where they are not a danger to themselves and others, a full diagnosis and course of treatment can be prescribed by a clinician or doctor. This will often be part of inpatient or outpatient treatment programs which include a course of behavioral therapy to help manage addiction, identify causes and triggers of addiction, and treat any co-occurring mental health disorders.
If you or someone you know is suffering from Flakka dependence or addiction, then contact a treatment provider today to discuss what options are available.