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Can conventional treatment handle Flakka?

September 14, 2015
by Roland Reeves, MD
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Flakka roared into national consciousness three years ago when a man ate the face off of a homeless person on the street in Miami. After the man was shot by police, his behavior was blamed on bath salts. This created a media buzz at the time, but more recently, increasing Flakka use and its effects have led to even more of these bizarre reports.

Flakka is the latest incarnation of bath salts, which are cheap, easily obtained synthetic stimulants or “designer drugs.” Headlines are now declaring things like: “Naked Sniper Blames Flakka,” “Wild Man Kicks In Police Door,” or “Designer Drug Creates Zombies!” Some have stated that media reports about Flakka are exaggerated and hyped, but something must be going on that harkens to the days of acid trippers flying out of windows. What is Flakka, what are its real effects and dangers, and how do we treat addiction to it?

Jim Hall, an epidemiologist at Nova Southeastern University in Florida, says, “Flakka is a Spanish term referring to an elegant beautiful woman who charms all she meets,” but it does anything but charm. Flakka’s effects have led to nicknames such as “White Lightning of Magic” because its high lasts longer than crack, and it has a stimulant effect more potent than methamphetamine. These same effects at times can also lead to a frenzied delirium and psychotic paranoia; fantastical media reports have highlighted behavior by those intoxicated with it, who in fact resemble zombies.

Thousands of people are using Flakka, though, and they do not as a rule kick in the doors at police stations or get reported as committing other notorious acts. Still, on an individual basis, there is a characteristic “crazy” description of these users, and the rapid spread of its use is alarming. One treatment clinic in South Florida reports having seen about one Flakka patient per month in 2014, but about 40 to 50 per month this year. Flakka is also becoming increasingly prevalent in rural communities already hard hit by drugs in Kentucky, Tennessee and Ohio, and its use is spreading at an alarming rate throughout drug-using populations.

At their presentation, patients on Flakka can be more difficult to manage than the opiate-, alcohol- or cocaine-dependent person seen more commonly in the ER or at a treatment center. Intoxication with Flakka can lead to a “fight or flight” fueled aggression fed by scary delusions that are difficult for law enforcement and treatment centers alike. It can take anywhere from 3 to 30 days to detox from this substance, and there is no treatment known to speed up this process.

Flakka is the street name for alpha-pyrrolidinopentiophenone (alpha-PVP), a compound related to other cathinones or bath salts that can be taken orally, snorted, smoked, vaped or injected. It is a potent stimulus for the release of dopamine in the brain, even more so than cocaine and methamphetamine. This leads to its extremely addictive nature. A testament to its addictive nature is the fact that former users have reported effects so profound that they became afraid of the drug’s effects, yet they would still continue to use it. Some say they have sold their heroin or cocaine in order to buy Flakka.




The guy who ate the man's face off under the over pass only had marijuana in his system, not bath salts when the final toxicology report was released. I agree that Flakka and bath salts in general are dangerous, but too many people still say that he was on bath salts and that is incorrect according to all of the reports I have seen.

Thank you for reading and commenting on the article.
I am aware of the inconclusive toxicology on the man that are a face off. That is why the article states that it was "blamed" on bath salts and raised national attention.
Roland Reeves, MD

I don't think there's a good way to deal with any drug distribution and use unless the addicted person agrees to get admitted or treated or drug dealers have a change of heart and don't make illegal money anymore which happens quite rarely. And restrictions or laws won't help much since even now the addicted can get their hands on heroin as easy as students can get a research from Probably, getting rid of drug cartels and drug dealers could solve the problem, but as we all know humans tend to get creative in critical situations.


Roland Reeves MD

Physician, T R Reeves


Roland Reeves, MD, provides medication assisted treatment for the practice T R Reeves, MD, in...

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