Less than 1 percent of high school kids report using the club drug nicknamed “flakka.”
But more may be exposed to this dangerous synthetic drug than they realize, especially if they take more popular club drugs such as ecstasy or Molly.
The first report to estimate the prevalence of flakka use among U.S. teens found that 0.8 percent of high school seniors in 2016-2017 reported using flakka in the past year.
The data comes from the annual Monitoring the Future report, which surveys middle school and high school students on their use of a wide variety of illicit drugs as well as alcohol and tobacco.
Joseph Palamar, PhD, MPH, a lead researcher and a principal investigator at the New York University School of Medicine’s Center for Drug Use and HIV/HCV Research (CDUHR), told Healthline that flakka generally doesn’t have much appeal to novice drug users.
“I don’t think a kid who is curious about weed will be offered flakka and use it,” he said.
However, hair samples gathered at nightclubs and parties where synthetic drug use is common often reveal traces of flakka among youths who admit to using other party drugs but insist they don’t use flakka.
“They laugh at me when I ask — then test positive,” said Palamar, who explained that flakka could be used to cut drugs more popular drugs such as ecstasy to increase potency.
“That’s the scary part. We’re not detecting unknown use,” he said. “It’s the unintended use that’s the biggest problem.”
Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York, told Healthline that club drug users are essentially “playing Russian roulette” because they don’t know about the adulterants that are commonly added to the pills they take.
“This drug is not safe at any exposure and you’re putting yourself at risk even by trying street drugs that have unknown ingredients,” said Glatter.
Flakka is the street name for alpha-PVP, a synthetic cathinone in a class of psychoactive drug commonly referred to as “bath salts.”
Cathinone is the psychoactive ingredient found in khat, a shrub whose leaves have been chewed in Africa for centuries as a stimulant.
These drugs act as both hallucinogens and stimulants — a potent combination that has landed tens of thousands of people in emergency rooms in recent years.
Glatter said the drug — which is known as “gravel” in some regions of the country —induces a state of “excited delirium,” which studies show can contribute to accidents, homicides, and suicides.
Flakka itself was associated with at least 80 deaths in Florida between September 2014 and December 2015 alone, according to researchers. Reported cases of flakka poisoning rose more than 700 percent between 2010 and 2015, Glatter said.
“People try it because it’s cheap — it can cost just $5 for a dose — but they’re really not aware of the dangers of this drug,” said Glatter. “The margin between the recreational dose and the toxic dose is pretty slim.”
Flakka can be used in a variety of ways — eaten, snorted, injected, or vaped. It is listed as a banned schedule 1 drug by the U.S. Drug Enforcement Administration, meaning it has high potential for abuse and no medical use.
Palamar dismissed claims that the drug turns users into “zombies” or “cannibals.”
The real dangers include rapid heart rate, elevated body temperature, anxiety, seizures, agitation, aggression, hallucinations, paranoia, and suicidality, he said.
Even in the emergency room, it’s difficult to tell whether patients have ingested flakka, which doesn’t show up on routine drug tests, said Glatter.
Adolescents who don’t live with their parents or whose parents have less than a high school education are at higher risk of flakka use, according to the study published in the journal Drug and Alcohol Dependence.
Flakka users also were more likely to report use of other drugs, including the synthetic cannabinoids spice and K2, ketamine, and marijuana. More than half of flakka users also used other drugs, researchers found.
“This suggests that the use of flakka or other ‘bath salts’ alone is rare and the use of multiple substances may compound adverse effects of these drugs,” said Palamar.
Glatter, who previously worked in hospitals in the Midwest, warned against assuming that use of flakka and other synthetic cathinones is limited to urban “club kids.”
“Rural areas of Ohio and Florida have been hotbeds of use,” he said. “It should be on our radar, especially among kids who are known to use other street drugs.”
Less than one in 100 adolescents report having used the drug flakka.
Flakka exposure may be higher than reported because the synthetic drug is sometimes used to cut other more popular club drugs such as ecstasy.
The drug can induce a state of “excited delirium” and cause a wide range of potentially fatal side effects.