Immediate harms of flakka
Flakka does not need years to do harm; the most dangerous effects can happen the same night. A scientific review published in 2018 summarizes its harmful effects as: rapid pulse, agitation, high blood pressure, hallucinations, delirium, dilated pupils, self-harm, aggressive behavior, and suicidal thoughts.
- Excessive activity that turns into anxiety and agitation.
- Rapid heartbeat, high blood pressure and chest pain.
- High body temperature with heavy sweating.
- Suspiciousness and visual and auditory hallucinations.
- Nausea, and blood salt disturbances such as low sodium.
- Seizures in severe cases.
Delirium with agitation: the most dangerous harm flakka causes
A review published in 2020 describes this condition as a change in mental state that includes bizarre behavior, anxiety, agitation, violence, confusion, muscle twitching and seizures, accompanied by physical signs: rapid pulse, high blood pressure, high temperature, heavy sweating and dilated pupils. High temperature and violent muscle exertion come together here, so the muscles begin to break down, and the review notes that severe cases may end in organ damage and muscle breakdown.
Harms of flakka to the body's systems
| System | Possible harms |
|---|---|
| Brain | Agitation, delirium, hallucinations and psychosis, seizures, and depression after the effect wears off. |
| Heart | Rapid pulse, high blood pressure and chest pain. |
| Muscles | Muscle breakdown because of heat and violent exertion during agitation. |
| Kidneys | May be damaged by the products of muscle breakdown and by dehydration. |
| Skin | Dangerous rise in temperature with heavy sweating and dehydration. |
Psychological harms of flakka
Psychosis is not a rare complication with these substances. In a pooled analysis of 32 studies published in 2024 in the journal Psychopharmacology, psychotic symptoms of hallucinations or delusions appeared in about 38% of people exposed to synthetic cathinones. Psychosis can also be prolonged: a case report from Florida describes a 17-year-old girl who needed days of treatment with sedatives and antipsychotics before she regained touch with reality, and who still had residual symptoms when discharged. Another report describes prolonged psychosis with catatonia, and estimates that catatonia occurs in about 1% of synthetic cathinone cases.
The 2018 review also lists self-harm and suicidal thoughts among the effects of flakka. If someone talks about harming themselves after using, call the ambulance (123) or the mental health support line (16328) and do not leave them alone. You can find more in drug-induced psychosis.
Does flakka kill?
Yes. According to the European risk assessment published by the United Nations Office on Drugs and Crime in 2016, eight European countries reported 116 deaths linked to the substance between 2012 and 2015. The 2020 review reports that a single county in South Florida recorded 18 deaths, and presents cases of death by drowning, suicide and multiple injuries in which the substance was found. In many of these cases, other substances were found alongside flakka, which makes mixing an additional serious risk.
The danger of mixing flakka with other substances
The 2020 review notes that people who use flakka reported high rates of using other substances: synthetic cannabis (85.6%), ketamine (72.3%), marijuana (59.1%), and GHB (47.5%).
| The mix | The main risk |
|---|---|
| Flakka + other stimulants | Double strain on the heart and a greater rise in temperature and agitation. |
| Flakka + synthetic cannabis | Seizures, psychosis and unpredictable behavior. |
| Flakka + alcohol or sedatives | Dangerous swings between agitation and depressed consciousness, and difficulty assessing the person's condition. |
| A powder sold as something else | Exposure to flakka without knowing, at a dose no one knows. |
Long-term harms of flakka
Scientific reviews acknowledge that knowledge of the short-term and long-term effects of flakka is still limited. But what is known is enough to cause concern: the US National Institute on Drug Abuse explains that a person who regularly uses synthetic cathinones may develop stimulant use disorder, which means cycles of repeated use, crashing, depression and cravings, along with the risk of repeated psychotic episodes with each return to use.
Do the harms of flakka go away after stopping?
Many of them improve: psychosis subsides in many people within days to weeks with abstinence and treatment, and mood and energy improve gradually. But some cases leave residual symptoms that need longer psychiatric follow-up, and complications of the acute state, such as kidney damage, need medical follow-up. The most important step is to stop now, with a clear treatment plan, which you can find in flakka addiction treatment.
Danger signs after flakka use: call an ambulance (123) immediately
- Severe agitation with a high temperature and heavy sweating, or hot skin
- Seizures or loss of consciousness
- Chest pain, or a very fast or irregular pulse
- Delirium and detachment from reality, with violence or no sensation of pain
- Talk of suicide or an attempt to harm themselves
Call an ambulance at 123 immediately, keep sharp objects and other people away from the person, speak calmly, and do not try to restrain them by force or press on their chest or back. Reduce noise and lighting and try to cool the room. If they lose consciousness but are breathing, place them on their side, stay close, and tell the paramedics everything you know about what they took.
Call the ambulance 123
17Social and legal harms