First Study to Estimate Prevalence of Use of Dangerous Stimulant Drug Linked to Deaths, Especially in Florida

Glass jar of synthetic drug Flakka
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Nearly 1 percent of high school seniors report using Flakka, a highly potent and potentially dangerous synthetic drug, according to a study by researchers at NYU School of Medicine, the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health, and Columbia University Mailman School of Public Health.

The study, published online in the journal Drug and Alcohol Dependence, is the first to estimate the prevalence of Flakka use among adolescents in the United States.

Synthetic cathinones—psychoactive substances known as “bath salts”—have been associated with tens of thousands of emergency department visits in the United States. One such compound called alpha-PVP, commonly referred to as Flakka, was associated with at least 80 deaths in Florida between September 2014 and December 2015 alone.

Flakka has cocaine-like stimulant effects and is as potent as methamphetamine. The drug—which can be eaten, snorted, injected, or vaped—is associated with adverse effects such as rapid heart rate, elevated body temperature, anxiety, seizures, agitation, aggression, hallucinations, paranoia, and suicidality.

“Flakka is infamous for being tied to rashes of bizarre behavior which has led the media to refer to it as the ‘zombie’ or ‘cannibal’ drug,” said CDUHR researcher Joseph Palamar, PhD, MPH, the study’s lead author and an associate professor in the Department of Population Health at NYU Langone Health. “Flakka has not turned users into cannibals, but the drug can in fact be very dangerous.” He further explained that this stimulant drug is very potent and chronic use has led to death from heart attacks, accidents, suicides, and homicides.

Because few studies have looked at Flakka use, Palamar and his colleagues sought to understand how prevalent use is among adolescents. The researchers analyzed data from the 2016/2017 Monitoring the Future study, which surveyed a national sample of 3,786 high school seniors across the U.S.

Overall, 0.8 percent of high school seniors in 2016-2017 reported using Flakka in the past year. Students who do not live with their parents and students whose parents have less than a high school education were at higher odds for use.

Notably, Flakka users reported using other drugs, particularly Spice/K2 (synthetic cannabinoids)(85.6 percent), ketamine (72.3 percent), and marijuana (59.1 percent). Flakka use was associated with using a higher number of other drugs and using other drugs more often, with more than half of Flakka users (51.7 percent) using four to 12 other drugs.

The authors note that Flakka use may be underreported in surveys; recent studies have found that the use of Flakka and other “bath salts” is often unintentional, as these drugs are frequently added to the party drug known as Ecstasy or Molly.

“Flakka use rarely occurs in isolation, as most users also frequently use other drugs. 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.

The study, “‘Flakka’ Use among High School Seniors in the United States,” is published in the journal Drug and Alcohol Dependence and was authored by Palamar as well as Katherine Keyes and Caroline Rutherford of Columbia University Mailman School of Public Health. Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health (K01DA038800, R01DA044207, and R01DA001411).

About CDUHR
The mission of the Center for Drug Use and HIV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041).  It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the New York University College of Global Public Health. For more information, visit www.cduhr.org.

About NYU Langone Health
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. For more information, go to nyulangone.org, and interact with us on FacebookTwitterYouTube, and Instagram.

About NYU College of Global Public Health
At the NYU College of Global Public Health (NYU GPH), we are preparing the next generation of public health pioneers with the critical thinking skills, acumen, and entrepreneurial approaches necessary to reinvent the public health paradigm. Devoted to employing a nontraditional, inter-disciplinary model, NYU GPH aims to improve health worldwide through a unique blend of global public health studies, research and practice. The College is located in the heart of New York City and extends to NYU's global network on six continents. Innovation is at the core of our ambitious approach, thinking and teaching. For more, visit: http://publichealth.nyu.edu/