Call 2-1-1 for local resources · Life-threatening emergencies: 9-1-1
Back to education guides

Substance education guide

Synthetic Cathinones

Bath Salts · Flakka · Substituted Beta-Keto Phenethylamines

Representative photo of Synthetic CathinonesWhat it looks like
Image: DMTrott · CC BY-SA 4.0 · Wikimedia Commons. Appearance varies; illicit products may look different or be counterfeit.

01 · How it works

Variable stimulant pharmacology

Synthetic cathinones include transporter-releasing agents such as mephedrone and methylone and potent dopamine/norepinephrine reuptake blockers such as MDPV and alpha-PVP. New analogues can have uncharacterized potency and duration.

02 · Immediate effects

Recognize the effects

Signs of Use

  • Extreme agitation or persecutory delusions
  • Hot skin, sweating, or shedding clothing
  • Tachycardia, tremor, and dilated pupils
  • Violent thrashing or unusual strength
  • Muscle rigidity, dark urine, or seizures

Short Term

  • Intense euphoria and wakefulness
  • Severe anxiety, paranoia, or hallucinations
  • Dangerous blood pressure and heart-rate elevation
  • Hyperthermia and dehydration
  • Serotonin toxicity with some combinations

Long Term

  • Prolonged stimulant psychosis
  • Anhedonia, depression, and suicidal thoughts after stopping
  • Rhabdomyolysis and acute kidney injury
  • Cardiac and vascular injury
  • Unpredictable toxicity from changing analogues

03 · Long-term consequences

Excited delirium and hyperthermia

Combining cathinones with cocaine, methamphetamine, amphetamines, MDMA, or serotonergic medicines greatly increases the risk of fatal hyperthermia, arrhythmia, and seizures.

Medical emergency

Identifying an emergency

Call 911 immediately, reduce stimulation, begin external cooling with cold towels or ice packs, and prevent injury. Do not aggressively restrain the person; continuous struggle worsens acidosis and muscle breakdown.

Naloxone may still be appropriate when the product could contain an opioid
Back to education guides