Alpha-PVP (alpha-PyrrolidinoValeroPhenone), also colloquially known as “flakka”, is a synthetic version of the stimulants known as cathinones, one of the main psychoactive components of khat. While first synthesised in the early 1960s, alpha-PVP first entered the recreational drug market in 2011, classified as a Novel Psychoactive Substance (NPS). It’s often found in the form of a white or pink crystal and produced mainly in laboratories in China and Russia as a cheaper and less controlled alternative to traditional stimulants like cocaine and methamphetamine.
When it first hit the drug market, alpha-PVP gained popularity in the US and received substantial media attention, frequently known as the “zombie drug” or the “devil’s drug”, supposedly due to its high potential for addiction and destructive behaviours associated with its consumption and comedowns such as aggressive tendencies, suicidal thoughts, paranoia, and hallucination. After numerous deaths in the US associated with flakka, the substance was banned in 2014, losing much of its popularity.
Despite its rise and fall in the US, alpha-PVP use surged in Eastern Europe and Central Asia (EECA) from 2017 onwards; alongside mephedrone, alpha-PVP continues to be the drug of choice of many in the region.
Why has alpha-PVP become so prevalent in the EECA region?
NPS have filled gaps in traditional drug markets, supplementing demand for substances that are targeted by law enforcement operations. Cathinones like alpha-PVP are fairly easy to produce, with precursor chemicals and reagents easily accessible at relatively low prices.
In a conversation with TalkingDrugs, Eliza Kurcevič, Program Manager with the Eurasian Harm Reduction Association, explained why NPS like alpha-PVP have become so popular in the region
“It’s an increasing issue I think because of the geopolitical situations and where the countries are based; loads of NPS are coming from China, and we know a few of our countries border with China, then also many substances come from Russia too”, Kurcevič told TalkingDrugs.
Border proximity with the biggest producers of NPS has contributed to a significant increase in use and widespread availability of NPS in the EECA region. Consumption has also accelerated due to conflict in the area, disrupting traditional drug markets from other international regions, and facilitating the development of closer industries. Since the Russian invasion of Ukraine in February 2022, Ukraine has witnessed a significant increase in its drug market. Ukrainian officials have seized large amounts of NPS, destroying various clandestine laboratories which produced alpha-PVP and mephedrone. Many of the precursor chemicals and reagents found in labs, as well as the seized drugs themselves, were believed to be arriving from Russia through frontline-focused cartels like Khimprom. The Russian state has also noted a rise in problematic use of mephedrone, which has also spilled into urban centres.
With forces on both sides locked into a war going on for over two years, specialised drug traffickers are heavily supplying frontline military personnel, leading to increasing use amongst soldiers, who use the substances to find an escape and relief from the conflict. There is an established relationship between military service and substance use; given the political situation in Ukraine and its geopolitical importance in drug trafficking routes, soldiers and the Ukrainian population have become particularly vulnerable to NPS use.
“With all the political situations, and with many crises coming into the region, like to any country, people are starting to use more substances – and they need mental health support”, Kurcevič added.
Many countries in the EECA region have repressive drug laws, with enforcement agencies harshly criminalising drug use and possession. The intensity of these actions have successfully limited traditional drug markets, making them unavailable, inaccessibly expensive or so risky to access that they are not found: this is largely the case with cocaine, for example. Drug sellers, however, are infamously resilient and adaptive; this harsh crackdown on the market has had unintended side-effects.
“To be more on the safe side, people are starting to use NPS because sometimes police and law enforcement can’t identify what people are doing because they might be super new NPS and not on UN treaty lists” said Kurcevič.
Use has been fomented by a burst of regional production: the Global Initiative Against Transnational Organised Crime (GI-TOC) has documented the growth of alpha-PVP production across Ukraine, with seizures in 2019 highlighting a network of micro-labs set up across the country to supply local and international drug markets. A 2020 Khimprom laboratory bust uncovered a network of storage facilities and call-centre operators.
Not only have drug producers innovated with substances like alpha-PVP and mephedrone, drug distributors have too: online drug markets function near-flawlessly in the EECA region: from darknet markets to open platforms like Telegram, the process of buying drugs online and anonymously has become incredibly streamlined. This has meant that while there may be more issues around the trafficking of international drugs into the region, the production, movement and sale of drugs within EECA has developed greatly.
Harm reduction responses to NPS in the EECA region
The increase in problematic NPS use and distribution in the EECA region has been a topic of concern and a priority for harm reduction organisations like the Eurasian Harm Reduction Association (EHRA). Harm reduction responses for the use of alpha-PVP has been limited: with a priority on drug law enforcement and lack of funding for peer-led harm reduction interventions, the tools available to protect people using drugs is restricted. EHRA’s research highlighted how there is minimal collaboration between different health sectors to support people using NPS; harm reduction services are also not adapted to support these new drug-using populations who don’t fit the profile of “traditional” drug-using groups, like those using opioids.
New legislative efforts are also hampering harm reduction interventions. “Foreign agent laws”, implemented in Russia and most recently in Georgia has placed many NGOs on hold, thus placing any advancement on harm reduction and drug policy on hold too. “As for drug policies, even now we can feel that it’s not the question that is discussed. Decision makers are not interested in it because it is not on their agenda, NGOs are afraid to raise the issue, just because they don’t want to be pointed out” said Kurcevič to TalkingDrugs.
However, there are still some notable harm reduction efforts in place for NPS:
- Increased Drug Checking: Drug checking is a crucial part of harm reduction, allowing individuals to make informed decisions about the substances they are taking and preventing overdose and exposure to dangerous substances. Mandala, a harm reduction organisation in Georgia, has focused on adapting harm reduction services to NPS over the past few years, specifically by making reagent testers for NPS available at dance events where they are present. Part of their work includes increased drug checking, especially at music events.
- Online Peer-to-Peer Counselling: With the darknet acting as a hub for the drug market in the EECA region, harm reduction organisations and in some cases doctors have implemented online peer-to-peer counselling. Telegram-based pages exist where users can message professionals and volunteers with questions concerning substance use, where to seek support, and inquire about injuries. Harm reduction specialists have also started reaching out to sellers, asking for harm reduction information to be made available on their pages and channels, with some sellers going as far as sending buyers equipment with they samples such as pipes or clean needles, according to Kurcevič.
While harm reduction organisations and public entities are increasingly understanding the seriousness of NPS and their effects, health-based interventions need to be implemented across the board to prevent harms from escalating. This not only means acknowledging the extent of its use across the region, but also admitting that the interventions of the past (and for different drug-using groups) won’t be enough to stop this growing crisis in its tracks.
