Dissociative Drugs Overview
What Is a Dissociative Drug?
The dissociatives are a class of substances comprised of various psychoactive compounds that result in a distorted sense of reality and, characteristically, dissociation—or a sense of feeling disconnected or detached from one’s environment and body.1,2
Dissociative drugs, some of which have legitimate medical uses, are sometimes abused for their psychoactive effects including:1,2
- Altered sensory experiences.
- Hallucinations, which involves seeing, hearing, or feeling sensations that are not real.
Dissociative Drugs List
The most widely abused dissociative drugs include:1,2,3,4
- Phencyclidine, or PCP. Originally developed as an general surgical anesthetic in the 1950s, PCP’s illicit use grew over the latter half of the century. PCP is usually found in liquid or powder form and users may smoke, swallow, inject, or snort it. People also will sometimes sprinkle it on marijuana or tobacco.
- Ketamine, also known as “K” or “Special K” in illicit forms. Another once widely used anesthetic (both in human and veterinary medicine), ketamine has become a major dissociative drug of abuse. Pharmaceutical sources of ketamine are available as injectable solutions, though the drug is commonly used illicitly as a powder which may be snorted or pressed into pill form for oral consumption. Odorless and tasteless, there have been reports of ketamine being used to facilitate sexual assault because it cannot be detected in a drink and causes memory loss.
- Dextromethorphan, or DXM. This ingredient found in certain over-the-counter cough and cold medicines can result in dissociation and other dangerous side effects at high doses. DXM abuse among adolescents has been a concern because of the drug’s easy availability.
- Salvia divinorum. With a unique mechanism of action in the brain, salvia is sometimes also classified as a hallucinogen. As the primary psychoactive compound in a plant native to Central and South America, salvia causes profound, albeit fleeting, psychoactive effects. Salvia users will chew fresh leaves, smoke or inhale dried leaves, or drink the leaves’ extracted juices.
- Methoxetamine, or MXE. This is a newer dissociative drug that has recently increased in popularity because of its availabilty over the internet. There are significant risks of using MXE, including fatal overdose.
Effects of Dissociative Drugs
Dissociative drugs are associated with a range of physical and psychological effects. The psychoactive effects of these drugs and how quickly they set in can vary depending upon the dose and route of use (e.g., snorting, swallowing, injecting).1 In some cases, the effects may begin within a few minutes of taking the drug and can persist for several hours or even days.1,2
At low to moderate doses, dissociative drugs can have several effects such as: 1,4
- Disoriented/confused state.
- Sense of detachment from the body.
- Visual and auditory hallucinations.
- Changing perception of sight, sound, and other senses.
- Increased heart and breathing rate.
- High blood pressure and body temperature.
At higher doses, these effects become more severe and can lead to dangerous changes in blood pressure, pulse, respiratory rate, and body temperature.1
Other effects associated with high doses include:1,2
- Extreme fear or panic.
- Feelings of extreme strength or invulnerability.
- Loss of memory.
Combining dissociative drugs with alcohol or other depressant substances can lead to potentially fatal respiratory depression.1
Specific types of dissociative drugs may have their own severe and dangerous effects:1
- PCP—High doses of PCP can cause aggression, violence, psychosis, and seizures.
- Ketamine—“Special K” users can go into a “K-hole,” where they may feel completely detached from their senses and feel as though they are near death.
- DXM—High doses of DXM can lead to increased heart rate, respiratory distress, and seizures.
- Salvia—Users may experience severe mood swings.
Dissociative Drugs Long-Term Effects
The long-term risks of dissociative drugs are not fully understood.1 However, repeated use of certain dissociative drugs like PCP can lead to addiction,2 which involves continued drug use despite consequences, such as the drug having a negative impact on a person’s health and relationships. 2 Users of dissociative drugs may also develop physical dependence and suffer withdrawal when they attempt to stop using.1
Long-term use of dissociative drugs, such as PCP, may result in may result in persisting negative effects on a person’s mental and physical health such as:1,2
- Social isolation.
- Suicidal ideation.
- Memory problems.
- Problems with speech.
- Unhealthy weight loss.
These effects can continue for a year or more after a person has stopped using.1
Overdose on Dissociative Drugs
Overdose can occur when consuming certain dissociative drugs:
- High doses of PCP are associated with seizure and coma risk and may be fatal.2
- High doses of ketamine can cause slowed breathing and loss of consciousness.3
- When PCP and ketamine are used together, there is an increased risk of respiratory depression, seizures, coma, and death.3
- DXM overdose symptoms can include drowsiness, labored breathing, bluish lips and finger nails, stomach and intestinal spasms, seizures, and coma.5
Polysubstance use can increase the risk of overdose when dissociative drugs are mixed with other classes of drugs or alcohol. Taking PCP with central nervous system depressants, including benzodiazepines and alcohol, can increase the risk of coma.2 Overdoses involving DXM and MXE are more likely to result in death when other drugs are also involved.3,6 Taking DXM with certain antidepressants can also be deadly.3
Dissociative drugs can profoundly alter a person’s sensory perceptions and mood, which can lead someone to engage in behaviors that may be harmful and potentially fatal.2 For example, users of dissociative drugs may act on suicidal or violent thoughts.2 People under the influence of dissociatives may also be at risk for accidental deaths involving motor vehicle accidents or drowning.3,6
How Do I Find Treatment for Addiction?
Dual diagnosis or co-occurring disorder programs such as the one at Desert Hope specialize in treating both addiction and mental health conditions.
Dissociative drugs can be addictive.1 Some people may require treatment when attempting to quit. If you’re having a difficult time quitting dissociative drugs, addiction treatment could help. Different types of programs are available depending upon your needs:
- Detoxification programs can help you initially attain sobriety if you are at risk for experiencing withdrawal symptoms. These programs provide medical treatment for withdrawal, which can reduce the discomfort experienced and prevent adverse reactions. PCP users may benefit from detox because dependent users may experience withdrawal when the drug is stopped.1
- Inpatient and residential programs are another option for treatment. These types of programs offer 24-hour care, drug education, counseling and therapy, and self-help group participation.
- Outpatient programs offer regular group and individual therapy throughout the week. They differ from inpatient programs in that people attending them can come and go from the facility outside of treatment hours. Some people choose to stay in a sober living home while attending outpatient therapy. Sober living homes provide a drug-free living environment for people who are new to recovery.
People who use dissociative drugs may have pre-existing mental health conditions. Other times, users may develop certain mental health issues, such as depression and anxiety, that persist beyond the period of active drug use.1 Dual diagnosis or co-occurring disorder programs such as the one at Desert Hope specialize in treating both addiction and mental health conditions. If you think you might be experiencing mental health issues, this type of program may be right for you.
When searching for the right treatment program, you may want to be sure that the program provides certain services such as:
- Licensed addiction treatment professionals. If you are seeking medical detox, then it is important that the program is staffed with medical doctors and nurses. If you are looking for dual diagnosis treatment, you want to be sure that you will be under the care of qualified mental health professionals, like psychiatrists, psychologists, and therapists.
- Evidence-based behavioral therapies. Most programs offer a variety of different types of group therapy sessions and some also offer individual and family therapy.
- An introduction to addiction self-help groups, such as SMART Recovery and 12-step groups like Narcotics Anonymous. Some programs will hold meetings on-site, while others may transport you to the meeting several times per week.
- Accreditation from organizations such as The Joint Commission, which ensures that the program meets a certain standard of care.
Seeking help for addiction to dissociative drugs is a step in the right direction. While the sensory-distorting high may seem appealing, these drugs carry serious risks. Quitting sooner rather than later can prevent dangerous and potentially fatal consequences.
- National Institute on Drug Abuse. (2015). Research report series: Hallucinogens and dissociative drugs.
- National Institute on Drug Abuse. (2019). DrugFacts: Hallucinogens.
- S. Department of Justice, Drug Enforcement Agency. (2017). Drugs of Abuse: A DEA resource guide.
- Zanda, M. T., Fadda, P., Antinori, S., Di Chio, M., Fratta, W., Chiamulera, C., & Fattore, L. (2017). Methoxetamine affects brain processing involved in emotional response in rats. British Journal of Pharmacology, 174(19), 3333-3345.
- S. National Library of Medicine. (2019). MedlinePlus, Dextromethorphan overdose.
- Chiappini, S., Claridge, H., Corkery, J. M., Goodair, C., Loi, B., & Schifano, F. (2015). Methoxetamine?related deaths in the UK: An overview. Human Psychopharmacology: Clinical and Experimental, 30(4), 244-248.