These types of drugs cause distortion of perception

Dissociatives (also referred to as 'dissociative anaesthetics') are a class of psychedelic drug. This class of drug causes people to feel separated or detached from their body or physical environment.

Dissociatives can also cause hallucinations and other changes in thoughts, emotions and consciousness.1

Examples of dissociatives

• Ketamine – dissociative anaesthetic that is used in surgery and veterinary medicine. It causes amnesia (memory loss) and analgesia (pain-relief). Low doses produce stimulant effects; medium to high doses produce possible out-of-body or near death experiences.2
• PCP – Phencyclidine (PCP) is a drug that has both hallucinogenic and dissociative properties. The dissociative effects of PCP leaves users feeling removed from their body and their environment. This effect produces a trance-like state. It also has strong anaesthetic effects, which produces amnesia (memory loss) and analgesia (pain-relief). Also known as “angel dust”.2
• DXM – (lean, dank) Dextromethorphan is a medication usually used as a cough suppressant in cold and cough medicines. It is sold in syrup, tablet, spray, and lozenge forms.4
• Nitrous Oxide – (nangs) Nitrous oxide is a dissociative anaesthetic and has been found to produce dissociation of the mind from the body (a sense of floating), distorted perceptions and in rare cases, visual hallucination.3
• Methoxetamine is derived from ketamine and also has dissociative properties. It lasts longer and has more powerful effects than ketamine, but lower analgesic and aesthetic effects. The main effects include hallucinations, depersonalisation and dissociation.4

What do dissociatives look like?

Dissociatives can be in the form of pills, powders, gases, liquids and plants.

How are they used?

Dissociatives are usually ingested via snorting, oral, intramuscular injection or inhaled.

Effects of dissociatives

There is no safe level of drug use. Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.

Dissociatives affect everyone differently, based on:

• size, weight and health
• whether the person is used to taking it
• whether other drugs are taken around the same time
• the amount taken
• the strength of the drug (varies from batch to batch)
• the environment (in which the drug is taken).

The individual effects and toxicity of each dissociative can vary greatly between each person using them.

Many dissociatives have general depressant effects including drowsiness, slow ineffective breathing, pain relief, anesthesia, and loss of muscle control, as well as cognitive and memory impairment.

Amnesia is an often-reported side effect. Some dissociatives affect dopamine release and the opioid systems of the body and may produce euphoria.5

The effects of dissociatives can vary but generally speaking they are short acting, depending on the specific type of dissociative. The following may be experienced during this time:

• euphoric
• floaty
• relaxed
• happy
• pain-free
• numb
• protected
• safe
• unconscious
• unaware
• in a ‘hole’

You might also become unconscious or experience visual or auditory hallucinations (seeing or hearing things that aren’t there or are distorted).

Long term effects

Large regular doses of ketamine can cause ‘ketamine bladder syndrome’, a painful condition that requires ongoing treatment. Symptoms include difficulty holding urine and incontinence, which can cause ulceration in the bladder.

It’s important that if you’re suffering from ketamine bladder syndrome you stop using the drug and see a health professional immediately.7, 8

Inhaling nitrous oxide (nangs) is considered to be relatively harmless. But, regular long-term use can cause vitamin B12 deficiency, which can lead to nerve damage and some types of anaemia.8

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have different effects depending on a person’s mood (often called the ‘set’) or the environment they are in (the ‘setting’).

Set: a person’s state of mind, previous encounters with dissociative drugs, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using dissociatives may result in an unpleasant experience.9

Setting: the environment in which someone consumes dissociatives – whether it’s known and familiar, who they’re with, if they’re indoors or outdoors, the type of music and light. For example, using dissociatives in a calm, quiet and relaxed environment can lead to, or contribute to, a pleasant experience but being in a noisy, crowded place may result in a negative experience.9

Being in a good state of mind, with trusted friends and a safe environment, before taking dissociatives reduces the risk of having a negative experience.

Reducing harm from dissociatives

Use of dissociatives is likely to be more dangerous when:

• taken in combination with alcohol or other drugs, in particular benzodiazepines and opiates as these can slow breathing and increase the risk of overdose
• driving or operating machinery, as a person’s ability to judge distance and space is extremely limited
• used in unsafe environments such as nightclubs or festivals. There have been several reports of people hurting themselves whilst impaired and attempting to move around
• used in large doses or repeatedly. Dissociatives may be neurotoxic, meaning toxic to the nervous system
• alone (in case medical assistance is required)
• the person has a mental health problem.10

You might feel nauseous on many dissociatives, usually directly after dosing and often only when you have something in your stomach. It is best to not eat for 3-4 hours before dosing.10

Dependence and tolerance

There’s evidence to suggest that people who use dissociatives can develop dependence (addiction) and tolerance to them. Tolerance means you need to take larger amounts to get the same effect.

Tolerance to dissociatives develops with repeated, prolonged use. This results in having to take increasing larger doses to achieve the same effect. It can take around 2 weeks for tolerance to be back at zero.10

Dependence on dissociatives can be psychological, physical, or both.

People who are dependent on dissociatives may find that using them becomes far more important than other activities in their life. This might include craving dissociatives and finding it very difficult to stop using them.

Physical dependence occurs when a person’s body adapts to the dissociatives and gets used to functioning with the drugs in their system.

Psychologically dependence might include someone feeling an urge to use it when they are in specific surroundings or socialising with friends.