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Dissociative Drugs: Dissociatives Effects & Dangers

Last Updated: January 4, 2022

Dissociatives, which are also known as dissociative anesthetics, belong to the psychedelic drug group. An individual affected by the drugs of this class experiences disconnection with the surrounding environment, the feeling of separation from the self, and also altered sensory perception. If one still wonders what dissociative drugs are, there is a broad answer to this question.

Dissociatives: What They Are?

Dissociative drugs list can be divided into two categories: legal and illegal. The first ones are used as anesthetics or cough and cold medications, while the second ones are related to abuse. Both of them are referred to the hallucinogenic drug class.

Some of the most common examples of these drugs include Ketamine, Dextromethorphan (DXM), Nitrous Oxide, Salvia divinorum, and Phencyclidine (PCP). Out of this list of dissociatives drugs, only PCP is illegal, while Salvia divinorum is banned on the federal level in more than half of the US counties. As for Ketamine, DXM, and Nitrous Oxide, these are safe and legal anesthetics. Here is what one should know about the mentioned substances in a nutshell:

  • Ketamine is an anesthetic that is widely used in both veterinary and surgery. If taken in low doses, Ketamine creates stimulant effects, while medium and high doses are likely to produce an out-of-body experience and may cause amnesia.
  • PCP is an illegal drug with hallucinogenic and dissociative effects. Interestingly, the second name for PCP is ‘angel dust’ due to the effects it produces: it makes one experience the feeling of body detachment, a state of trance.
  • DXM is considered to be a safe drug which is mostly used as cold and cough medication. As DXM is a cough suppressant, it is sold in the form of a tablet, spray, and lozenge.
  • Nitrous Oxide is a legal dissociative anesthetic. Many may know it as a laughing gas which creates a dissociation effect so that one experiences a detachment from mind and body. Rarely, visual hallucinations occur.
  • Salvia divinorum, a mint plant, that belongs to the sage family. People use Salvia as a recreational drug. Since this drug affects the way one thinks, acts, and perceives the world, Salvia is prohibited in some states.

how do dissociative drugs work

How Do Dissociative Drugs Work?

For a better understanding of how dissociatives work, one should imagine the entire process as signals blockage. Specifically, such drugs block out the signals sent by diverse parts of the brain to the conscious mind. It is worthy of mentioning that dissociatives also affect an important neurotransmitter – glutamate – which is critical for cognitive function, perception of pain, and emotions.

The best thing to have a positive experience with the drugs under consideration is to learn more about how dissociatives work. Because such drugs also impact glutamate, some people may experience pain relief, while others have hallucinations and experience trance states to a certain extent. If nerve cells do not release enough of glutamate or, on the contrary, release more glutamate than needed, the effect of a particular drug would differ as well.

Dissociatives vs Psychedelics

The psychedelic drug category unites three groups, namely, cannabinoids, serotonergics, and also empathogens. The reason why all these groups belong to one category is due to the fact that their consumption results in some unfamiliar states of consciousness. As a comparison, dissociatives produce some magnified states of consciousness which are, nevertheless, familiar to a person. Psychedelics modify cognition working against the serotonin receptors. Dissociatives vs psychedelics difference in effects include:

Dissociatives Effects:

  • detachment from the body and world;
  • depersonalization;
  • derealization of the surrounding environment.

Psychedelics Effects:

  • cannabinoids produce some light euphoria, stimulate hunger, improve one’s well-being in general, others may slightly alter the current processes of the linear memory;
  • empathogens produce euphoria, hyper-sensory experiences, elevated feelings of openness, and love;
  • serotonergics produce intense modifications of perception, specifically, synesthesia, unfamiliar and new emotional responses, and also hallucinations both auditory and visual.

In such a way, despite some similarities between the effects of dissociatives and psychedelics, there are some profound differences as well.

Dissociative Drugs Effects

There are short-term and long-term effects of dissociatives drugs. Despite the duration of the effects, the principle of drug’s work is always the same – the disruption of the glutamate activity concerning NMDA receptors. Below, there are major differences between dissociatives effects in the context of their duration.

Short-Term Effects

Dissociatives drugs may result in feelings of dissociation from the self and the environment, floating feeling, and also causes visual, as well as auditory distortions. Also, one can experience such side effects as:

  • anxiety
  • amnesia
  • numbness
  • body tremors

The side effects named above are considered to be the general ones. At the same time, however, some effects may be rather dangerous and characterize a particular drug in this class.

Drug-Specific Short-Term Side Effects Of Dissociatives

PCP Taking high doses of PCP results in the following effects: strong seizures, unexplained aggressiveness, and psychotic symptoms similar to those experienced by people with schizophrenia.
Ketamine For Ketamine, the effects after a moderate to high dosage include amnesia, sedative state, and immobility. If the dose is high, one may face a severe sensory detachment which reminds of a near-death experience.
Salvia In the case of Salvia, some users experience short-term effects like intense mood swings.
DXM When the doses of this dissociative are high and go beyond the recommended amount, adverse reactions occur. For example, disruption of the cardiovascular system function, disruption of the nervous system function, higher heart rate, severe seizures, and respiratory distress.

Long-Term Effects

Dissociative drugs side effects that last longer are not that well investigated yet. Nevertheless, a regular intake of PCP, for instance, is likely to facilitate the occurrence of drug tolerance and, as a result, the development of substance abuse. Despite the long-term effects of dissociatives require further investigation, the drug-specific ones may include:

  • temporary loss of memory
  • impaired speech
  • long-standing depression and anxious states
  • suicidal thoughts
  • social isolation

As soon as one stops taking PCP, they experience withdrawal syndrome. That’s why it is always better to stop the use of dissociatives under medical supervision in a rehab facility.

Dissociatives High

Considering the possible effects of dissociatives, it is no wonder that people use it to get high. When one does not follow the recommended dose or a person is hypersensitive to specific components, there might be hallucinogenic experiences similar to that characteristic of some common psychedelics, including state of euphoria and “rush.”

The recreational use of dissociatives provides a person with many pleasurable feelings. These feelings are based on sensory dissociation. The most common dissociative effects include:

  • depersonalization – a state of detachment, disconnected from one’s self, from one’s body and/or mind;
  • a feeling of being unreal – the world around seems vague and dreamlike;
  • purposeless movements – an inability to control one’s actions, believing that someone or something “bigger” forces a person to move in the way he or she does.

Abuse Of Dissociatives Drugs

Dissociative abuse is not rare: the hallucinogenic effects of drugs create powerful visions. There are several ways of abusive dissociatives ingestion: via snorting, intramuscular injection, oral intake, or by inhaling. Сonsidering the hallucinogenic side effects and the fact that the majority of dissociatives are accessible and legal, many started to misuse the medications. People abuse dissociatives at night clubs and home parties, with friends, strangers, or alone. In every case, they are driven by the desire to get that feeling over and over again, escaping from reality and routine life. Taking this into account, it is critical that one is aware of all the possible consequences of the abuse, side effects, and also rehabilitation procedure.

long term abuse of dissociative drugs

Are Dissociatives Addictive?

Dissociative drugs are addictive. The problem with any drug in this class is that a person may even do not understand that addiction evolves. Thinking about why dissociatives are addictive, one should consider the individual perception of the drug. Typically, such drugs become addictive as soon as one systematically uses higher doses or continues to take medium doses when it is not needed. When one notices such changes in own behavior or someone else’s behavior, it is better to have a consultation with a specialist and find the proper substance treatment.

Can One Overdose On Dissociatives?

Signs Of Overdose

First and foremost, one should remember that there is a risk of overdose from any dissociative drug. While some medications are likely to cause severe overdose, others have milder symptoms. Knowing all the symptoms, it is easier to combat the overdose of dissociatives and prevent similar cases.

The common signs of dissociatives overdose are as follows:

  • high blood rates
  • agitation
  • hallucinations
  • inability to control own movement
  • changes in cognitive function
  • dizziness
  • troubled breathing
  • mood swings
  • sluggishness
  • nausea and vomiting
  • coma

what are the side effects of taking dissociative drugs for long time?

There are also specific symptoms of overdose. They include:

  • psychosis
  • catatonic trance
  • severe seizures
  • Hyperthermia
  • psychomimetic reactions
  • rhabdomyolysis
  • gut spasms
  • frostbite in one’s nose, mouth, and throat
  • mixing it with alcohol results in uncontrolled body movement, sluggishness, and low concentration

Overdose Management

As for the Ketamine overdose, benzodiazepines are widely used in cases of agitation, while glycopyrrolate is applied when a considerable amount of salivary secretions appear.

For the DXM overdose, stomach pumping and exercises for even breathing are needed. Besides, benzodiazepine is applied in cases of spasm.

Nitrous Oxide becomes dangerous and unpredictable if taken together with other drugs, alcohol, or nicotine. If one passed out, there is a need for mouth-to-mouth resuscitation.

Finally, if it is clear that one has overdosed from Salvia, antipsychotics may be prescribed.

Think Ahead

Dissociative drugs belong to the class of hallucinogens and also share some effects with the common representatives of that class. There are risks of addiction to the common dissociatives as well as an overdose on them. For that reason, knowing the symptoms, one can start rehabilitation before the problem becomes too serious.

Page Sources

  1. Hallucinogens and Dissociative Drugs. National Institute on Drug Abuse. 2015.
  2. Hallucinogens And Dissociative Drugs: Including LSD, PCP, Ketamine, Psilocybin,Salvia, Peyote, and Dextromethorphan. National Institute on Drug Abuse. 2014.
  3. Bowman N. Official Newsletter Of Theutah Poison Control Center. Toxicology Today. 2015; 17 (2).
  4. Nitrous Oxide: The Facts. NSW Ministry of Health. 2018.

Published on: July 23rd, 2019

Updated on: January 4th, 2022

About Author

Peter J. Grinspoon, MD

Dr. Peter Grinspoon is an experienced physician with long-term clinical practice experience. As a former analgesic addict, Dr. Grinspoon knows precisely how important it is to provide patients with effective treatment and support. Medical writing for him is the way to communicate with people and inform them about their health.