Dissociatives

Effects of dissociatives

Use of any drug can have risks. 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.

Getting help

If your use of dissociatives is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about a loved one, you can find help and support.

Call the National Alcohol and Other Drug Hotline on 1800 250 015 for free and confidential advice, information and counselling about alcohol and other drugs

Help and Support Services search

Find a service in your local area from our list. Simply add your location or postcode and filter by service type to quickly discover help near you.

If you're looking for other information or support options, send us an email at druginfo@adf.org.au