Methoxetamine (MXE)

How is it used?

MXE is usually snorted, swallowed or injected.⁷

Effects of MXE

The use of any drug can have risks. It’s important to be careful when taking any type of drug.

MXE can 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 (where the drug is taken).

Onset and duration of effects

How fast a drug takes effect and how long it lasts can vary depending on how it's taken - for example, whether it's snorted, swallowed, or injected.

• If snorted: effects can be felt within 5 to 20 minutes, peak after about 1 to 2 hours, and can last 3 to 5 hours.
• If swallowed: effects can be felt within 15 to 30 minutes, peak after about 1.5 to 2.5 hours, and can last 4 to 6 hours
• If injected: effects can be felt within 1 to 5 minutes.^{7, 8}

It can sometimes take up to 90 minutes for the effects of MXE to be felt. Wait at least 1.5 hours before deciding whether to take more to reduce the risk of overdose.⁹

Effects

Effects can include:

• feeling relaxed and chilled
• euphoria
• empathy
• feelings of physical wellbeing
• dissociation
• vivid hallucinations
• introspection
• anti-depressant.
• agitation
• disorientation
• confusion
• dizziness
• anxiety
• rapid heart rate
• nausea
• paranoia
• vomiting
• slurring or difficulty speaking
• psychomotor agitation e.g. tapping or pacing.^{4, 7}

Impact of mood and environment

Drugs that affect a person’s mental state (psychoactive drugs) can also have varied 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 the drug, and expectations of what’s going to happen. For example, feelings of stress or anxiety before using MXE may result in an unpleasant experience and make those feelings worse.
• Setting: the physical and social environment where you take MXE – whether it’s known and familiar, who you're with, if you're indoors or outdoors, the type of music or sounds, and lighting. The ideal setting to take MXE will vary based on the individual and drug they’re using.¹⁰

Bad trips

A ‘bad trip’ usually includes anxiety, paranoia, panic, or other negative emotions. People can also experience unpleasant or intense hallucinations.^11-13

Taking a large dose of MXE can increase the risk of a bad trip. Other things like age, sex, personality, mental state, and previous experience with the drug, also affect someone’s experience.^11-13

While a bad trip can be scary, it’s generally not life threatening and the effects will go away as the drug leaves someone’s system.^11-13

Being with trusted friends, in a good state of mind, and in a safe environment before taking MXE reduces the risk of having a bad trip.^{12, 14}

Overdose

If you take a large amount of MXE or use a strong batch, you could overdose.

Your risk of overdose can also increase if you mix MXE with alcohol or other drugs, including medications.¹⁵

People may also be at a higher risk of physical harm/accidents while under the influence of the MXE.^{15, 16}

MXE overdose can cause death.¹⁶

Call triple zero (000) and request an ambulance if you or someone else has any of the following symptoms (emergency services are there to help and can provide more instructions).

Signs of MXE overdose may include:

• unconscious or non-responsive
• spasms or seizures
• slow breathing, abnormal breathing, or not breathing at all
• slow or no heartbeat and pulse
• heart attack symptoms such as:
• difficulty breathing
• sharp pain/discomfort in chest, arm, shoulder, back, neck, or jaw
• severe agitation, confusion, or panic
• hot, flushed (red), or sweaty skin.^{5, 16-18}

Learn more on overdose and drug-related emergencies.

Mixing with other drugs

Mixing MXE with other drugs can have unpredictable effects and increase the risk of harm.

Mixing includes using more than one drug (including alcohol or medications) at the same time, or one after another. You should also consider what drugs you’ve taken in the last 24 hours.

• MXE and depressants (such as alcohol, benzodiazepines, and GHB/GBL): can cause memory loss, vomiting, poor coordination and unconsciousness. If unconscious, a person can choke on their vomit. Placing them in the recovery position can help reduce this risk.
• MXE and stimulants (such as amphetamines and cocaine): increases the risk of fast heart rate, high blood pressure, and mental health concerns such as mania.
• MXE and opioids (such as codeine, heroin, and tramadol): can negatively increase the effects of opioids, increasing the risk of overdose.
• MXE and psychedelics (such as NBOMes, LSD, and psilocybin (magic mushrooms)): increases the risk of having a bad trip. Can be very unpleasant.
• MXE and MDMA/some antidepressants (such as SSRIs and MAOIs): potentially increases the risk of serotonin syndrome, which can be fatal.^{7, 9}

Using more than one drug or type of drug at the same time is called polydrug use.¹⁸

Reducing harm 

There are ways you can reduce the risk of harm when using MXE.

• Start low, go slow - try a little bit first to see how you feel. Wait at least 2 hours before deciding whether to take more.
• Test your drugs if there is an available drug checking (pill testing) service near you, to find out what the drugs contain and how strong they are.
• Stay hydrated by taking small sips of water regularly - to avoid dehydration.
• Avoid operating machinery, driving, or swimming.^{16, 19}

If snorting

• Crush into a fine powder, as crystals can cause cuts.
• Rinse your nose with water before and after to protect your nose from irritation.
• Use your own straw, or a disposable one, and avoid money notes to reduce the risk of infections or transmission of viruses like HIV or Hep C.
• Switch nostrils and take breaks to avoid nasal damage.¹⁹

If injecting

• Always use new needles - never share needles or other injecting equipment. Use your own spoon/cup and tourniquet. Use new barrels, filters, sterile water, and swabs. Safely dispose of used equipment.
• Visit a needle and syringe program for sterile equipment, disposal of used equipment, and expert medical advice.¹⁹

Avoid or use less if any of the following apply to you, as the risk of experiencing harms from taking MXE is increased:

• You have experienced symptoms or have a family history of psychosis, schizophrenia, or bipolar disorder - MXE may worsen existing symptoms and cause psychosis
• You have pre-existing heart conditions - MXE may increase the risk of blood pressure issues like hypertension, and heart problems like fast or irregular heartbeat.¹⁵

Coming down

There is limited evidence on the comedown effects of MXE.

Long-term effects

There is limited evidence on the long-term effects of MXE.¹⁵

However, reports suggest that using high doses over several weeks or months may cause bladder or urinary tract problems similar to ketamine-induced cystitis.^{5, 7}

Ketamine or MXE-induced cystitis can become extremely serious and is a painful condition that needs ongoing treatment.^{5, 7}

It’s best to speak with a health professional immediately if symptoms start occurring.

MXE and mental health

There is limited evidence available that the use of MXE affects mental health.

Studies in mice have explored MXE as a possible treatment for depression. More research is needed before studies in humans can begin.^{5, 20}

Tolerance

Regularly taking MXE can lead to developing a tolerance, which means you need to take larger amounts to get the same effects.⁷

Dependence

There is limited evidence regarding MXE and dependence. However, experts believe that the similarity to ketamine means that it carries a similar risk of dependence.^{7, 21}

Withdrawal

Withdrawal refers to the symptoms that can occur when someone who is dependent on a drug, or who has been using it regularly over time, stops or reduces their use.²²

Withdrawal can include physical symptoms (such as headaches, or nausea) and psychological symptoms (such as anxiety, or depressed mood).²²

Symptoms - including how strong they are and how long they last - will vary depending on the type of drug and a person’s history of use.²²

There is limited information on MXE withdrawal symptoms, however if you experience symptoms after stopping or reducing your use, or have concerns, contact your doctor or the help and support services listed below for advice and support.

Pregnancy and breastfeeding

There isn’t enough information about the effects of MXE on fertility. Like other illicit drugs, it is recommended to avoid using them if you’re trying to get pregnant, to increase your chances of a healthy pregnancy and baby.

Getting help

If your use of MXE is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone, there is 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.
• Search our Help and Support directory to find your preferred support, by adding your location or postcode and filtering by service type.