Is it actually ketamine? Exploring novel dissociatives

With the increase in ketamine use across Australia, there’s also been a rise in the detection of novel dissociatives by drug checking services.

Novel dissociatives can be far more potent than ketamine and can cause unpredictable effects.

They are often taken unknowingly by people who think they’re using another drug - most often ketamine - increasing the risk of harm.

What are novel dissociatives?

Novel dissociatives are new and emerging psychoactive substances (NPS). They’re also called:

• potent/synthetic dissociatives
• ketamine analogues
• PCP analogues
• phencyclidine-type substances.

Dissociatives cause people to feel separated or detached from their body or physical environment. They can produce similar effects to psychedelics, such as experiencing hallucinations or other changes in thoughts, emotions and consciousness.¹

Dissociatives include:

• ketamine
• nitrous oxide
• dextromethorphan (DXM)
• phencyclidine (PCP).

We’re now seeing more novel dissociatives being sold as ketamine in Australia and around the world, including:

• methoxetamine (MXE)
• tiletamine
• 2-FNENDCK (‘CanKet’), which is also known as 2-fluoro-2-oxo-PCE or 2-FXE
• 3-HO-PCP.

For a full list of novel dissociatives detected in Australia, check out drug alerts from The Know.

Where do novel dissociatives come from?

After discovering the dissociative drug PCP in 1956, scientists began searching for another anaesthetic with less adverse or unwanted effects.²

During this search, many dissociatives were created.³ Ketamine was eventually discovered in 1962 and approved for medical and veterinary use.²

In the 2010s, some of the dissociatives not approved for medical use began appearing in illegal drug markets, alongside new dissociatives created by illegal manufacturers.^2,4

Since then, they’ve been increasingly detected around the world.²

Why are they becoming more common?

In the past, recreational ketamine use was not as common, so laws and enforcement related to ketamine were a bit more relaxed.

But as ketamine became more popular during the 2000s, governments around the world (including the US, UK and Australia) began increasing restrictions on possession, use, trafficking and manufacturing.^5-7

At the same time, public access to scientific studies on dissociatives increased via the internet, growing interest in the class of drugs.

And illicit manufacturers also created slightly different chemical versions of existing drugs, in an attempt to avoid detection and criminal penalties.

People then began selling them on the dark web (online markets for illegal goods), making them more accessible.⁵

What are the effects of novel dissociatives, such as ketamine analogues?

There are many different novel dissociatives, each with their own effects and risks.

While ketamine has been researched for decades and is a World Health Organization (WHO) essential medicine⁸, novel dissociatives haven’t been researched much, and their effects are not well understood.³

We do know that novel dissociatives can have different, unpredictable, and longer lasting effects than ketamine.

Generally, most of them create feelings of euphoria and detachment from your body or surroundings. But the strength of these effects can vary.

For potent novel dissociatives, the risk of harmful psychological effects increases, such as short term memory loss, psychosis or hallucinations.³

Long term effects

While the long-term effects of novel dissociatives are unknown, long-term ketamine use may lead to tolerance and dependence. It can also cause bladder, urinary tract, stomach, and liver function issues.⁸

So with this in mind, it’s possible that novel dissociatives cause similar long-term effects.³

And, they could also have other long-term effects that aren’t caused by ketamine.⁵

How can the risk of harm from novel dissociatives be reduced?

If you, or someone you care about, is using ketamine, there are effective harm reduction tips to prevent harms from accidentally taking novel dissociatives.

Pill testing and drug alerts

Drug checking (pill testing) can detect novel dissociatives in drugs and let you know that it’s in there before you take it. They also provide the opportunity to speak to trusted health professionals and peer workers about drug use.⁹

Findings from drug checking services can also be used to alert the public. For example, when CanTEST identify novel dissociatives in a sample they’re testing, they release a drug alert to warn the public.¹⁰

Drug checking and drug alerts lead to safer behaviours, with people:

• choosing not to use the drug once they know what else is in it
• avoiding using drugs matching an alert
• changing their approach to using the drug – most commonly by using a smaller amount.^11-13

Other strategies for reducing harm

• ‘Start low, go slow’ - pace yourself by only taking a little of the drug to start with, and leave time between doses.
• Never use alone - make sure someone nearby has a phone to call for help if needed. Ideally, someone in your group should not be using drugs so they can keep an eye on others.
• Avoid mixing drugs (see polydrug use) - mixing with other drugs can have unpredictable effects and increase the risk of harm. Mixing means 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.

Getting help

If your use of drugs is affecting your health, family, relationships, work, school, financial or other life situations, or you’re concerned about someone you care about, 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.