Dissociatives, colloquially dissos, are a subclass of

hallucinogen Hallucinogens, also known as psychedelics, entheogens, or historically as psychotomimetics, are a large and diverse class of psychoactive drugs that can produce altered states of consciousness characterized by major alterations in thought, mo ...

s that distort perception of sight and sound and produce feelings of detachment – dissociation – from the environment and/or self. Although many kinds of drugs are capable of such an effect, dissociatives are unique in that they do so in such a way that they produce

ic effects, which may include dissociation, a general decrease in sensory experience,

hallucination A hallucination is a perception in the absence of an external stimulus that has the compelling sense of reality. They are distinguishable from several related phenomena, such as dreaming ( REM sleep), which does not involve wakefulness; pse ...

s, dream-like states or

anesthesia Anesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prev ...

. Despite most dissociatives' main

mechanism of action In pharmacology, the term mechanism of action (MOA) refers to the specific biochemical Drug interaction, interaction through which a Medication, drug substance produces its pharmacological effect. A mechanism of action usually includes mention o ...

being tied to NMDA receptor antagonism, some of these substances, which are nonselective in action and affect the

dopamine Dopamine (DA, a contraction of 3,4-dihydroxyphenethylamine) is a neuromodulatory molecule that plays several important roles in cells. It is an organic chemical of the catecholamine and phenethylamine families. It is an amine synthesized ...

and/or opioid systems, may be capable of inducing more ''direct'' and repeatable

euphoria Euphoria ( ) is the experience (or affect) of pleasure or excitement and intense feelings of well-being and happiness. Certain natural rewards and social activities, such as aerobic exercise, laughter, listening to or making music and da ...

or symptoms which are more akin to the effects of typical " hard drugs" or common drugs of abuse. This is likely why dissociatives are considered to be addictive with a fair to moderate potential for

abuse Abuse is the act of improper usage or treatment of a person or thing, often to unfairly or improperly gain benefit. Abuse can come in many forms, such as: physical or verbal maltreatment, injury, assault, violation, rape, unjust practices, ...

, unlike psychedelics. Despite some dissociatives, such as phencyclidine (PCP) possessing stimulating properties, most dissociatives seem to have a general

depressant Depressants, also known as central nervous system depressants, or colloquially known as "downers", are drugs that lower neurotransmission levels, decrease the electrical activity of brain cells, or reduce arousal or stimulation in various ...

effect and can produce sedation, respiratory depression,

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. It can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the throat. Over 30 d ...

, disorientation, analgesia, anesthesia,

ataxia Ataxia (from Greek α- negative prefix+ -τάξις rder= "lack of order") is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in e ...

, cognitive and memory impairment as well as amnesia. Examples of dissociatives include arylcyclohexylamines like

ketamine Ketamine is a cyclohexanone-derived general anesthetic and NMDA receptor antagonist with analgesic and hallucinogenic properties, used medically for anesthesia, depression, and pain management. Ketamine exists as its S- (esketamine) a ...

and phencyclidine (PCP); morphinans like

dextromethorphan Dextromethorphan, sold under the brand name Robitussin among others, is a cough suppressant used in many cough and Common cold, cold medicines. In 2022, the US Food and Drug Administration (FDA) approved the combination dextromethorphan/bupropi ...

(DXM); inhalants like

nitrous oxide Nitrous oxide (dinitrogen oxide or dinitrogen monoxide), commonly known as laughing gas, nitrous, or factitious air, among others, is a chemical compound, an Nitrogen oxide, oxide of nitrogen with the Chemical formula, formula . At room te ...

(N₂O); diarylethylamines like diphenidine; and adamantanes like memantine, among others.

Effects

The effects of dissociatives can include sensory dissociation, hallucinations,

mania Mania, also known as manic syndrome, is a Psychiatry, psychiatric Abnormality (behavior), behavioral syndrome defined as a state of Abnormality (behavior), abnormally elevated arousal, affect (psychology), affect, and energy level. During a mani ...

, catalepsy, analgesia and amnesia. According to Pender (1972), "the state has been designated as dissociative anesthesia since the patient truly seems disassociated from his environment." Both Pender (1970) and Johnstone et al. (1959) reported that patients under anaesthesia due to either

or phencyclidine were prone to purposeless movements and had hallucinations (or "dreams") during and after anaesthesia. Some patients found the hallucinations euphoric while others found them disturbing. At sub-anesthetic doses, dissociatives alter many of the same cognitive and perceptual processes affected by other hallucinogenic drugs such as

mescaline Mescaline, also known as mescalin or mezcalin, and in chemical terms 3,4,5-trimethoxyphenethylamine, is a natural product, naturally occurring psychedelic drug, psychedelic alkaloid, protoalkaloid of the substituted phenethylamine class, found ...

, LSD, and

psilocybin Psilocybin, also known as 4-phosphoryloxy-''N'',''N''-dimethyltryptamine (4-PO-DMT), is a natural product, naturally occurring tryptamine alkaloid and Investigational New Drug, investigational drug found in more than List of psilocybin mushroom ...

; hence they are often contrasted and also considered hallucinogenic. Perhaps the most significant subjective differences between dissociatives and the classical hallucinogens (such as LSD and

) are the detaching effects, including: depersonalization, the feeling of being unreal, disconnected from one's self, or unable to control one's actions; and derealization, the feeling that the outside world is unreal or that one is dreaming.

Use

Medical use

Many dissociatives such as

are used as anesthetics for

surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...

or pain relief in medical contexts such as in hospitals. However, due to possible psychotomimetic reactions they are sometimes used reluctantly. Certain morphinan dissociatives such as dextromethorphan are also used in sub-psychoactive dosages to suppress coughing.

Ketamine Ketamine is a cyclohexanone-derived general anesthetic and NMDA receptor antagonist with analgesic and hallucinogenic properties, used medically for anesthesia, depression, and pain management. Ketamine exists as its S- (esketamine) a ...

is also currently being studied and is showing promising results as a possible fast-acting

antidepressant Antidepressants are a class of medications used to treat major depressive disorder, anxiety disorders, chronic pain, and addiction. Common side effects of antidepressants include Xerostomia, dry mouth, weight gain, dizziness, headaches, akathi ...

. It may also function as a possible palliative treatment for C-PTSD and

chronic pain Chronic pain is pain that persists or recurs for longer than 3 months.https://icd.who.int/browse/2025-01/mms/en#1581976053 It is also known as gradual burning pain, electrical pain, throbbing pain, and nauseating pain. This type of pain is in cont ...

Recreational use

Some dissociative drugs are used recreationally.

and

are club drugs. Phencyclidine (PCP or angel dust) is available as a street drug.

Dextromethorphan Dextromethorphan, sold under the brand name Robitussin among others, is a cough suppressant used in many cough and Common cold, cold medicines. In 2022, the US Food and Drug Administration (FDA) approved the combination dextromethorphan/bupropi ...

-based cough syrups (often labeled DXM) are taken by some users in higher than medically recommended levels for their dissociative effects. Historically,

chloroform Chloroform, or trichloromethane (often abbreviated as TCM), is an organochloride with the formula and a common solvent. It is a volatile, colorless, sweet-smelling, dense liquid produced on a large scale as a precursor to refrigerants and po ...

and

diethyl ether Diethyl ether, or simply ether, is an organic compound with the chemical formula , sometimes abbreviated as . It is a colourless, highly Volatility (chemistry), volatile, sweet-smelling ("ethereal odour"), extremely flammable liquid. It belongs ...

have been used recreationally.

References

External links

* {{Chemical classes of psychoactive drugs Drug classes defined by psychological effects fr:Hallucinogène#Les hallucinogènes dissociatifs

Effects

Use

Medical use

Recreational use

See also

References

External links