Dissociatives: Ketamine, PCP, DXM, Nitrous
Ketamine is now an FDA-approved antidepressant. It's also a recreational drug with an emerging use disorder pattern. Both are true.
Body — 8 lenses: [Science: NMDA receptor antagonism (ketamine, PCP, DXM), nitrous as N2O NMDA + opioid. Biology: dissociation at moderate doses; K-hole at higher; ketamine bladder toxicity with chronic recreational use; B12 deficiency and neuropathy from nitrous. Psychology: dissociative experience; emerging ketamine use disorder pattern; the therapy/recreation confusion. Policy: ketamine Schedule III; esketamine (Spravato) FDA-approved for TRD; nitrous legal and lightly regulated; PCP Schedule II. Trends: ketamine clinics exploding; WhipIt+ canister culture; DXM abuse among adolescents declining. Social: the “ketamine therapy” wellness wave, Matthew Perry’s death and accountability. Treatment: ketamine use disorder — sparse evidence, harm-reduction-heavy approach. Harm reduction: nitrous B12 supplementation, ketamine urinary-tract monitoring, don’t mix dissociatives with depressants.]
Sources Cited
- 01.Ahttps://clinicaltrials.govClinicalTrials.gov
- 02.A
Filed Under
sciencebiologypsychologypolicytrendssocial-culturaltreatmentharm-reductionPeer-Reviewed Research
Keep up with the reporting.
One email each morning with the stories that put days like this in context.
Continue reading
More from this section
Getting High With Friends Is the Riskier Choice — If You Already Have a Problem
A September 2026 Addiction study of 104 adults found that using cannabis around other people amplifies craving and continued use, but only for those with more severe cannabis problems.
Science & MedicineThe Craving Doesn't Expire on Your Sobriety Anniversary
New EEG and animal studies show heroin cravings can be measured in the brain and persist more than a year into abstinence, challenging fixed-length treatment models.
Science & MedicineNitrous Oxide Deaths Rose Nearly 600% While Regulators Treated Galaxy Gas Like a Whipped-Cream Ingredient
A JAMA Network Open study of CDC data found US nitrous oxide deaths rose from 23 to 156 a year between 2010-2023. Researchers tie the spike to culinary-labeled brands like Galaxy Gas exploiting a regulatory gap.