Dissociatives Dissociative induced neurotoxicity in long-term users

[dopamimetic]

I did use deschloroketamine daily for 3 years. Don't tell me that was stupid, I know it but I was desperate for escape after the first serious breakup after 9 years of relationship, leaving me friend- and homeless in a foreign country. I remembered the solace DXM and MXE gave me and quickly found the back-then new deschloroketamine. Deliberately began using daily. Over these three years I had quite some adverse effects including auditory hallucinations, bladder irritation (mild), water retention in my legs and at some point stuttering which resolved itself despite continuing use. I simply didn't care and believed suicide were the only other way. Calculated from my orders I believe that I used maybe .75g a day. I was also using morphine during the later 2 years, and was all the time besides the last year on venlafaxine 150mg. The maybe most fucked up fact is that I got the morphine on legit doc's prescription after asking the local drug addiction clinic for something legal to replace my dissociative use. They only knew DXM and thought it was an opioid so I got offered methadone or morphine and thought these must be kind of the ultimate chemical pleasure so I accepted gladly. But in the end I just began consuming both drugs.

Now I am off any dissociative or opioid for 2.5 years with a brief relapse around the 1 year mark, used 5g DCK and then stopped again. Most of the adverse effects recovered themselves after weeks to months of abstinence but what I think remains is an exacerbated ADHD. I literally can't focus for more than 5 mins without getting distracted and am constantly switching between activities. I am living abroad and am desperate for learning Spanish but I just can't focus. Before the dissociatives I always had good marks and learning was easy.

Anybody else with a similar usage pattern of a dissociative, do you also suffer from side effects. I cannot be completely sure that it's the DCK to blame because of the other drugs involved but I think chances are that it is this way. Never heard of opioids exacerbating ADHD. But venlafaxine might have played its part, I also suffer from post-SSRI sexual dysfunction which seems to be related to low dopamine.

I remember reading a PubMed paper where they screened ketamine users for abnormalities in the MRI and found that people using at least .5g of K for 6 months or more had liquid-filled vacuoles in the brain. My usage was certainly above that level. Does this mean I should get a MRI? But what's the point in paying to know whether I have brain damage or not if there is no treatment?

 

[Isavelaa]

I think that DCK is much more toxic than pharma grade ketamine (r/s).

 

[Vastness]

Oh yeah dude, dissociatives are toxic as fuck. I'm reasonably convinced of it by now, but I'm also convinced that it's part of the brain damage (perhaps takes that phrasing a little hyperbolically) that dissociative use causes, that the afflicted individual is somehow not able to recognize fairly clear alert signals as to this toxic nature.

I've written a lot about my own usage, it's been heavier at times and it's been lighter, but I have done most of them, and I feel brain damaged. I can't solely attribute this general sense to dissociative use alone but... it's just so clear man, when I look back at my life... the association with dark times and self-sabotaging behavior that corresponded with heavy periods of dissociative use.

Ketamine has been the dominant one by far, never really got in to MXE until it was no longer widely available and therefore expense and irregular availability probably kept me away. Dabbled in the ~PCPs and the ~phenidines. But DMXE... and DCK... those are the peak of arylcyclodissociogenic substances that currently exist, if we forget about all the health stuff for a moment.

I kinda had a moment of clarity 9 months ago when on the tail end of a DCK binge I had a stimulant-psychosis type experience of imagining gangs invading my neighbours flat to kidnap or rob me, and even though I KNEW it had to be a total delusion I STILL thought I'd "just feel better" if I checked, said I thought I hard a noise and was just checking everything was alright, fuck me that would have been so strange. Anyway I knocked on like 3 of my neighbours in the end, just improvising my mad idea, and they were all out, so everything I thought I heard had been a total delusion.

Nonetheless... fuck me, it's got better but it is a struggle to care about anything enough to motivate myself to action that actually matters, a lot of the time. What can you do though? Hah. Anyway I've seen those studies too I believe, it's pretty clear that certain thresholds for even the mostly benign ketamine to induce lasting brain changes are not so unlikely. Equally - and somewhat harder to quantify - dissociatives are corruptive to emotional processing, and if this is maintained long enough, the associated neurological restructuring may be more difficult to reverse and lead to more complex cognitive changes that persist even beyond an apparent recovery by possibly quite crude scans.

I maintain - evidence for long term benefits of dissociatives for the dissociative state are nonexistent. Evidence for extreme, seemingly self inflicted harm is undeniable. Even if the "damage" is not a direct effect of the dissociative itself, certain patterns of usage could cause the user to inadvertently damage themselves.

I remember reading a PubMed paper where they screened ketamine users for abnormalities in the MRI and found that people using at least .5g of K for 6 months or more had liquid-filled vacuoles in the brain. My usage was certainly above that level. Does this mean I should get a MRI? But what's the point in paying to know whether I have brain damage or not if there is no treatment?

If you can afford the treatment easily, and you think it would be important in some way for you to know, then the point is removal of certain doubts by relatively scientific certainly (give or take) or becoming aware of something about yourself that may help you to understand yourself better. You may also find the knowledge profoundly unsatisfyiing in retrospect. But if nothing else, you could report the results here or somewhere, to add to the body of collective human knowledge in case it might be useful someday.

 

[dopamimetic]

Many thanks for your response @Vastness. It feels good to know that I'm not alone with this shit even when our symptoms seem to be pretty different. I definitely got bouts of psychosis from my disso use but it was mostly limited to hearing whispers in running water and fan noise where I was always conscious of stuff happening only in my brain. Also I get pronounced insomnia from any dissociative so I was skipping nights like they were for free. I think this contributed heavily to the symptoms but Idk what was responsible for the brain damage which I certainly have, it's like ADHD and when I'm stressed out I hear my own thoughts echoing in my brain which is pretty scary but I tell me that it's just in my head and it doesn't worsen so I stopped freaking out about it. The ADHD stuff is worse, I used to have an easy time learning new stuff but now I'm living in another country where Spanish is the primary language and I've tried countless times to do at least one exercise a day and it's so incredibly hard for me now to memorize new stuff and to keep focusing. Usually I keep distracting and switching between tasks literally every 2-3 mins. Need music to be able to focus at least a little while, and the music (fast electronic stuff) keeps distracting me as well. I also think I'm more poor in verbal fluency now but I don't know about this for sure, never been very good at knowing myself but with the ADHD stuff I'm sure. This wasn't there before.

But again to other factors. I already told about the opioid use which was pretty high, like 600mg/d of morphine high, but it is used so widespread that we would know if its use would lead to ADHD like stuff. Then we have venlafaxine on which I was dependent for 10+ years and quit soon after I quit the other stuff and I have post-SSRI sexual dysfunction now which is probably a dopaminergic issue which theoretically could cause ADHD, doesn't it? Mean ADHD is caused by low dopaminergic activity. I tried to get prescription stims but the docs are very wary about touching controlled substances here (fcking Mexico lol) and then there's the language barrier so I can't get any for now. I once got my hands on some prolintane which was sold in the clearnet but the local vendor doesn't restock it. It helped a fuckton. First and only times where I could work focused on the PC for hours. So I believe I might be suffering more from neurotransmitter disbalance than real toxicity as in dead brain cells but who knows for sure.

Yeah, I agree to that DCK is euphoric like the crack of dissociatives even when it lasts for a considerable amount of time. It isn't so different from MXE, at least not with tolerance. I think MXE was even warmer. These dissociatives are exactly like I always imagined an opioid to be, like a warm, cozy blanket. But also yeah, they compromise one emotionally. But opioids do so as well. I made a couple of really bad choices while on both, like lending a substantial amount of money to somebody I didn't know enough by far to do that, and driving without a license and intoxicated which of course backfired onto me. Thankfully I didn't hurt anybody. But I got off the dissos and stayed with morphine and venlafaxine for a year and continued to do stupid shit, less severe but still lacking self reflection to a dangerous degree so I blame the morphine maybe even more than the dissos.

At the moment I don't have any health insurance so I won't get a MRI or other evaluation done, I will probably try again to get stims but it sucks, my drive to do stuff is in the gutter right now and has been for quite a while. Initially the dissos were heavily stimulating in a calm way but this faded and left me depressed until the first few hours after a DCK dose. But again, I was also depressed right into tears out of nowhere kind with just the morphine (also had worse acoustic hallucinations with only morphine+pregabalin) so I'm not sure what to blame. But I definitely need to find a way to get more drive and focus. I acquired a bottle of Sabroxy which some compared to methylphenidate and it did absolutely nothing for me, and I took like 10 pills at once. I don't think it was bunk but also too expensive due to the only local reseller probably having to bribe the customs to get their stuff so I can't just try random nootropics like semax or 9-me-BC which I read good stuff about. I also tried unifiram and PRL-8-53 which both had zero effects as well. Somebody recommended sarcosine to me which helped said person after binges on MXE but given it seems to have inverse effects to the dissos (?) I'm not sure that would help me and not just cause worsened anxiety.

Hope you're well, thanks again!

 

[Thisisnew]

I've never had your level of use but I have used dissociatives quite a bit for almost 15 years now. For background, I've had periods of max 1-2 months of daily use (mxe, 3-meo, dmxe, fxe), very long periods (years) of 1-3x weekly, but also have had one couple year break, and have had many years where I only use a few times, or maybe a 3-5 day binge, every few months. Currently, I use on average 1-2x weekly, some weeks 3x and some weeks 0. I have tried most dissociatives, with the main ones being the ones listed above + dck. I exercise regularly, eat and sleep well, have a generally stimulating intellectual and social life.

I am somewhat familiar with what you're describing regarding the ADHD symptoms; for me, this normally lasts a bit after a binge. Sort of a scattered thought process, dispersed attention, inability to focus on a single thing. It's always gone back to normal. Granted, I've never used daily for three years, but my best guess is that it'll just take that much longer for it return to normal for you. I've also noticed DCK in particular makes me feel "dumb" compared to other dissociatives. I like it quite a bit, but I hate that the tail end of the experience -- which is probably twice the length of the main high -- has me feeling slow with lots of brain fog. I have no idea if this actually means anything with regards to long term effects of the drug, nor recovery from it, but figured I'd throw it out there.

To help with the ADHD, you could try practicing a concentration meditation. You can google it for various guides, but it's effectively training your ability to focus on a single object. It will probably be very difficult for you to start, considering you're asking to do your brain the exact thing it's having trouble doing, so look at it as a long-term thing to ease yourself into -- maybe try with just five minutes a day to start, and work your way up from there. IMO, this might be a better path to take than trying to throw more drugs at solving the problem, especially if you didn't have ADHD issues beforehand. Of course, probably goes without saying, but you should also be doing all the things that would be useful for brain health in any context: exercising, eating well, good sleep and sleep hygiene, socializing, challenging intellectual activities (learning a language is perfect), stuff like that.

I'd also highlight that while you now have had an extended break, your break still isnt quite equal to the period you were using. Additionally, you were using quite a bit -- 750mg/dck is frankly huge, I have 15 years of disso tolerance and my DCK dose in a day is probably like 150-200 -- and so, I guess I'm really just trying to say be patient and easy on yourself. It'll get better over time, just slowly.

I've also seen sarcosine recommended by some people for recovery after extensive dissociative use. I'd be curious for your experience if you try it yourself. I don't really have any good knowledge or first-hand experience, beyond knowing its an NMDA agonist, but I have read a lot of anecdotal experiences from people who have said it helped. It might be worth a try for a bit, considering it's low cost, but obviously do your own research.

Personally, the main side effect I've noticed over time is weird muscular pain/tightness. I am used to muscles tightening and relaxing while on dissociatives. I am also aware of the pain-killing effects of dissociatives, and how easy it is to sit in an uncomfortable position without knowing about it for however many hours, leading to tightness or the feeling of having "tweaked" something. With that said, I take great care when using with regards to sitting properly, hydration, not walking if too fucked up etc. Even still, I have had experiences where I've had long-lasting (weeks to months) muscle pain from using dissos. It is not a common occurrence, but sometimes I will use and a muscle will contract in a way that I can no longer get it to release. Afterwards, it doesn't "work right." It is almost like the mind-muscle connection has been severed during the dissociative experience. The few times this has happened have been absolutely terrifying -- honestly alien in a way, having a part of your body no longer respond like you're used to -- and has taken an insane amount of work (physical therapy, focused exercises) to get it to "fire" in the proper chain again. It is a significant enough side effect that if it continues or I otherwise can't figure out the cause of it, will probably lead to me stop using my DOC. I'd also be very curious if anyone else has had similar experiences to this.

Also, fwiw I have gotten a brain MRI and nothing unusual showed up. It's worth mentioning that it was for something unrelated, so they weren't really looking for disso-use damage or anything like that, but at least there was no damage egregious enough to catch the attention of the doctors.

 

[Vastness]

I exercise regularly, eat and sleep well, have a generally stimulating intellectual and social life.

Gods... isn't this just the answer to fucking everything? I'm not being sarcastic, I genuinely do believe it. I just wish it was the kind of "aha!" insight that most people don't already know, and could just be told to do... rather than something everyone knows is critical to physical and mental health, but STILL aren't doing because of some complex, mostly nonsensical self-destructive failure modes that evolution baked into our brains when retreating from these things was mostly just Not An Option and if you tried to, you wouldn't suffer long enough to even realise your mistake most of the time because something would kill you.

I used to be very active, health conscious, social, working in an area I felt appropriately competent and challenged in, and although I was always suspicious of ketamine and there is still some darkness lingering in some memories... my stance towards the dangers of dissociatives has certainly hardened since some unresolved shit finally hit a breaking point and the bottom seemingly fell out of the ship of my resolve to care enough about myself to keep making sure to do all that stuff... and then, of course... in that scary gloom of uncertainty and self-doubt, using any drug just to "feel better" - even though, god damn, why wouldn't anyone? Shit sucks sometimes - is just about one of the worst ideas imaginable and the entrance to a house of mirrors which is also a downward spiral of delusion and suffering.

Hmm, seems I cannot help being a little hyperbolic still, of course there's nuance everywhere and "feel better" drugs can indeed be therapeutic, it isn't a requirement that anything therapeutic (ie - likely to contribute to lasting positive changes that outlast the acute and after- effects of the substance itself) be frustratingly un-fun to take, and it's this weird attitude which in large part continues to corrupt the general cultural default outlook towards using drugs to solve problems, both in the legitimately medically trained and in the recreational or perhaps, self-medicating sphere, would be a better way to put it... it's an attitude that corrupts both sides of the spectrum of self-medicators, as the largely functional and careful ones with a mostly rational view of drug use still pick up on this overwhelming societal sense that any unprescribed drug use is shameful, thus noceboing themselves out of potential benefits... and it corrupts the other side, with a fairly irrational exuberance and rose-tinted view of everything, because they see the nonsense in the prevailing social attitude and throw several babies out with the dirty bathwater of stupidity, often pushing past the point of actual benefit and into clear and damaging overuse, adopting a viewpoint that is unbalanced enough to be mostly delusional...

Urgh... but anyway... I do feel the need to kinda backtrack just a little and provide some context for my recent extremely hard stance against dissociatives in particular... without going into too much detail I did have a pretty traumatic time that's induced a deep seated sense of generalized shame, and I had a kinda realization recently - after several years of therapy, I'll note, it was a gradual one, not like a sudden "aha! I'm cured!" realisation which is almost ALWAYS just a kind of temporary, disappointing upswing borne of long drawn out emotional instability, in my experience... anyway I had a realization after doing a little ketamine again after 9 months of abstinence because, fuck knows, confluence of factors, doesn't matter anyway, and feeling just really ashamed of myself afterwards - that actually, this sense of shame was not induced by any drug - it was pre-existing, has been ever present, and I think I've made some correlation/causation errors in my assessment of SOME of the damaging impacts of dissociatives, through not realizing this. The reasons for that sense of deeply rooted shame aren't things I really feel like getting into in detail but the usual suspects all apply, well-intentioned but ultimately damaging parenting techniques, various life stresses I wasn't really equipped to deal with but tried to just power through, most recently 15 years of having a best friend who I came to see was not really my friend at all... although my vulnerability to that is also somewhat a symptom of more nebulous childhood events that can be understood rationally fairly easily but can maybe never be completely unravelled since the root of this shame complex, inability to properly express anger except internally to myself, and whatever other shit has been going on in my brain probably begins before I really appreciated that I was even alive... certainly before I could think about these things abstractly in this way, anyway.

So... where am I going with this. Fuck, I always have a kind of urge to gaslight myself and downplay my own trauma when I say shit like this. I haven't had it that bad. I wasn't abused, really, wasn't raped, didn't experience war, I mean I did experience some prolonged and severe emotional abuse, I can acknowledge, but even saying that feels somewhat... weak... and shameful. Haha. So my point is kinda that the people who gravitate towards dissociatives and then start to exhibit the issues I've talked about as being actually induced by dissociatives, may in fact just be in a similar place, gravitating towards dissociatives to shut off this deep, all-pervasive sense of shame at being the person that they are. Or that I am, rather. And from that standpoint - who can blame anyone for it? Equally, from that standpoint - for people with a somewhat different complex of psychological dysfunction, dissociatives may not be quite as destructive.

Hmm... I kinda wanna backtrack on that again now because all the stuff I've said about dissos before (broadly - no evidence of long term benefit even in famous prominent users, lots of plainly obvious delusion and justification for continued use everywhere, blahblah) is still true. I do still think esketamine is not really any more suitable a candidate for treatment of depression than benzos are, for example... but... I dunno. I also worry myself a little even trying to soften my stance here a little because it can be justification to lapse back into old patterns... but then, you never cross the same river twice and all that. Some of these thoughts are no doubt psychological poisons leeching in from 12 step, once an addict always an addict, abstinence only, bullshit... huh I don't think I can finish this post coherently.

I guess I'll say what I'm still fairly certain about, ketamine is one thing, it's well studied, long history of human use, blah blah, but shortly after my weird DCK episode I had the insight that it is, surely a human failure mode of some kind to order substances with a clear risk of a high and generally unknown toxicity profile, manufactured in labs of completely unverifiable safety standards and... eat them, snort them, whatever. I mean that just seems a certain kind of ludicrously insane. Not that there isn't a way to do it with adequate precautions taken - and I don't really want to group together all non-arylcyclo~ novel psychedelics into that same category because I think the just should not be grouped generally and the risk profiles that should be assumed look, ratonally, quite different - and one class is just obviously worse. So... I think I'll be staying away from DCK, DMXE and the like for a lot longer. If I can keep a little K to once or twice a year that's probably fine too...

Just to bring this back to the first point I quoted above about exercise, socialising, all that healthy stuff, my god that's just so fucking important and the destructiveness and the dangers of all the aforementioned substances I blithely designated "Just Obviously More Dangerous" look very different if you just know that your life is going well, but it's exactly when it isn't of course that the "easier option" looks so much more tempting... but, this is obvious and the same with all substances really, I'm talking in circles now so I'll stop, just my 2c of ramblings on the topic.