Dissociatives

Non-competitive antagonism at the NMDA glutamate receptor, producing the anaesthesia the subject is named for: analgesia and sensory disconnection without the respiratory depression that defines the opioids, and amnesia towards the top of the range. Four scaffolds reach that site — the arylcyclohexylamines, the diarylethylamines, the dextrorotatory morphinans and the gases — and their potencies and durations are not comparable with one another. Several members also act at dopamine transporters, sigma or opioid receptors, so stimulant or opioid character is a property of the compound, not of the class.

DXM is a morphinan by structure and is filed here because the experience is dissociative. N₂O is here rather than under Inhalants: it is inhaled, but route is not a class. The class-level harms are loss of protective reflexes with vomiting, injury sustained while dissociated, additive depression with alcohol or benzodiazepines, and urinary tract damage with heavy sustained use.