Emerging new psychoactive ketamine analogues: patterns of use and health risks identified by the French Addictovigilance Network.
Salim Mezaache, Liselotte Pochard, Hélène Peyrière, Nathalie Fouilhé Sam-Lai, Joëlle Micallef
International Journal of Drug Policy July 1, 2026 DOI: 10.1016/j.drugpo.2026.105326 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective analysis Qualitative Peer reviewed |
|---|---|
| Sample size | 56 |
| Population | Individuals in France with reported cases involving ketamine analogues |
| Duration | 2017 to 2024 |
| Topics | Esketamine Ketamine |
| Keywords | Addictovigilance Chemsex Ketamine analogues New psychoactive substances Substance use disorders |
| Key points | Ketamine analogue use in France is increasing, with serious adverse effects including dissociation, impaired consciousness, and death, and unintentional exposure in chemsex contexts is particularly associated with distressing experiences. |
Abstract
Ketamine analogues are emerging dissociative substances structurally related to ketamine and increasingly detected on drug markets worldwide. This study aimed to characterize patterns of use, user profiles, and associated health outcomes in France. We conducted a retrospective analysis of cases involving ketamine analogues reported to the French Addictovigilance Network up to 31 December 2024. Substances of interest included 2-fluorodeschloroketamine (2-FDCK), deschloroketamine (DCK), N-ethyldeschloroketamine (O-PCE), fluorexetamine (FXE), and hydroxetamine (HXE). Cases were reported by healthcare professionals and reviewed by clinical pharmacologists. Data were extracted from the French National Pharmacovigilance Database and the DRAMES (drug-related deaths) registry. Fifty-six cases were identified from 2017 to 2024, predominantly involving 2-FDCK (52 %) and O-PCE (38 %). Most users were men (93 %), with a mean age of 32.1 years (range: 17-57). Adverse effects were mainly neurological and psychiatric, including dissociation and impaired consciousness. Serious cases accounted for 61 %, including 11 % deaths recorded in the DRAMES registry. Four user profiles were identified through qualitative analysis of case narratives: recreational experimenters, self-medicating individuals, regular users, and individuals unintentionally exposed to adulterated or substituted substances (e.g., sold as synthetic cathinones, cocaine or ketamine). Unintentional exposure, particularly in chemsex contexts, was frequently associated with distressing experiences. Ketamine analogue use is increasing in France, consistent with international trends. These substances pose significant health risks, potentially differing from or exceeding those of ketamine. Strengthened surveillance, improved analytical detection, and targeted harm reduction strategies are needed to mitigate their public health impact.
Comparable studies
Other observational and cohort studies on ketamine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Taming the Ketamine Tiger Volunteers from a prison population | 2010 | Observational study | n = 20 |
| Increased spontaneous MEG signal diversity for psychoactive doses of ketamine, LSD and psilocybin Humans | 2017 | Observational study | |
| Disruption of Frontal–Parietal Communication by Ketamine, Propofol, and Sevoflurane Surgical patients undergoing induction of anesthesia with intravenous ketamine | 2013 | Observational cohort | n = 30 |
| Do the dissociative side effects of ketamine mediate its antidepressant effects? Treatment-resistant inpatients with major depressive disorder or bipolar disorder | 2014 | Observational cohort | n = 108 |
| Concomitant BDNF and sleep slow wave changes indicate ketamine-induced plasticity in major depressive disorder Patients with treatment-resistant major depressive disorder | 2012 | Observational cohort | n = 30 |
Citations in the library
Cites 11
- From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs. Drug Testing and Analysis 2014
- A brief history of ‘new psychoactive substances’ Drug Testing and Analysis July 1, 2011
- Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017–2020: A Review Journal of Analytical Toxicology April 20, 2022
- Fatal intoxication related to two new arylcyclohexylamine derivatives (2F-DCK and 3-MeO-PCE). Forensic Science International July 1, 2021
- 2-Fluorodeschloroketamine has similar abuse potential as ketamine. Addiction Biology May 1, 2022
and 6 more in the library