Are There Dangers Associated Methoxamine Use?

Methoxamine is a pharmaceutical drug developed for the treatment of hypotension, or low blood pressure. It increases systolic and diastolic blood pressure in patients who experience low blood pressure due to spinal anesthesia, hemorrhage, reaction to medicine, complications from surgery, or physical trauma or tumors. Methoxamine affects blood pressure by increasing the heart’s pumping power and constricting blood vessels, also known as vasoconstriction.¹

Methoxamine belongs to the drug class of adrenergic and dopaminergic agents.² It is most commonly available in 20 mg doses in the form of an injectable solution. Doctors may alter dosage amounts, however, based on the presenting medical condition, other medications the person may be taking, the individual’s response to methoxamine, as well as their age, weight, height, and gender. Methoxamine can also be found under the brand name Vasoxyl.

Side Effects

Like many drugs, methoxamine comes with a list of side effects. Some side effects are uncomfortable but tolerable, while others can be life-threatening. Side effects of the drug include:³

Methoxamine has been illicitly sold online as a white powder since 2010.

The main psychedelic effects of the drug are hallucinations, depersonalization, and dissociation from the body.

How Methoxamine Is Abused

As of 2014, the World Health Organization had relatively little information about the recreational use history of methoxamine. Experts could not recognize any therapeutic benefit of using the drug recreationally and agreed that its presence on the streets posed a serious public health risk.

Hospitals across Europe and the United States have reported cases of methoxamine use that led to hospitalization and death. In Europe, 20 methoxamine overdose deaths and 110 nonfatal overdoses were reported in 2014. In most of these cases, people had drugs in their systems, such as alcohol, marijuana, MDMA, or cocaine, in addition to methoxamine.

As an illicit drug, methoxamine use varies. While exact recreational use information is unknown, the average dose taken ranges from 20 to 100 mg. People have reported snorting methoxamine as a white powder or dissolving it in water. The powder can also be placed under the tongue where it quickly enters the bloodstream. Other methods of consumption include swallowing a pill or injecting a liquid form of the drug. Use by injection poses the greatest risk for overdose, as well as contracting viruses such as HIV or hepatitis C due to sharing used needles.⁴

Methoxamine is thought to have effects similar to PCP or ketamine, though it is usually much stronger than these drugs and the effects last longer. Methoxamine, PCP, and ketamine are all known for their psychoactive and dissociative effects. Typically, it takes 10–15 minutes for the effects of methoxamine to be felt. It can take up to 90 minutes at times, however, leading people to consume more of the substance and increasing their risk of experiencing adverse side effects.

According to the U.S. Drug Enforcement Administration (DEA), there are a number of specific problems with these designer drugs. These drugs are made up of unknown ingredients, have no consistent manufacturing process, have no known safe dosage, have not been tested for human consumption, have unknown short- and long-term adverse effects, and have exponentially greater effects when combined with alcohol or other substances.

Addiction and Dependence

Because of the relatively short history of the drug, little clinical research has been done on the causes and risks of methoxamine addiction. Research has confirmed that psychological and physical dependence on ketamine, however, is possible. Because the two drugs are so closely chemically related, researchers and substance use professionals believe it is just as likely that someone can become dependent on methoxamine.

The high potency of methoxamine makes it a prime candidate for addiction. Addiction to drugs like ketamine and methoxamine is possible following a pattern of long-time regular use of the drug. The National Institute on Drug Abuse (NIDA) reports that compulsive drug-seeking behavior has been observed in individuals who regularly use dissociative drugs.⁵ Individuals who use ketamine have exhibited cravings and tolerance for the drug. Despite adverse consequences, individuals who use these drugs lack the self-control to stop use. The exact withdrawal symptoms of methoxamine are yet to be studied, but they are thought to be similar to the use of other drugs.

Research found that repeat ketamine use can lead to the formation of a quick and high tolerance of the drug. Large amounts of the drug were needed within a short period of time in order to experience any dissociative effects. Few physical withdrawal symptoms were reported by individuals who use ketamine.

Psychological dependence, however, is likely to occur in those who use ketamine. These individuals quickly developed an overwhelming urge to use the drug. Studies have found that they are unlikely to experience physical withdrawal symptoms, but do experience cravings and a high tolerance for the drug. Withdrawal symptoms observed in those who use ketamine were similar to the psychological withdrawal symptoms seen from cocaine, amphetamine, opiate, alcohol, and cannabis use.⁶

Common psychological withdrawal symptoms include:

• Anxiety.
• Insomnia.
• Irritability.
• Cravings.
• Mood swings.
• Depression.
• Concentration issues.

Treatment for Substance Use

There are not currently any medications approved for the treatment of addiction to dissociative drugs, like methoxamine and ketamine. Behavioral therapies have been proven effective for the treatment of drug addiction, though more research is needed for their specific application to dissociative drug use.

Because there are no physical symptoms associated with methoxamine withdrawal, it is possible to stop taking the drug all at once without tapering. The detox process can still be uncomfortable, though, with intense psychological symptoms consisting of cravings, anxiety, depression, and general emotional discomfort.

With no medical interventions approved for dissociative drug treatment, treatment focuses on behavioral therapies. Once through the detox process, behavioral therapies are used to help individuals gain a better understanding of the underlying causes of their drug use and develop positive coping skills for handling difficult situations following treatment.

Behavioral therapies that have been shown to be effective for the treatment of substance use disorders include:

• Cognitive-behavioral therapy (CBT).
• Contingency management interventions.
• Community reinforcement approach plus vouchers.
• Motivational enhancement therapy.
• The Matrix Model.
• Family and couples counseling.
• Group therapy.

Following completion of an inpatient, outpatient, or community treatment program, an aftercare plan increases one’s chances of maintaining long-term sobriety and preventing relapse. Aftercare plans may include continued participation in individual therapy, identification of community support groups, establishment of healthy daily activities, and establishing a support network.

Currently, relatively little is known about the long-term effects of methoxamine use. As an unregulated substance, the risks and side effects of the drug are difficult to predict. As a result, few treatment programs have been developed specifically for methoxamine use disorders. However, researchers and substance use professionals agree that methoxamine use poses many individual and community health risks that must be addressed appropriately.

If you or a loved one struggle with methoxamine use or any substance use or addiction, reach out to American Addiction Centers (AAC) to connect with a knowledgable admissions navigator, who can answer your questions, explain your options, and assist you in getting the help you need.