Use of these lab-made stimulants can be life-threatening and cause other serious health problems. The most frequently reported adverse effects are related to heart conditions and mental health. Heart-related issues include high blood pressure, heart muscle inflammation, irregular heartbeat and rapid heartbeat. Potential mental health challenges include anxiety, delusions, paranoia and depression.

DXM is a medication most often used as a cough suppressant in over-the-counter medicines. High doses of DMX from these medicines, whether acquired legally or not, can be damaging and dangerous. Short-term health effects can include slurred speech, increased heart rate and blood pressure, dizziness, nausea and vomiting. The use of high doses of DXM in combination with alcohol or other drugs is particularly dangerous, and deaths have been reported.

Ecstasy acts as both a stimulant and hallucinogen. Harmful health effects include increased heart rate and blood pressure, nausea, faintness, chills or sweating, and a sharp rise in body temperature that can lead to kidney failure or death. Longer-term impacts can include anxiety, confusion, depression, impulsiveness and problems with attention, memory and sleep. Limited research also suggests that using MDMA may be associated with mild or moderate heart valve disease.

Called “hallucinogens” because they can cause hallucinations—profound distortions in a person’s perception of reality—this category of drugs includes hallucinogenic mushrooms, ketamine (which is also available as a prescribed medication), LSD, MDMA (ecstasy), mescaline (peyote), PCP, psilocybin, salvia and ayahuasca. People under the influence of hallucinogens may have impaired thought processes and perception that cause them to behave in unusual or dangerous ways, and some people may feel extreme emotions such as fear, confusion or panic.

Short-term physical effects can include elevated heart rate, increased blood pressure, nausea and vomiting. People who use hallucinogens also may develop an uncommon disorder called hallucinogen persisting perception disorder, with life-disrupting flashbacks that mimic the experience of being under the influence.

Ketamine has hallucinogenic properties and has some accepted medical uses by prescription, such as for short-term sedation and anesthesia or treatment-resistant depression, but unhealthy (nonmedicinal) use of this drug can lead to dependence on the drug and harmful physical and mental effects. Short-term physical effects include hallucinations, confusion, memory loss and raised blood pressure. Overdoses can cause unconsciousness and dangerously slowed breathing. Long-term usage can result in ulcers and pain in the bladder, kidney problems, stomach pain, depression and memory issues.

Kratom is from a tropical tree native to Southeast Asia. Consumption of its leaves produces both stimulant effects in low doses and sedative effects in high doses—and can lead to psychotic symptoms and physical dependence on the drug. Long-term health effects include anorexia, weight loss, insomnia, skin darkening, dry mouth, frequent urination and constipation. Withdrawal symptoms can include muscle aches, insomnia, hostility, aggression and emotional changes.

Xylazine is a drug used in horses and other animals for sedation, numbing and muscle relaxation.  Although xylazine has no approved medical use in humans, it makes its way into human consumption by being mixed with other drugs. Xylazine can cause deep sedation, blackouts, loss of consciousness, and decreased breathing, blood pressure and heart rate. It also can cause severe skin wounds that spread and worsen quickly.

Unfortunately, you cannot tell whether a substance contains xylazine by how it looks, tastes or cooks. The only way to make sure you will not be harmed by xylazine is to avoid using nonprescribed drugs. If you are using these drugs, however, there are ways to reduce your risk of harm from xylazine.