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Some investigational compounds exist in both regulated clinical pipelines and unregulated street or online markets. Ketamine, psychedelics and cannabis are all under active clinical investigation while remaining accessible, in unregulated form, through illicit channels without clinician oversight. We propose the term parallel-access compounds for this category and argue that it deserves recognition in research ethics (see box 1). The most familiar examples are psychoactive, but non-psychoactive examples also exist: retatrutide, an investigational triple hormone-receptor agonist meant to be available only to trial participants, has nonetheless been illicitly manufactured and sold as a weight-loss drug.1