Ketamine
Also known As:
Special K, K, Ket, Vitamin K, Kitty, and Horse Tranquilizer.
What is it?
Ketamine is a dissociative anesthetic used in human and veterinary medicine to initiate and maintain anesthesia. Recently, the compound has been found to provide rapid, effective antidepressant effects in treatment-resistant patients with major depressive disorder. Recreationally, it is commonly insufflated (snorted), and sometimes injected intramuscularly (into muscle), smoked, or orally or rectally ingested to produce a dissociative psychedelic state. The drug is commonly used in the rave scene or by “psychonauts”—explorers of the mind—seeking out a “k-hole,” the name given to the intense dissociative state brought on by high doses (Lepra, 2019).
How does it work?
Ketamine blocks the n-methyl-d-aspartate (NMDA) receptors in the brain, which are normally activated by a chemical called glutamate. When activated, these receptors help send a signal down the brain cell (neuron), helping them communicate. When blocked by ketamine (or a related compound such as phencyclidine [PCP]), the resulting effect is a sense of separation with the body (dissociation) and sedation (Lepra, 2019).
When snorted, its onset takes 5 to 15 minutes and the total duration of the trip ranges from 45 minutes to an hour. After-effects (the “come down”) do not usually last for more than a couple of hours. When injected, the onset is much quicker and the duration shorter (around 30 minutes).
What does it look like?
In its pure form, ketamine is a clear to whitish crystalline substance with no odour and a bitter taste. It is available as a medical-grade solution for intravenous/intramuscular use, and more recently has been developed into an intranasal formula for use in treatment resistant depression in the United States and Canada. Street ketamine is often cut with other potentially harmful substances.
Is there a safe dose?
Under prohibition, there is no safe dose of ketamine because the drug is typically purchased illicitly. Illicit ketamine may be cut or contaminated with other dangerous substances, and the potency is typically unknown.
A common dose of ketamine (snorted) is around 30-50mg, frequently done over the course of small bumps at raves or parties. To K-hole, the rule of thumb is around 1mg/lb, which usually amounts to 100-200mg cut into several lines. If orally or rectally consuming ketamine, higher doses are needed (500mg or so to k-hole) due to much of the active drug being lost in liver metabolism (Lepra, 2019).
Illicit ketamine is frequently cut or contaminated with other substances; drug testing kits such as the Mandelin Test can give you a better sense of what is in a batch, but are NOT foolproof.
Effects
Desired Effects include (Lepra, 2019):
Disassociation (out-of-body experiences)
Euphoria
Dream-like closed-eyed and open-eyed visuals
Enjoyable cerebral and body high
Sedation
Relaxation
A sense of peace and calmness
Experiences of a mystical or spiritual nature
At higher doses (generally 100mg+, depending on body weight and tolerance), users reach an intense shift in perception colloquially known as a “K-hole”, an altered state characterized by extreme dissociation and realistic closed- and open-eyed visuals, sometimes resulting in profound spiritual experiences.
Side effects
Like any other drug, ketamine has negative effects. The likelihood and intensity of these unfavourable effects increases with the dose. Some of these include:
Negative Effects:
Nausea and vomiting
Nasal irritation/discomfort (if snorting)
Numbness at site of injection (if injecting intramuscularly)
Frightening hallucinatory experiences
Extreme dissociation/depersonalization
Loss of motor coordination (Ataxia)
Complete loss of consciousness at higher doses
Serious Risks:
Overdose: Ketamine is extremely dangerous to combine with central nervous system (CNS) depressants like alcohol, benzos or GHB
Death related to respiratory blockage
Accidents related to loss of motor coordination
Risk of psychological dependency, especially with heavy use
Disruptions in consciousness and neuroses or other mental disorders from frequent use
Severe urinary tract, kidney, and bladder damage with prolonged heavy use
If impure, the compounds used to cut street ketamine carry their own adverse effects.
(Lepra, 2019; DanceSafe, 2019)
Therapeutic uses
Ketamine is a dissociative anesthetic used to maintain anesthesia in human and veterinary medicine. Recent research has found some evidence that ketamine can provide rapid, effective antidepressant effects in treatment-resistant patients with major depressive disorder (Lepra, 2019).
Harm Reduction Tips
Start low and go slow. Street ketamine is often cut with fillers or other drugs which may change the effects of ketamine or be dangerous in small doses, such as the opioid fentanyl.
In case of a suspected overdose from opioid contamination, administer naloxone and call 911 immediately. Note that naloxone will not have an effect on ketamine overdoses.
Never use alone. If you must use alone, have a friend know how much you took and at what time, and have them check up on you in person or over the phone.
Use personal straws or rolled-up paper for snorting. Sharing straws can spread blood-borne infections like Hepatitis C, while rolled-up bills can spread infection-causing bacteria to your nasal cavities.
If injecting, use a sterile syringe every time (the entire rig - needle and barrel, plus other supplies). Never share syringes—there is a serious risk of contracting blood-borne illnesses such as HIV and Hepatitis C. Old used rigs can harbour bacteria and make you ill.
Avoid mixing other drugs with ketamine, especially alcohol. It is quite difficult to fatally overdose on ketamine alone, but when mixed with other depressants the risk of respiratory depression is increased dramatically and these drug cocktails can become deadly very quickly.
Weigh your doses: It is incredibly difficult to eyeball powders. Cheap scales are available from head shops—try to find one that goes to at least two decimal places.
If doing a large dose to k-hole, be in comfortable, familiar place. Prepare an area to rest after consumption. While in a K-hole it is dangerous and very difficult to move. Remain seated or lying down during the experience.
(Lepra, 2019; DanceSafe, 2019)
Legal Status: Use, Possession, & Distribution
Although esketamine (a form of ketamine) is under review from Health Canada and has been approved by the FDA in the United States, Ketamine is a Schedule I drug under the Canadian Controlled Drugs and Substances Act, in the same category as morphine, heroin, and PCP (Government of Canada, 2019). It is only legally available to medical or veterinary professionals. Possession of ketamine for recreational purposes is punishable by maximum 7 years’ imprisonment under Canadian law. Trafficking or sale for recreational purposes can be punished by maximum life imprisonment.
References
DanceSafe. (2019). Ketamine. Retrieved from https://dancesafe.org/ketamine/
Government of Canada. (2019). Controlled Drugs and Substances Act. Retrieved from https://laws-lois.justice.gc.ca/eng/acts/c-38.8/fulltext.html
Lepra, Mariel. (2019). Ketamine.
Image sources
Banner: Liquid ketamine. Teresa Crawford/AP/REX/Shutterstock. Retrieved from https://www.rollingstone.com/culture/culture-news/ketamine-esketamine-fda-depression-treatment-803901/
Ketamine pills. (2018). Psychiatry Advisor. Retrieved from https://www.psychiatryadvisor.com/home/depression-advisor/oral-ketamine-an-effective-sertraline-adjuvant-for-relieving-major-depressive-disorder-symptoms/