Ketamine is a dissociative drug in many parts of the world as an anaesthetic in both humans and animals, which is also frequently used recreationally thanks to its ability to produce a variety of effects in the user (which can vary significantly by dosage) including dissociative (“out of body”) experiences, trance-like states and hallucinations. Ketamine can be consumed orally or intravenously, though most recreational use is through snorting; it is typically available as a white powder though can be obtained in tablet or liquid form. Its effects are relatively short-lived, dependent on the quantity consumed: primary effects can last for up to an hour, while residual effects may be felt for a couple of hours after that.
Although it is not known for its stimulant properties, ketamine has enjoyed a good degree of popularity in the rave/dance subculture where it is often consumed alongside stimulants such as ecstasy to increase the intensity of the experience, as well as in the aftermath of parties when it is commonly used to stave off the “comedown” as other drugs wear off. It is especially popular amongst young people and can be found across the UK, including in rural areas thanks partly to its widespread availability as a medication for animals including horses.
Its dissociative effects, especially its impact upon motor control, mean ketamine is a factor in a number of accidents, while long-term ketamine abuse is associated with serious health conditions (both physical and mental).
Ketamine was first synthesised in 1962 in the United States, and within a few years was being used as an anaesthetic on American soldiers in Vietnam. At about the same time it began to be adopted as a recreational drug, spreading from the West Coast of the USA (where it featured in some prominent works of art and literature, helping to increase public awareness of the drug) out to the wider world. Its accessibility as a medicine created supply chains (from its primary production sites in Asia) which enabled it to become available to a relatively large number of suppliers and dealers, attracted by its comparative affordability and, compared with substances such as cocaine and heroin, its low profile and limited legal risk: ketamine was a Class-C – prescription-only – drug in the UK until 2014 when it was reclassified as Class B (the same as cannabis).
From the end of the century onwards, ketamine was established as a staple element of the UK’s recreational drug repertoire; around a quarter of drug users in the country admit to having taken ketamine over the past year, whilst in the population at large some 0.3% of Britons aged 16-59 used ketamine at least once in 2015/16 (down from 0.5% the previous year) according to the Home Office.
Ketamine is available as a branded medication under brand names including Ketalar; common street names include K; Special K; ket; Cat Valium; shards; powder; jet; horse dust.
People who have taken a very small amount of ketamine (“microdosing”) may not exhibit any outwardly noticeable signs of having done so; however, from small doses upwards ketamine produces increasingly obvious effects, until at large doses a user may effectively be paralysed until the drug wears off. Because of its popularity in the rave/club scene, ketamine is often taken in combination with other drugs which may have more prominent symptoms, so it’s worth bearing in mind that if a person appears to be under the influence of drugs their intake may have included ketamine even if you can’t identify any specific symptoms thereof.
Some symptoms associated with ketamine use include:
If a person consumes more than a certain quantity of ketamine (which will vary from person to person) they may enter a state known colloquially as the “K-hole”: extreme dissociation accompanied by (sometimes very intense and complex) visual and auditory hallucinations and frequently including partial or complete paralysis. The K-hole can be a hideously unpleasant experience, although some users state that they enjoy the sensation and seek it out during subsequent bouts of ketamine abuse.
Although as noted above the immediate effects of ketamine can be short-lived – especially compared with certain other hallucinogens – the long-term implications of use can be profound, with devastating impacts upon users’ physical and mental health. A greater understanding of these long-term effects and their ramifications both for individual users and for health and social services prompted the UK government’s reclassification of ketamine to a Class-B controlled substance in 2014, despite growing interest in the drug’s therapeutic qualities.
Over the last couple of decades, as ketamine abuse has grown more widespread and the consequences of long-term abuse began to be more commonly observed, the drug has become notorious for its catastrophic impact upon the urinary system, especially the bladder: symptoms are collectively known as “ketamine-induced ulcerative colitis” and “ketamine-induced vesicopathy” include incontinence, bloody urine, increased susceptibility to urinary tract infections and necrosis, and in the worst cases (of which the number is sadly growing) the user’s bladder needs to be removed and permanent incontinence results. The liver can also be damaged by ketamine abuse, as can the nasal septum and throat (from snorting). Users may experience long-term respiratory and pulmonary damage. The pronounced effects on a user’s motor control place them at much greater risk of accidents, including falls; meanwhile, their reduced ability to feel pain leaves them open to harm, such as burns, which they might normally be alerted to and hence avoid.
Ketamine has been seen to cause neurological damage in rats, although there is as yet no confirmation that this is replicated in humans. However, whether or not ketamine can cause brain damage directly, seizures and comas resulting from an overdose (as well as any concussive injury sustained in an accident) can certainly have such effects, with potentially profound implications for mental health.
In terms of psychological impact, even limited ketamine use can prove traumatic if the user experiences unpleasant hallucinations, schizophrenia-like effects and other consequences of the “K-hole”. While ketamine is being investigated as a potential treatment for depression, experiences whilst using the drug, as well as when withdrawing from it, can lead to or exacerbate depression in users (which, understandably, can be much worse if the user is suffering any of the more debilitating physical consequences of ketamine use). As with any addiction, dependence on ketamine can also lead to a diminution of the addict’s self-worth, while the brain’s chemical rebalancing during and after withdrawal means that a recovering addict may struggle to feel happiness and/or pleasure, potentially for quite some time after cessation of use.
It is possible to smoke ketamine – either along with tobacco in a “joint”, or in a pipe by itself or with other substances – but the effects tend to be relatively minimal compared with consuming it in other ways, and you may find the taste especially unpleasant.
Ketamine can cause death directly – for example, as a result of seizures during an overdose , or of users choking on vomit whilst unconscious – or indirectly: as noted above, its effects on a user’s motor control and coordination mean it can be a contributing factor in a variety of fatal accidents. If a user takes too much ketamine and enters the “K-hole” they may be temporarily paralysed and unable to escape, for example, a fire or even (if they fall face-first) drowning. Ketamine users suffering from depression (especially during withdrawal from the drug) may experience suicidal ideation which they might put into effect if they do not seek help. Intravenous users also run a significant risk of exposure to HIV/AIDS and other potentially fatal conditions.
Regular ketamine use has been shown to lead to a degree of dependence resulting in certain withdrawal symptoms – including tremors, palpitations and anxiety – manifesting within a day or so of cessation of use. It can be psychologically addictive, as users feel the need to keep taking ketamine to recreate pleasurable sensations and experiences – and, as the brain adjusts to the regular presence of ketamine, brain chemistry can be temporarily altered to the extent that chemicals associated with pleasure and happiness are no longer produced in quantities sufficient to avert feelings of depression in the user, who consequently craves more ketamine to return to a state of “normality”.