- Classification: Dissociative Anesthetic
- CSA Schedule: Schedule III
- Trade or Other Names: Ketanest, Cat, K, Special K
- Medical Uses: Anesthetic
- Physical Dependence: Low to moderate
- Psychological Dependence: Low to moderate
- Tolerance: Yes
- Duration (hours): <1 hour
- Usual Method: injected, intranasal, topical
- Possible Effects: high, dizziness, hallucinations, dream-like state
- Effects of Overdose: hallucinations, increased blood pressure, increased heart rate, nausea, vomiting, numbness, depression, amnesia
- Withdrawal Syndrome: double vision, hearing loss, increased heart rate, rapid breathing, loss of motor skills, loss of coordination, depression
Ketamine is part of a class named dissociative anesthetics. Before we start talking about this drug’s symptoms and warning signs of abuse, it is very important to clarify what dissociative anesthetics are.
Drugs such as ketamine, which were initially developed as general anesthetics for surgery, distort perceptions of sight and sound and produce feelings of detachment and dissociation from the environment and self. However, these mind-altering effects are not hallucinations. Ketamine is, therefore, more properly known as a “dissociative anesthetic.”
The dissociative drugs act by altering the distribution of the neurotransmitter glutamate throughout the brain. Glutamate is involved in the perception of pain, responses to the environment, and memory.
Origins of Ketamine Use
Ketamine was first introduced as an anesthetic agent in 1965 (Domino et al., 1982). It is classified as a dissociative anesthetic with a structure and actions closely related to those of PCP (Phencyclidine – anesthetic pharmaceutical drug) but produces less confusion, irrationality, and violence. Ketamine was used as a surgical anesthetic for children who presented negative reactions to other anesthetics, for battlefield injuries in which rapid onset is critical, and for repeated procedures such as chemotherapy and treatment of burns. It is also used in veterinary medicine, primarily to immobilize cats or monkeys. Its use in human surgery has declined with the introduction of safer, more effective products.
Ketamine gained popularity for abuse in the 1980s, when it was realized that large doses cause reactions similar to those associated with use of phencyclidine (PCP), such as dream-like states and hallucinations. Even though it was used for many years as an anesthesia adjunct (Ketalar®, Parke-Davis), in 1999 the DEA placed ketamine, including all of its salts, isomers, and salts of isomers, into Schedule III of the Controlled Substances Act (21 U.S.C. 801 et seq.). It continues to be sold in the U.S. as a veterinary anesthetic under the names Ketajet®, Ketaset®, and Vetalar®. Although it appears that Ketalar® is no longer sold in the U.S., it is widely sold in Europe and even offered for sale in the U.S. by Internet pharmacies. The synthesis of ketamine is complicated, and at this time obtaining the legitimate product, particularly from the burglary of veterinary facilities, is the only known source on the street.
Street users often refer to the drug as “K” or “special K,” and it is sold in powder, capsule, tablet, solution, and some injectable forms. Ketamine powder can be snorted like cocaine, mixed into drinks, or smoked. The liquid is injected, applied to smokable materials, or consumed in drinks. Its illegal use is associated with “acid house” music, which also makes references to other hallucinogens, such as LSD and MDMA. Less is known about the extent of the abuse and dangers of ketamine, although habituation can result in significant mental and emotional problems (Dotson, Ackerman, and West 1995).
This drug can produce a very wide range of effects, and users adjust the dosage depending on the desired effect. The drug’s effect can be influenced by body size, tolerance, the presence of alcohol or other drugs, the method of administration, and the setting in which the drug is consumed.
A number of studies are detecting alarming increases in the popularity of some very dangerous substances known collectively as “club drugs.” This term refers to drugs being used by young adults at all-night dance parties such as “raves” or “trances,” dance clubs, and bars. MDMA (Ecstasy), GHB, Rohypnol, ketamine, methamphetamine, and LSD are some of the club or party drugs gaining popularity. NIDA (National Institute on Drug Abuse) supported research has shown that use of club drugs can cause serious health problems and, in some cases, even death. Used in combination with alcohol, these drugs can be even more dangerous.
“Club drug” is a vague term that refers to a wide variety of drugs. Uncertainties about the drug sources, pharmacological agents, chemicals used to manufacture them, and possible contaminants make it difficult to determine toxicity, consequences, and symptoms that might be expected in a particular community.
Because some club drugs are colorless, tasteless, and odorless, they can be added unobtrusively to beverages by individuals who want to intoxicate or sedate others. In recent years, there has been an increase in reports of club drugs used to commit sexual assaults.
How Ketamine is Consumed
Ketamine is usually used intranasally or orally. It can also be injected, but the rapid onset of effects from oral or nasal use makes it more convenient and marketable than the injectable forms.
Each method of ingestion varies in the amount of time it takes to produce effects in the user:
• injection generally takes between 1 and 5 minutes;
• snorted ketamine between 5 and 15 minutes;
• oral ingestion between 5 and 30 minutes.
The hallucinatory effects of ketamine last approximately one hour or less, but the user’s senses, judgment, and coordination may be affected for up to 24 hours following initial use.
Effects of Ketamine
Short Term Use Effects
- Altered body image
- Pain at injection site
- Hearing loss
- Blurred vision
- Vivid dreams
- Impaired judgment
- Impaired attention
- Impaired memory
- Involuntary eye movement
- High blood pressure
- Rapid heart beat
- Excessive salivation
Long Term Use Effects
- Muscle rigidity
- Increased heart rate
- Increased blood pressure
- Vomiting and nausea
- Impaired cognitive functions