Ketamine is a dissociative anaesthetic and a synthetic depressant that acts upon the central nervous system. It has a number of legitimate uses in medicinal and veterinary fields, most commonly as a tranquiliser for horses, though it is also used as an anaesthetic for humans in some parts of the world.
Because of its dissociative effects, it has become popular as a recreational drug with predominantly young drug users. In low doses it may be used as a ‘club drug’ to induce euphoric and psychedelic states. In higher doses however it is reported to bring on an ‘out of body’ type experience in which the user feels detached from their own senses and their environment.
This latter state is often referred to by users as the ‘K-hole’, and may be accompanied by a hallucinogenic ‘trip’ and paralysis of the muscles. Though this intense period of the drug’s effects may only last between 1-2 hours, its influence is often felt for much longer, and may result in substantial impairment of senses and coordination.
Ketamine was first synthesised in 1962 as a replacement for the anaesthetic phencyclidine (PCP – which itself has also been abused). It is less commonly used as an anaesthetic for humans today, due to its dissociative effects, but it is still utilised by hospitals in some countries and in certain scenarios. The main source for the drug on the street therefore is vet clinics, from where it may be either stolen or illicitly acquired.
In its original form it is a clear odourless liquid usually contained within a small pharmaceutical bottle, but when used for recreational drug taking this liquid is often evaporated or boiled away to leave a white powder. In some cases it may then be pressed into tablet form and laced with other illegal drugs.
Ketamine is most commonly snorted through the nose, but it may also be taken orally, smoked with tobacco or injected intravenously. Unlicensed possession or sale of the drug is now illegal in many parts of the world.
Ketamine is used as a recreational drug in many Western countries, as well as in China and other parts of Asia. On the street it is known by a variety of names, including Ket, K, Special K, Vitamin K, Green, Kit Kat, Donkey Dust and Super K.
Its full medicinal name is Ketamine Hydrochloride, and it is bottled under a variety of names such as Ketalar, Ketaset and Ketavet. The street version of the drug is almost always derived from these legitimate sources, usually turned into a powder through the process of evaporation.
Its popularity as a club drug has grown in recent years. It is sometimes pressed into pill form and deceptively sold as Ecstasy (which would ordinarily contain MDMA), by itself or in conjunction with other drugs such as stimulants.
Ketamine is also sometimes mixed with cocaine, and sold by dealers under the name CK1.
Because Ketamine is a dissociative anaesthetic, users under the influence who have taken a high enough dose experience disconnection between their mind and their external senses. This in itself can be a major risk, causing them to become vulnerable to accidents and injury. There have even been deaths reported in which Ketamine users have drowned in the bath due to their reduced awareness of their environment.
Being in such a state of reduced awareness, and paralysis in some cases, also leaves users vulnerable to the actions of predatory individuals, and Ketamine has been used as a ‘date rape’ drug in the past.
Some users have experienced bad ‘trips’, similar to those experienced with LSD, during the primary phase of the drugs effects (the so called K-hole). Such experiences can induce extreme anxiety, nightmarish hallucinations and temporary psychosis. Individuals with pre-existing or undiagnosed mental health conditions may be more susceptible to these negative effects, and more profoundly affected by them.
Frequent use of Ketamine can lead to a persistently confused state of mind, anxiety, paranoia and depression. These can in turn lead to a greater risk of accidents, and severe interpersonal problems.
Particularly high doses of the drug can lead to dangerous changes in breathing and heartbeat, and when mixed with stimulants such as MDMA can lead to significantly increased blood pressure.
Long-term Ketamine use has been found to cause serious irreparable damage to the urinary system, which has led to some users having their bladders removed. Other bodily dysfunctions such as abdominal cramps have also been reported.
Finally, users who take the drug by injecting are at high risk of complications and infection, particularly if sharing needles.
Ketamine is artificially synthesised in a laboratory and has a legitimate purpose as a medical anaesthetic for humans and animals throughout the world. Thus it is produced legally by legitimate pharmaceutical companies, and it is these supplies that eventually reach the street through illegitimate means. Because of the relative complexity of the manufacturing process and the difficulty obtaining all of its chemical precursors, Ketamine is not produced in underground illegal laboratories or ‘home labs’ in the way that drugs like amphetamines are.
Though unlicensed sale or possession of Ketamine is illegal in many countries, it is not controlled by international law, and flows freely between borders. This leads to situations in which the drug is trafficked from countries with laxer controls over pharmaceutical sales, or higher levels of corruption, to nations with a tighter grip on their own domestic supplies. Its legitimate use as an anaesthetic makes it easy for criminal elements and smugglers to divert it for street use, while making policing the substance even harder.
According to a report on drugs by the United Nations Office on Drugs and Crime, 99% of global Ketamine seized in 2009 was in Asia. Between 2005 and 2009, the amount of illegal Ketamine seized in the region grew from 3,256 KG to 10,693 KG. In China, there have been unconfirmed reports of Ketamine-producing laboratories being dismantled regularly by the government.
India is also a major illicit supplier of Ketamine, with evidence that batches of the anaesthetic produced there are appearing on the streets of Europe, North America and other regions.
In the US, the drug is often smuggled across the border from Mexico, after either being stolen or diverted from hospitals and veterinary practices.
It’s important to clarify that in virtually all cases the drug is produced legally by legitimate pharmaceutical companies, before being acquired illegally by deception, theft or collusion. In some cases it is bought with fake pharmaceutical licenses and through impersonation of legitimate buyers, such as hospital procurement staff. In China in 2004, an official audit discovered that more than nine million bottles of Ketamine had vanished from legitimate channels within a year.
Once acquired through these means, the drug is usually prepared for street sale by evaporating or boiling the liquid anaesthetic to form a white powder. The Ketamine may then be sold illegally on the street of its country of its origin in its powder form, or pressed into tablets. Alternatively, it may be trafficked overseas via international organised crime and smuggling rings.
Sometimes a company is able to produce the drug legitimately with a license from their government, and then deliberately divert it to the black market for sale overseas. In India there have been instances where legal producers of Ketamine have been found to sell their product legally in domestic pharmaceutical markets, at the same time as increasing production to supply overseas markets illegally.
On a smaller scale, criminal gangs may break into local hospitals and vet clinics in order to steal their supplies of the anaesthetic.
Though it does not create a chemical dependence as with drugs like Heroin and alcohol, Ketamine can lead to a psychological dependence in which individuals use it as a way of escaping their life and its problems. Experiences with the drug are seen as a powerful source of pleasure by the user, and so its continued use is pursued.
In addition, over time users may build up a tolerance to certain levels of the drug, requiring them to take more and more to achieve the desired effect.
If someone is under the influence of a particularly heavy dose of the drug they may appear to be almost catatonic for a period of around an hour or more. With lower doses they may appear to be ‘not quite with it’, slur their speech and become highly accident prone. They may seem confused and act out of character, and even react to things that aren’t there as they hallucinate.
Frequent users may regularly exhibit a state of confusion, even when they have not taken the drug at that time. They may also appear depressed or emotionally disturbed. In common with many other drugs, regular Ketamine users may seem to be uninterested with daily life and be lax on mundane matters such as academic work or paying the bills.
In users who inject the substance, scars from hypodermic needles may be visible on the arms or other areas of the body.
Ketamine addicts may talk about the ‘K-hole’ – a state of being induced by large quantities of the drug, in which the individual experiences detachment between body and mind.
Ketamine is not known to be physically addictive, but there is a large body of evidence that suggests an intense psychological addition to the substance is possible amongst regular users of the drug.
Physical withdrawal effects from Ketamine are generally mild in addicts who quit, and may include increased tension and heightened anxiety, restlessness and occasional muscle spasms.
The psychological withdrawals may however be much worse, and present a substantial challenge to those wishing to break their dependence on the drug. In some frequent users, particularly those with emotional difficulties or difficult life circumstances, taking Ketamine becomes their way of dealing, or rather avoiding dealing with, the stresses of everyday life. Some crave the feeling of dissociation from their senses and their environment that the drug brings, and it is this intense desire to return to that state that can make addiction particularly hard to break.
Because the nature of the addiction is mostly psychological, a holistic approach to treating it is often used, taking into account not just the individual’s relationship to the drug, but also to themselves and their wider life. ‘12 step’ programmes similar to those used for alcoholism may be utilised to help the addict break free of their dependency on Ketamine.
Treatment for Ketamine addiction may be carried out either as in inpatient at a rehabilitation centre or as an outpatient attending support groups, therapy sessions and other activities designed to prevent relapse.
Talking and behavioural therapies such as Cognitive Behavioural Therapy (CBT) may form an effective part of a successful treatment programme.
Cognitive Behavioural Therapy can help the individual to determine the underlying reasons why they take the drug, and assist them in developing alternative behaviours for a healthier and substance free future.
In addition to formal therapies such as these, the user may attend informal support group meetings with people in a similar situation to them. In many cases this type of emotional peer support can be just as useful as more formal treatment methods, as it helps the recovering addict to see that they are not alone in their struggle, and that there are others like them who have already battled the addiction and won.
A comprehensive treatment programme for Ketamine addiction may also include more generalised lifestyle and health-based treatments, designed to foster a sense of increased physical and mental wellbeing. This can help prevent relapse, and provide a stepping stone to healthier and more constructive ways of living without drugs.
Whatever the exact treatment methods used to beat Ketamine addiction, the initial step will always be cessation of using the drug, followed by a short period of detoxification. At the same time or prior to this, an assessment of the individual and their addiction may be made by a drug rehabilitation professional, in order to determine the best treatment path for that particular person.
Depending on the level of addiction, continuing support and therapy may be needed for some time to ensure that the individual remains Ketamine free and does not fall back into old destructive behaviours.