Ketamine is used officially as a tranquilizer for animals and for humans on rare occasions when other anesthetics are not appropriate or available, but on the black market, it is sold as a recreational, hallucinogenic drug. Called cat valium, K, vitamin K, special K, jet, lady K, kit kat, and other slang terms, the drug is classified by the federal government as a Schedule III drug, which means that it has a high potential for abuse as well as both psychological and physical dependence. Because it is a difficult drug to recreate in a lab, many who sell the drug on the street steal it from veterinarian offices or buy it from other countries.
Ketamine comes in the form of a white powder and in liquid form. Depending on the form and the personal preference of the user, it can be injected, sprinkled on top of tobacco or marijuana and smoked, snorted, swallowed, or inserted rectally. In both forms and no matter how it is ingested, ketamine can have serious and extreme physical effects on the user.
Many who have used ketamine report that the effects are akin to the effects of LSD and PHP, both hallucinogenic drugs. These hallucinations can last for up to an hour after they begin, but the other effects can last for up to 24 hours after last use of the drug.
Other physical effects of ketamine use can include:
- Slurred speech
- Lack of coordination
- Involuntary muscle contractions
- Lack of memory or blackout
- Higher blood pressure
- Increased salivation
- Extremely rapid heart rate, sometimes more than 100 beats per minute at rest
- A sudden loss of muscle tone while awake that results in loss of muscle control and weakness
- Uncontrollable, rapid eye movements
- Muscle tissue breakdown that can trigger a release of muscle fibers into the blood
- Increased urge to urinate
- Physical anesthesia, or insensitivity to pain
The psychological effects of using ketamine can be just as intense as the physical effects of using the drug. They can include:
- Lesser awareness of the environment
- Vivid dreams
- The feeling of being all-powerful or limitless
- Inability to focus or concentrate
- Chest pain
- Feeling as if in a dream-like state
- A feeling of disorientation
- Disinterest in talking or interacting with others
- Intense hallucinations
- Out-of-body experience
- Altered perception of time, environment, sounds, and body
- Impaired cognitive ability
These effects can last for up to a day after last use of the drug.
Method of Use
The way that ketamine is ingested can have a significant impact on the intensity of effects as well as how long it takes for those effects to begin and how long they last. According to the National Highway Traffic Safety Administration (NHTSA), the following may occur.
- When smoked: It can take just a few seconds for effects of ketamine to kick in when the drug is smoked.
- Via injection: The most rapid and intense effects are experienced when ketamine is injected. About 90 percent of the drug is made bioavailable within 1-5 minutes of injection, and the effects will usually last 30-45 minutes.
- When snorted: The effects of ketamine begin 5-10 minutes after ingestion when it is snorted, and it is estimated that 25-50 percent is made bioavailable using this method. Effects last from 45 minutes to an hour after snorting the drug.
- Via oral ingestion: Effects of ketamine usually begin 15-20 minutes after swallowing the drug with about 20 percent (+/- 7 percent) bioavailability. Effects last 1-2 hours after onset.
Mental Health Effects
- Anxiety and paranoia
- Symptoms similar to schizophrenia
Because it is a short-acting, many take repeated doses during a period of use, and effects – especially the mental health issues related to use of the drug – can last for days. Many experience intense dreams in the days following use of ketamine, and still others continue to experience dissociative effects of the drug, impaired memory, and schizotypal symptoms.
For those who take ketamine regularly and develop a physical tolerance to the drug as well as a psychological dependence, addiction can develop. Should the person suddenly stop taking the drug or abruptly cut their dose, they could experience withdrawal symptoms. Cravings as well as flashbacks generally define this experience. Like all other drugs of abuse that create an acute detoxification experience in the user, professional detox and supervision are recommended in order to ensure physical safety and mental health support.
Effects Caused by Combining Ketamine with Other Substances
In some cases, combining the use of ketamine with other addictive substances can have the effect of altering the physical, psychological, and mental health effects experienced. For example:
- Midazolam: The use of midazolam, also sold under the brand name Versed, can lessen the changes to perception often experienced by users of ketamine as well as the changes to their thought-processing abilities.
- Lorazepam: Using lorazepam, also known as Ativan, can mitigate the emotional distress experienced by some who take ketamine but will have no effect on the behavioral or cognitive issues expressed in users.
- Diazepam: The use of diazepam, or Valium, rather than diminishing the effects of ketamine can instead lengthen the half-life of the drug.
- Lamotrigine: Lamotrigine, or Lamictal, can limit the changes in perception often experienced by users of ketamine, but will increase the mood-elevating effects.
- Haloperidol: Haloperidol, or Haldol, may stop or limit the changes to executive control functioning often experienced by people who use ketamine, but none of the other symptoms of psychosis or schizotypal symptoms, even though it is often prescribed to treat psychotic disorders.
- Alfentanil: Also known as Rapifen, alftentanil can amplify the lack of sensitivity to pain and increase the effect of impairment to cognitive functioning.
Any or all of these substances may be used to cut ketamine, to alter the high experienced by the user by making it more or less intense in certain ways rather than others, but this is not something that is advertised to or known by the end consumer. Thus, people who use the drug in recreational situations, buying whatever is available at a party or a club, may be taking serious risks with their health and wellbeing, especially if they take these or similar medications regularly or are living with serious mental health issues that signify a co-occurring disorder even if undiagnosed.
Impaired Driving Ability
Another significant physical effect of taking ketamine alone or in combination with other substances is the negative impact its use has on the person’s ability to drive safely. Impaired cognitive processing as well as a decreased ability to make quick and safe decisions and avoid distraction all play a role in making it more difficult for the person to respond to oncoming traffic and pedestrians while behind the wheel. Even patients who are given the drug for the purposes of anesthesia during surgery (a safe and controlled dose under the supervision of a professional) are warned to avoid driving not only in the hours after surgery but for the next 24 hours or longer as it leaves the system. Similarly, those who take the drug for recreational purposes, whether by itself or in combination with other drugs of abuse, should be warned that driving while under the influence or in the days following use is a significant risk to oneself, passengers, and others on the road.
Though not a direct effect of using ketamine, it is worth noting that the drug is very often associated with sexual assault in club and bar settings. The National Drug Intelligence Center reports that because ketamine triggers rapid dissociative and sedative effects in the user, it has been put into the drinks of unsuspecting victims.
This is a serious crime and if you believe you have been drugged with ketamine and a crime has been perpetrated against you, it is important to undertake a drug test in a hospital or police setting within 48 hours of the event. The drug is metabolized quickly out of the body and may not be caught by drug tests after that point, but if it is caught and there is other evidence in support of a crime, the attacker could end up with a prison term of up to 20 years due to use of ketamine in the act of the crime.