What is ketamine used for?

Drug lexicon

Ketamine

Ketamine is an anesthetic that is mainly used in veterinary medicine and, under certain conditions, also in humans. It can greatly reduce the sensation of pain and cause unconsciousness.

history

Ketamine was first synthesized in 1962. A pharmaceutical company was looking for an anesthetic that would not affect heart rate or breathing. This should enable painless operations without ventilators.

One substance that was previously supposed to serve this purpose was phencyclidine (PCP). However, PCP had to be withdrawn from the market due to massive hallucinogenic side effects. The newly developed ketamine is structurally related to PCP and has similar, but less severe side effects compared to PCP. After waking up from the ketamine narcosis, patients experience hallucinations, are disoriented or have delusions. Because of these side effects, the use of ketamine is usually limited to emergency medicine and mostly in combination with a benzodiazepine.

Due to its special properties, ketamine was one of the most important anesthetics for US soldiers during the Vietnam War. Today it is used especially in countries and situations in which the necessary technical equipment for other anesthesia is not available. The World Health Organization (WHO) therefore puts ketamine on the list of indispensable drugs.

Because of its hallucinogenic side effects, ketamine is also abused as a narcotic drug. The first reports date from the 1970s. It is traded as Special K, Vitamin K, Kate or K on the illegal market.

Form of consumption and effect

When consumed as a narcotic drug, ketamine is usually snorted in the form of a white, crystalline powder. It is pulled through the nose with the help of a tube or a rolled up banknote. Smoking the crystals and splashing the liquid also belong to the forms of consumption. Ingestion as a liquid or in the form of tablets, however, is rather rare, as ketamine is quickly converted to norketamine with this form of consumption and the effect is less hallucinogenic.

Depending on the amount ingested and the form of consumption, unconsciousness can occur immediately after consumption. If ketamine is injected, the anesthesia starts within 30 seconds and lasts about 5-10 minutes. When sniffing, the effect usually occurs after a few minutes and lasts for one to two hours. However, the active ingredient content of illegally acquired ketamine powder is usually not known, which is why there is always the risk of overdosing.

At low doses, hallucinations occur and the perception of time and space is distorted. Higher dosages can be something called Near death experiences have as a consequence. Consumers are put into states that are supposed to be similar to dying: The feeling arises of leaving one's own body or merging with the environment, which is referred to as ego dissolution or ego dissolution of boundaries. Consumers come to a point where they feel completely detached from reality. The term "K-Hole" embossed.

Acute psychological risks

The strong changes in consciousness resemble the symptoms of a schizophrenic psychosis. Experiments have even been conducted under controlled conditions to investigate the psychotic effects induced by ketamine. For some users, the attraction of the drug is probably precisely the hallucinogenic effects and immersion in them "K-Hole". However, these extreme conditions can also trigger anxiety and panic attacks.

Memory gaps and blackouts can also occur, which is why ketamine, like GHB, have also become known under the keyword "knockout drops".

Acute physical risks

In medical use, ketamine is considered to be relatively safe, as overdosing usually does not cause serious problems. Still, there have been reports of deaths in which ketamine was found as the sole substance in the deceased. However, the details of these cases could not be clearly clarified.

Palpitations, nausea, and temporary inability to move are commonly reported side effects. The acute physical risks are, however, mainly characterized by a increased risk of accidents. On the one hand, consumers are severely restricted in their perception and mobility, and on the other hand, ketamine reduces the sensation of pain. For example, in one documented case, a person received third-degree burns from losing consciousness and falling face-to-face on an electric grill. Other cases have resulted in deaths from drowning or hypothermia.

Surveys with consumers also show that such accidents are not uncommon. In a study of 90 ketamine users, 13 percent said they had been involved in an accident as a direct result of the consumption. 83 percent of them knew someone who was injured while under the influence of ketamine.

Often, ketamine is also used with other drugs. The Mixed consumption of ketamine with alcohol, heroin, GHB or other depressant substances can affect the respiratory center, which can lead to life-threatening conditions.

Long term risks

Since the consumption of ketamine quickly leads to a development of tolerance, a dose increase is necessary with repeated consumption in order for the desired effect to set in. Previous studies indicate that daily consumers in particular have problems controlling their consumption behavior. Hence, ketamine becomes a relevant one Dependency potential attributed when it is used as an intoxicant.

The more often this substance is consumed, the more serious the consequences for memory, learning and perception. As a result of long-term consumption, impaired memory performance and neurological disorders have been observed in users.

Chronic consumption of ketamine is partly causing irreparable damage to the urinary tract. These primarily include diseases of the bladder and kidneys. Why regular ketamine consumption damages the urinary tract is still unclear, but those affected have very similar and, for them, highly stressful symptoms. These include frequent urges to urinate, painful urination, and blood in the urine.

Some people suffer from Incontinence, that is, they wet themselves uncontrollably. While symptoms in most cases subside after stopping use, the urinary tract can also be irreversibly damaged. Even in very young patients, the bladder had to be surgically removed in individual cases.

According to reports, some chronic users suffer from severe cramping abdominal pain. This leads to users taking more ketamine to get relief from the pain. It is still unclear whether this is related to liver damage in ketamine users.

Since ketamine puts a strain on the cardiovascular system, people with heart problems and high blood pressure are particularly at risk of heart attacks and strokes. This is especially true when other stimulant drugs such as cocaine or amphetamines are consumed.

Legal position

In Germany, ketamine is a prescription drug. This means that the strict requirements of the Narcotics Act (BtMG) do not apply. However, the illegal trade is subject to the provisions of the Medicines Act. Violations can be punished with a prison sentence of up to three years or a fine.

Swell:

  • Advisory Council on the Misuse of Drugs (2013). Ketamine: a review of use and harm. London.
  • EMCDDA (2002). Report on the risk assessment of ketamine in the framework of the joint action on new synthetic drugs. Luxembourg: Office for Official Publications of the European Communities.
  • Heinz, T. W. (1999). Ketamine abuse. New fashion substance on the scene. Deutsches Ă„rzteblatt, 96 (43), A-2724.
  • State Parliament of Rhineland-Palatinate (June 13, 2013). Small inquiry about abuse with the drug ketamine and others. (Anesthetic) as a drug.
  • Li, J.-H., Vicknasingam, B., Cheung, Y.-W., Zhou, W., Nurhidayat, A. W., Jarlais, D. C. D. & Schottenfeld, R. (2011). To use or not to use: an update on licit and illicit ketamine use. Substance Abuse and Rehabilitation, 2 (1), 11-20.
  • Morgan, C. J. & Curran, H.V. (2012). Ketamine use: a review. Addiction, 107 (1), 27-38.
  • Schifano, F., Corkery, J., Oyefeso, A., Tonia, T. & Ghodse, A. H. (2008). Trapped in the "K-hole": Overview of Deaths Associated With Ketamine Misuse in the UK (1993-2006). Journal of Clinical Psychopharmacology, 28 (1), 114-116.
  • Wang, C., Zheng, D., Xu, J., Lam, W. & Yew, D. T. (2013). Brain damages in ketamine addicts as revealed by magnetic resonance imaging. Frontiers in Neuroanatomy, 7, 23.
  • World Health Organization (2013). WHO Model List of Essential Medicine. 18th list (April 2013).


Information as of January 2014

All entries in the drug lexicon for the letter "K"