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Summary

• Ketamine is a synthetic (man-made) drug which is used legally in medical settings as an anaesthetic and analgesic (pain-killer). It is illegal to possess ketamine without a prescription from a licensed medical professional in Australia.
• The chemical structure of ketamine is similar to that of PCP (phencyclidine – “Angel Dust”)
  and can therefore have hallucinogenic effects causing you to experience things that aren’t really there.
• Very little is known about the long-term effects of ketamine use but it has been suggested that memory, attention and vision may become impaired from long-standing use.
• Although ketamine is not physiologically addictive, people who regularly use ketamine may develop a psychological dependence, much like people who regularly use cannabis.

What is ketamine?

Ketamine hydrochloride (special K, vitamin K, K, kitkat, super K, Dorothy) is a pharmaceutical drug, used in medical and veterinary procedures as a short-term anaesthetic and analgesic (pain-killer). Like PCP, ketamine is a dissociative anaesthetic, resulting in changes to perception and feelings of isolation and detachment from one’s body.

First used as a recreational drug in 1965, ketamine is still used illegally, often for its psychedelic or hallucinogenic effects. Like other hallucinogens, ketamine works on the brain to distort the senses, causing you to experience sights, sounds, tastes and feelings that aren’t actually there. Ketamine can also cause hallucinations, and interfere with thought processes together with your sense of reality, time and emotion.

In addition, ketamine has a powerful effect on the body’s muscles, ranging from loss of physical coordination to temporary paralysis. Perhaps as a result of these effects, ketamine has been implicated as a drug used to facilitate sexual assault.

How does ketamine work?

Ketamine works by blocking nerve paths without completely suppressing respiratory (breathing) and circulatory functions.

What is the K-hole?

The “K-hole” describes the peak effect of a strong ketamine trip when a user's body is virtually paralysed, while the sense of self feels disconnected or removed from the body.

Classification 

While ketamine is essentially a “depressant”, due to its analgesic, anaesthetic and dissociative effects, ketamine also has some features common to stimulants. When used at high doses, ketamine behaves differently to most depressants, by stimulating the circulatory system and consequently increasing heart rate and blood pressure.

How is ketamine used?

Due to its anaesthetic nature, ketamine can produce wide ranging effects from thought disturbances, hallucinations and loss of primary senses to temporary paralysis and unconsciousness. It’s usually snorted, swallowed or injected. Ketamine takes effect over varying time periods depending on the method of administration.

• Ingested (eaten): Ketamine can come in pill form, or as a white powder that can be dissolved in water. When it is absorbed through the lining of the stomach, it produces effects in 15-20 minutes. On an empty stomach, effects may be felt within 5 minutes.
• Injected into the vein: When injected, ketamine takes effect within 30 seconds. Due to the speed of its effects, it is common to lose motor control before the entire dose has been injected. This is the most dangerous way to take ketamine, as it bypasses all the body’s natural defences by putting the drug directly into the bloodstream. It also increases the risk of blood-borne viruses (such as hepatitis, HIV and AIDS) and infections from using unsterilised equipment.
• Injected into the muscle: When injected into the muscle, the effects of ketamine are generally felt in less than 2 minutes.
• Smoked (often with tobacco or cannabis): Ketamine powder is combined with tobacco or cannabis in a hand-rolled cigarette.
• Snorted: Ketamine in powder form can be snorted up the nostrils. Doses usually range between 0.06 and 0.1 grams, and effects are generally felt within 5 - 10 minutes.   

How does ketamine affect you?

The effects of ketamine vary substantially across people, but have generally been described as including an initial cocaine-like “rush”, followed by a number of physiological and psychological symptoms.

Depending on dosage, effects can begin to occur anywhere from 10 seconds to 20 minutes, and last from 1 to 3 hours. The effects of ketamine will vary depending on:

• Your height and weight (smaller people need smaller doses)
• The amount taken (high doses may lead to unconsciousness, smaller doses to hallucinations)
• The method of administration
• The last time you ate (substances are absorbed more quickly into the blood stream when you haven’t eaten and so may affect you more)
• How much of the drug you have taken before – tolerance to ketamine can build up very quickly, with people needing increasing amounts to experience the same euphoric and psychedelic effects
• Whether you are taking other drugs – mixing drugs is always a bad idea as the effects are unpredictable, particularly with ketamine, as taking other sedatives or respiratory depressants (such as alcohol) may have serious consequences  

Immediate effects of ketamine

The immediate to short-term effects of ketamine use at low to moderate doses can include:

• blurred vision
• slurring of speech
• heightened sense of touch
• impaired muscle coordination
• euphoria and relaxation
• feelings of dissociation (being detached from the body)
• hallucinations and distorted sensory processing and distortion of time and space perception
• synesthesia (“seeing” sounds and “hearing” colours)
• disorganised thoughts, confusion and difficulty concentrating, thinking or maintaining attention
• anxiety, agitation, paranoia and feelings of panic
• increased heart rate and blood pressure
• breathing rate increased but shallow
• nausea and vomiting
• sweating
• reduced sensitivity to pain and numbness of the hands and feet

The immediate to short-term effects of ketamine use at high doses can include:

• drowsiness
• erratic, hostile and bizarre behaviour
• feelings of panic and terror
• paranoia
• depression
• amnesia
• anaesthesia
• muscle stiffness
• fever
• irregular heartbeats
• convulsions
• coma
• "near death" experiences
• risk of accidents due to change in pain perception

When ketamine is injected, the effects can include:

• collapsed veins
• infection, leading to amputation of limbs, damage to organs, stroke and even death
• sharing injecting equipment such as needles and syringes greatly increases the risk of contracting blood-borne viruses such as hepatitis B, hepatitis C and HIV (virus causing AIDS)

Effects of regular ketamine use

Very little is known about the long-term effects of ketamine use. Emerging evidence suggests that there may be memory, attention and vision impairment from long-term use. Additional research has reported mild schizophrenic symptoms several days after use.

Is ketamine addictive?

While tolerance to ketamine can build very quickly, with people needing more of the drug to experience the same effects, there is no evidence to suggest that ketamine is physically addictive.

However, people who regularly use ketamine can develop a psychological dependence. People who are psychological dependent on ketamine will experience cravings and feel compelled to use the drug in situations where they want to feel good or function at their best.

Ketamine and the law

Ketamine is a controlled substance in Australia, and it is therefore against the law to possess ketamine without a prescription from a licensed medical professional for medical reasons. It is also an offense to obtain or fill a prescription for ketamine by making false reports to medical practitioners, and to introduce drugs into the body of another person (drink-spiking).

There are both state and federal laws in place which provide penalties for possessing, using, making and selling controlled substances. These penalties will typically range from receiving a police caution and/or fine to jail time depending on where you are and how much of the substance you have on you.

Driving under the influence of any illicit drug is a criminal offense as hallucinogens such as ketamine can be particularly dangerous given the associated sensory changes that occur with use. Penalties may include loss of licence, fine and/or jail.