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Using ketamine with other drugs

Mixing drugs is never a good idea as the effects are unpredictable and, in the case of ketamine, potentially life-threatening. Ketamine is a depressant and mixing it with other depressants (such as alcohol, barbiturates, heroin etc.) may have the effect of completely suppressing respiratory functions – which means that you could stop breathing. Due to the uncertain interaction of ketamine with other drugs, it is always advised not to mix it with anything.

‘Bad trip' - what it is and what to do

A bad trip is a very extreme adverse reaction to ketamine. It may present as erratic, hostile and bizarre behaviour, feelings of panic and terror, paranoia or confusion. The effects of ketamine are highly variable and unpredictable, and have the potential to be quite frightening.

If someone is having a ‘bad trip’:

• Reassure and comfort the person until the effects of the drug wear off. This can take many hours and may not completely disappear for a couple of days.
• Move and speak calmly and confidently.
• Address the person by name to remind them who they are and tell them who you are. Do not leave someone experiencing a bad reaction to hallucinogens alone.
• Provide them with reassurance and a safe atmosphere.
• If you are unsure of your own or someone else’s safety, it is always best to seek medical advice and/or care.

Overdose – what it is and what to do

The term overdose is used to describe the ingestion or application of a drug at a dosage that is high enough to cause harm or result in death. Severe overdoses may cause respiratory depression, heart failure, coma, seizures and death.

As ketamine causes hallucinogenic effects that alter sensory perceptions and mental functioning, deaths under the influence of ketamine may also be related to suicide, accidents and dangerous behaviour. 

If someone has a serious reaction to using ketamine, it is important to receive medical attention as soon as possible; quick thinking and action could be the difference between life and death. If you find yourself in this situation:

• Call 000 straight away. Ambulance officers are not obliged to involve the police. 
• Stay with the person and perform CPR if necessary.
• Ensure the person has adequate space and air around them by keeping crowds back, opening windows and loosening tight clothing.
• If a person is unconscious, don’t leave them on their back. Roll them onto their side in the recovery position, by tilting their head back slightly to stop them from choking and making sure there is nothing already blocking their airway.
• Try and provide the ambulance officers with as much information as possible – what drug was taken, how much, how long ago and any pre-existing medical conditions of the user.

Mood, environment and personal factors

Like alcohol, personal factors such as weight, height, sex and general health all influence the way in which a drug may affect you.The setting in which you choose to take ketamine can influence the effect it will have on you.

It is best to use the drug in a place where you feel safe and relaxed to reduce the chance of anxiety attack or paranoia and as with all drugs have a close friend nearby in case anything goes wrong.

How you are feeling when you take ketamine can influence how the drug will affect you.  If you are feeling anxious or paranoid the drug may only enhance these feelings.

Methods of use

Be extremely careful – some methods of use have higher risks associated with them than others. One of the most dangerous aspects of using ketamine is the small difference between an amount that produces the desired effect and the amount that results in overdose. To be on the safe side, always take ketamine in very small doses and prepare it yourself with an amount you are comfortable with.

• Injected – Injecting drugs is associated with greatly increased risk to disease. Sharing needles, syringes and injecting equipment greatly increases the risks of contracting blood-borne viruses such as hepatitis B, hepatitis C and HIV.
  If you are going to inject obtain clean syringes from a needle and syringe program (NSP) or chemist. The Alcohol and Drug Information Service (ADIS) in each state should be able to provide you with the locations of NSPs within your state.
• Smoked - Smoking tobacco or cannabis mixed with ketamine can cause respiratory illness, lung cancer, stroke and many other smoking related illnesses.
• Snorting – Snorting drugs though shared straws or paper increases the risk of passing on all types of germs and infections including hepatitis C.

Tolerance and withdrawal

Tolerance refers to how people build up a resistance to a drug after prolonged use. This means that the person will gradually have to use more and more of the drug to achieve the same effects. At present, there is no evidence to suggest that ketamine is physically addictive.

However, like cannabis, people who regularly use ketamine may 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.

Driving

Ketamine is a depressant. This means it affects the central nervous system by slowing down the messages going between the brain and the body. Driving after using ketamine is dangerous because it slows down reaction times, affects coordination, affects your ability to concentrate, slows the processing of information and often causes confusion and impaired thinking.

As ketamine is also classed as a dissociative it can distort perception while driving. This means that you may see or hear things that are not actually there. Like driving under the influence of any drug, driving under the influence of ketamine is illegal.

Pregnancy and breastfeeding

Little is known about the effects of ketamine on the unborn child. As is the case with many other drugs and medications, it is recommended that people do not use ketamine while pregnant or breastfeeding. It is possible that the drug may be present in breastmilk and have adverse effects on the development of the baby.