Ketamine Addiction

Ketamine Addiction

Ketamine Addiction

Ketamine AddictionKetamine is a hallucinogenic drug similar to PCP and LSD, but it does not have as bad a reputation as its two cousins because the majority of those who used it first were doctors, nurses and other medical professionals in the 1960s. Later it became popular among intellectuals and university students seeking enlightenment.  Although the drug has the potential to make people violent and psychotic in the same way PCP and LSD do, ketamine was never as widely used, and the people who did use it tended to do so under controlled situations and were not likely to cause trouble for police and other authorities.  By the late 1970s, as it became more popular at dance clubs and raves, the drug gained a more troublesome reputation.[i]   Today there is a cult around ketamine, with its enthusiasts wearing t-shirts or hanging posters with images of Special K cereal, Kit Kat candy or bands associated with the drug. It has also become popular with high school students.

Ketamine is by no means a benign drug.  Those who repeatedly abuse “Special K” can become addicted to the K-hole lifestyle, and risk damage to their livers, kidneys, bladders and even their brains.

What is Ketamine?

Ketamine is a manmade drug used as an anesthetic in both human and veterinary medicine. As a recreational drug, Ketamine is abused as a hallucinogen in the same way people abuse lysergic acid diethylamide (LSD) and Phencyclidine (PCP).  Ketamine is very similar to PCP, but PCP is ten to 50 times stronger.[ii]

Researchers at Wayne State University first synthesized Ketamine in 1962, and medics used it on the battlefields of Viet Nam until the mid-1970s.[iii] Ketamine does not induce a state of unconsciousness for surgery, but rather relaxes the patient and produces a dissociative state in which the person feels no pain. Today it is used mostly on pediatric patients or in veterinary medicine. Drug companies manufacture ketamine for medical uses in the United States as a liquid packaged in vials, but illicit drug dealers evaporate the liquid to form a powder sometimes put into capsules.[iv]  Illegal ketamine usually comes in small packages of white powder that cost about $25 each, but it is sometimes sold as tablets or vials.

The chemical name for Ketamine is (RS)-2-(2-Chlorophenyl)-2-(methylamino) cyclohexanone.rf e h rst fu f[v]

What Is the Legal Status of Ketamine?

The United States classifies ketamine as a Schedule III Controlled Substance, which means that although it has potential for addiction, it can be used for medical purposes under a doctor’s supervision. Schedule III drugs are not as tightly controlled as Schedule I or Schedule II, but nevertheless you may face heavy fines and jail terms if you are caught possessing, selling, or otherwise dealing in ketamine. Ketamine is illegal even for medical purposes in United Kingdom, and is a Class I Controlled Substance in Canada.[vi]

How Does Ketamine Work?

Ketamine acts on the glutamate receptors, blocks the uptake of dopamine, and inhibits cholinergic transmission. Glutamate is an amino acid that serves as a neurotransmitter. Dopamine is a chemical associated with sedation and feeling pleasure, so as dopamine levels increase, so do feelings of euphoria and relaxation.[vii] Ketamine acts in the brain and central nervous system, and it is not a narcotic.

What are the Medical Uses of Ketamine?

Ketamine is an anesthesia for surgeries or procedures that do not require muscle relaxation. It works best for short procedures. Nitrous oxide, barbiturates and diazepam (Valium) sometimes supplement ketamine, but it is not a good idea to mix the drugs in the same vials during a procedure.[viii] Doctors or surgical nurses usually inject ketamine in offices, clinics or hospital situations. Ketamine liquid should be discarded if it is cloudy or discolored.[ix]

The usual dosage is 0.5mg to 2mg per pound of body weight. The 2mg dose produces five to ten minutes of anesthesia, but it can also be repeated, using a micro-drip system.[x]

In the late 1960s and 1970s, studies of ketamine tended to be negative and focused on the brain damage that could occur if it is used for surgery on children or if it is abused as a street drug. Today drug studies are increasingly positive and focusing on medical uses for hallucinogens and marijuana, partly because certain interest groups want them legalized.

A very recent study published in the Archives of General Psychiatry by Dr. Carlos Zarate, Jr. found that ketamine reduced symptoms in bipolar patients who had not responded to lithium. The ketamine group had fewer symptoms for three days after injection, compared to those who received a placebo. However, the study was small – only 18 patients.[xi] Another small study also published in the Archives of General Psychiatry found that ketamine reduced feelings of despair in severely depressed patients for several hours, and for some of them, the effect lasted for a week.[xii] A study from Stanford University, presented by Dr. Stephen Peroutka before the American Association for the Advancement of Science found that drugs like ketamine and PCP damage the brain, but also protect the brain during heart attacks or strokes, when blood loss to the brain leads to the death of brain cells.[xiii]

People with a rare condition called Complex Regional Pain Syndrome have been able to find some relief using ketamine. These patients who suffer from unbearable but untreatable pain reduced their symptoms for three to six months after going into ketamine-induced comas.[xiv]

One researcher at the University of Maryland got into trouble when she administered ketamine to hospitalized patients with schizophrenia, after authorities found that the consent form used was not specific about the dangers of the drug, including an increased risk for suicide.[xv] Ketamine research has a checkered past – researchers once used it to induce psychoses in patients with schizophrenia.[xvi]

What are the Side Effects of Ketamine during Medical Uses?

Even at low doses, ketamine produces a dream-like state and can cause hallucinations.  When used for medical reasons, ketamine can cause drowsiness that lasts 24 hours or more, mental and behavioral changes, moodiness, and confusion.[xvii] Other typical side effects are unusual thoughts, extreme fear, and double vision. Physical effects can be elevated pulse and blood pressure, depression of respiration, nausea, vomiting, and involuntary eye movements.[xviii]  The following side effects can be serious: difficulty in urination, fainting, irregular heartbeat, hallucinations, and pain or swelling at the point of injection.[xix]

About 12% of patients who receive ketamine under medically supervised situations develop emergence reactions that include hallucinations and delirium. These patients can be difficult to handle, even for medical professionals.  Most of the time emergence reactions can be prevented by using other drugs with ketamine such as diazepam. People under 15 years old and over 65 years old are least likely to have emergence reactions.[xx]

What are the Effects of Ketamine When It is Abused Recreationally?

People administer ketamine to themselves at higher levels than doctors do during procedures.  At these high non-therapeutic levels, ketamine produces a dreamlike state, feelings of invulnerability, hallucinations, disorientation, out-of-body experiences, lack of pain sensation, and anesthesia.  Other effects can be flashbacks, dystonia, seizures, delirium, chest pain, high rate of heart beat, rigid muscles, violent actions, loss of coordination and cataplexy.[xxi]

People who abuse ketamine are trying to achieve alternate states of consciousness called the “K-Hole” or “K Wonderland.” This is sometimes described as a feeling of oneness with God and includes a distorted sense of time, space, colors and self. They usually have to inject 60 mg to 100mg into veins or at least 2mg per kilogram of body weight to achieve that. The higher the dose used, the more likely a person is to enter a coma and die.[xxii]

Ketamine takes 30 seconds to produce effects if it is injected, and 20 minutes when taken by pill.  A ketamine-induced psychosis can last four to six hours.[xxiii]

What Drugs Interact with Ketamine?

Ketamine is supposed to be used under medical supervision when doctors will not allow it to interact with other drugs. Most harmful drug interactions occur when people are abusing ketamine and taking it along with alcohol, marijuana or other drugs.

Which People Should not Take Ketamine?

Ketamine is used legally under such closely supervised medical situations and for such short periods of time that this is not usually a problem. In general, it is not administered to pregnant or nursing women, and the elderly are more sensitive to its effects.[xxiv]

People who have histories of mental illness or drug abuse would be at above average risk for addiction or psychosis when they experiment with ketamine for recreational reasons.

What are the Risks of Taking Ketamine?

The most troubling risks of taking ketamine are psychological dependence, brain damage, allergic reactions, and overdoses.

People who get involved in a “ketamine” lifestyle often finds it interferes with their everyday lives, in that they become preoccupied with taking mind-expanding drugs and achieving their next drug-induced experience instead of seeking experiences and relationships in real life. They have trouble expressing their mystical adventures to others and increasingly isolate themselves either by taking drugs alone or with a few people. This is the introverted kind of person addicted to hallucinogens.  The other kind of ketamine abuser takes the drug along with illegal drugs, prescription drugs or alcohol, and is a person who is just into a drug-oriented lifestyle.

You can develop a tolerance to ketamine so that after a while, you need to keep increasing the amounts in order to achieve the dissociative state you desire. This puts you in danger of overdosing.

Not everyone who uses ketamine has a happy transcendental experience.  Many become paranoid and violent, and experience panic attacks or profound anxiety.[xxv] In an interview with the British Broadcasting Corporation, Dr. Susan Blackmore described her unpleasant experience with ketamine in which she was unable to move or think for many hours.[xxvi]

Some research indicates that ketamine may cause brain damage.  In 1989 Dr. John Olney could produce reversible brain damage in laboratory animals by administering ketamine.[xxvii] Laboratory animals that were four years old in human terms suffered brain cell death after being exposed to ketamine, and five-day-old monkeys developed cognitive problems after a similar exposure. These and other studies have led pediatricians to perform more procedures on young children all in one day rather than to use ketamine multiple times.[xxviii]

A June 2007 study published in the Hong Kong Medical Journal found that ketamine can cause liver, bladder and renal damage.[xxix]

A 2011 study found that ketamine users developed “ketamine-induced vesicopathy,” a condition characterized by urinary tract toxicity, decreased bladder volume, overactivity of the detrusor muscles, and blood in the urine. The only way to cure it is to stop using ketamine.[xxx]

People who abuse ketamine as a street drug run the risk of injecting themselves with unsafe fillers, such as talcum powder.[xxxi]

Some people are allergic to ketamine and will enter anaphylaxis or a life-threatening syndrome that includes hives, rashes, swelling of the face and lips, shutting down of the throat, wheezing, inability to breathe, fast heartbeat, and other symptoms. Without medical treatment, it is possible to die from anaphylactic shock.

Does Ketamine Show up on Urine Tests?

Ketamine does not usually show up in standard urine tests given at work or schools, but it can be detected in expanded tests for two to four days after taking it.

What is a Ketamine Overdose?

One study found that twelve people died of ketamine overdoses from 1985 to 2005.  One gram can be fatal.[xxxii]

Symptoms of a ketamine overdose are loss of consciousness, severe slow or shallow breathing, vomiting, convulsions, and inability to move or speak. There is no antidote for ketamine overdoses, but doctors at emergency room facilities usually open the person’s airways and administer benzodiazepines for seizures.[xxxiii]

What is Ketamine Withdrawal?

Ketamine does not necessarily cause a physiological withdrawal syndrome. However, it is considered an addictive drug because it produces other symptoms of addiction, including psychological dependency, tolerance, and drug-cravings. People who repeatedly use ketamine and other mind-expanding drugs can get to the point where these drugs are the most important thing in their lives, and they become preoccupied with obtaining and using them. It is hard for them to recover from their psychological dependencies without professional help.  Ketamine loses its power to produce a dissociative state if used repeatedly, and therefore people keep increasing the amounts they take until they are in danger of overdose. This is a sign of addiction.

What is Ketamine Addiction?

The 2011 Monitoring the Future Study, an annual survey of 50,000 high school students, found that 0.8% of eighth-graders and 1.7% of high school seniors have experimented with ketamine. Only one percent of the people who enter drug treatment facilities are addicted only to hallucinogens; the majority of the people who do abuse hallucinogens are polydrug abusers, which means they also are using drugs like alcohol, marijuana or heroin along with ketamine and its cousins. They enter drug rehab for polydrug addictions.[xxxiv]

Ketamine abusers inject it, snort it, put it into drinks, smoke it with marijuana or swallow it in pill form. The pills often contain Ecstasy as well.  Criminals can use ketamine as a date rape drug because it causes amnesia.[xxxv]  About 80% of the ketamine used in the United States comes from veterinary supply stores in Mexico where it is legal to buy the drug over-the-counter. The other 20% is mostly bought through illegal stores on the Internet or from drug smugglers.[xxxvi]

Street names for ketamine are Kit Kat, Cat Valium, Vitamin K, Ket, Jet, Special L.A. Coke, Super Acid, Super C, and Green K.[xxxvii]

What Treatments are Available for Ketamine Addiction?

People enter treatment for addictions to mind-expanding drugs once they realize that taking and obtaining drugs has become the most important thing in their lives to the detriment of their ambitions and their relationships with others. They no longer want to spend so much time and energy getting and obtaining drugs illegally, putting their finances at risk to buy drugs, risking problems with legal authorities, ruining relationships with friends and family members, and letting life pass them in terms of their careers and goals.  Drugs affect every aspect of their lives, and therefore the state-of-the-art treatment is about addressing every aspect of the person’s life or treating “whole person.”

A residential drug treatment center will offer a person addicted to drugs an opportunity to get away from his current environment and live with others struggling with the same problems within a therapeutic community. Staff members would include psychologists, psychiatrists, nutritionists, experts in physical fitness, art, and music therapists, career counselors, family counselors, recreational directors, and others specializing in the helping professions.

A typical day at a residential treatment center allows for hours of self-exploration through individual psychotherapy, journaling, creating art and music, and exploring career goals and current relationships within a therapeutic situation. You might also attend classes in the chemistry of drug addiction and how to avoid relapses once you return home. Your program should have plenty of hours of fun scheduled into it, including outings to local attractions, outdoor sports, parties, and nature study. You should be able to discover a new direction for your life, even if that means entering a new career path for yourself or dropping unhealthy relationships.

Once you return home, you continue in individual and family counseling, and you probably will attend self-help support meetings in your community.

Certain studies have shown that the longer you remain in a residential treatment center, the more likely you are to have a complete recovery.[xxxviii]

How Can I Tell if I am Addicted to Ketamine?

Consider the following questions in an honest way. If you can answer yes to any one of them, it may be time to approach your family physician or an addiction specialist at a drug treatment center about your problem with drugs.

  • Have you used ketamine alone more than once?
  • Do you have trouble explaining your mystical experiences or otherwise relating to people who are not involved with drugs?
  • Are your experiences with ketamine or similar drugs the most important thing in your life?
  • Do you think you spend too much time and energy thinking about and obtaining drugs like ketamine?
  • Do you worry that you will get trouble with the law because of your drug use?
  • Have you already got in trouble with the law because of your drug use?
  • Are your relationships with family or other loved ones suffering because you use drugs?
  • Do your family members or other loved ones criticize you because you use drugs?
  • Do you have trouble going more than a day or two without using drugs?
  • Have you tried to stop using drugs on your own?
  • Do you ever experience flashbacks from ketamine?
  • Have you built up a tolerance to ketamine in the sense that you need more to achieve the effects you want?
  • Do you think your career or educational opportunities would expand if you did not use drugs?
  • If money were no object, would you check yourself into a drug rehabilitation center?

[i] Emmett, David and Graeme Nice. Understanding Street Drugs. London: Jessica Kingley Publications, 2006, pg. 128.

[ii] “Ketamine: Fast Facts,” The United States Department of Justice, posted at http://www.justice.gov/ndic/pubs4/4769/index.htm

[iii] Porrata, Trinka. “Ketamine,” Project GHB, posted at http://www.projectghb.org/ketamine.htm

[iv] “Ketamine,” Parents the Anti-Drug, posted at http://www.theantidrug.com/drug_info/drug_info_ketamine.asp

[v] “Ketamine,” The RX List, see http://www.rxlist.com/ketamine-hydrochloride-drug.htm

[vi] “Ketamine: Fast Facts,” The United States Department of Justice, posted at http://www.justice.gov/ndic/pubs4/4769/index.htm

[vii] “Club Drugs, Revised July 2010,” The National Institute of Drug Abuse, http://www.drugabuse.gov/publications/drugfacts/club-drugs-ghb-ketamine-rohypnol

[viii] “Ketamine: Indications and Dosage,” the RX List, see http://www.rxlist.com/ketamine-hydrochloride-drug/indications-dosage.htm

[ix]“Ketamine,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/cdi/ketamine.html

[x] “Ketamine: Indications and Dosage,” the RX List, see http://www.rxlist.com/ketamine-hydrochloride-drug/indications-dosage.htm

[xi] Bakalar, Nicholas. “Anesthetic Said to Aid Depression,” The New York Times, August 9, 2010.

[xii] Carey, Benedict. “New Depression Findings Could Alter Treatment,” The New York Times, August 8, 2006.

[xiii] “Ecstasy Drug Tied to Brain Damage,” The New York Times, January 17, 1989.

[xiv] McGrory, Kathleen. “Doctors Struggle to Treat Mysterious and Unbearable Pain,” The New York Times, May 30, 2006.

[xv] Hilts, Philip. “Do Consent Forms Tell Enough? One case from the front lines,” The New York Times, May 19, 1998.

[xvi] Carey, Benedict. “New Depression Findings Could Alter Treatment,” The New York Times, August 8, 2006.

[xvii] “Ketamine,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/cdi/ketamine.html

[xviii]  “Ketamine: Side Effects and Dosage,” the RX List, see http://www.rxlist.com/ketamine-hydrochloride-drug/side-effects-interactions.htm

[xix] “Ketamine,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/cdi/ketamine.html

[xx] “Ketamine: Warnings,” the RX List, see http://www.rxlist.com/ketamine-hydrochloride-drug/warnings-precautions.htm

[xxi] “Ketamine As an Abused Drug,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/ketamine.html

[xxii] Jensen, KLR. “Using Ketamine to Induce a Near-Death Experience,” Yearbook for the Study of Ethnomedicene and Consciousness, Issue 4, 1995.

[xxiii] Emmett, David and Graeme Nice. Understanding Street Drugs. London: Jessica Kingley Publications, 2006, pg. 128.

[xxiv] “Ketamine,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/cdi/ketamine.html

[xxv] “Ketamine,” Parents the Anti-Drug, posted at http://www.theantidrug.com/drug_info/drug_info_ketamine.asp

[xxvi] Ketamine Fact File, The British Broadcasting Company, posted at http://news.bbc.co.uk/2/hi/uk_news/4315466.stm

[xxvii] Jensen, KLR. “Using Ketamine to Induce a Near-Death Experience,” Yearbook for the Study of Ethnomedicene and Consciousness, Issue 4, 1995.

[xxviii] Belluck, Pam. “FDA to study whether anesthesia poses cognitive risks in young children,” The New York Times, March 9, 2011.

[xxix] Jensen, KLR. “Using Ketamine to Induce a Near-Death Experience,” Yearbook for the Study of Ethnomedicene and Consciousness, Issue 4, 1995.

[xxx] “Ketamine as an Abused Drug,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/ketamine.html

[xxxi] “Ketamine,” Parents the Anti-Drug, posted at http://www.theantidrug.com/drug_info/drug_info_ketamine.asp

[xxxii] Emmett, David and Graeme Nice. Understanding Street Drugs. London: Jessica Kingley Publications, 2006, pg. 132.

[xxxiii] Ketamine as an Abused Drug,” Official Information from the United States Food and Drug Administration, see http://www.drugs.com/ketamine.html

[xxxiv] Drug Treatment Statistics, the National Institute of Drug  abuse 2013, see http://www.drugabuse.gov/publications/drugfacts/treatment-statistics

[xxxv] Ibid.

[xxxvi] “Ketamine,” Drug Enforcement Agency, United States Government, posted at http://www.usdoj.gov/dea/concern/ketamine.html

[xxxvii] “Ketamine: Fast Facts,” The United States Department of Justice, posted at http://www.justice.gov/ndic/pubs4/4769/index.htm

[xxxviii] Treatment Approaches for Drug Addiction, The National Institute of Drug Abuse, 2013, see http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

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