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KETAMINE POWDER
(ketamine)
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Background
Ketamine is a rapid-acting anesthetic that can produce anesthesia while maintaining skeletal
muscle tone, laryngeal-pharyngeal reflexes, and cardiovascular and respiratory stimulation
Regulatory Status
FDA-approved indication: Ketamine is used as an adjunct in general anesthesia as well as a
sedative in minor surgical or diagnostic procedures that do not require skeletal muscle relaxation
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There are several off-label uses that have been studied for ketamine including, but not limited to,
chronic pain, including chronic neuropathic pain, restless legs syndrome and phantom limb
syndrome. Alternative routes of administration, including oral, intranasal, transdermal, rectal and
subcutaneous have been studied. However, these routes of administration and uses are
investigational and are not supported by the FDA (2).
Common adverse effects of ketamine include hypertension, tachycardia and psychiatric signs and
symptoms. Ketamine can also produce a transient respiratory depression therefore its use requires
regular monitoring of vital signs (1).
Ketamine injection is commercially available in 10 mg/ml, 50 mg/ml and 100 mg/ml vials (1-2).
Summary
Ketamine powder is a rapid-acting anesthetic that can produce anesthesia while maintaining
skeletal muscle tone, laryngeal-pharyngeal reflexes, and cardiovascular and respiratory
stimulation. Ketamine is used in patients 16 years of age or older for the induction of anesthesia or
for conscious sedation for minor surgical procedures (1).
Prior approval is required to ensure the safe, clinically appropriate and cost effective use of
Ketamine powder while maintaining optimal therapeutic outcomes.
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What is Ketamine?
Ketamine is a short-acting “dissociative” anesthetic due to its ability to separate perception from sensation. It also has hallucinogenic and painkilling qualities that seem to affect people in very different ways. . Ketamine is chemically related to PCP (‘Angel Dust’). Ketamine is occasionally administered to people but, more commonly, is used by vets for pet surgery. Generally street K is most often diverted in liquid form from vets’ offices or medical suppliers.
How is Ketamine used?
Special K is prepared by evaporating the liquid from the legitimate pharmaceutical injectable product and grinding the residue into a powder. Drying of the liquid has been reported to be accomplished by placing the liquid on warming trays, pancake griddles, or cast-iron skillets placed on low heat. More recent reports describe the use of microwaves to achieve a fast boiling-off of the liquid to dry crystals. There has been no reported clandestine manufacture of ketamine (which would be a difficult process). All of the ketamine encountered by law enforcement to date has been diverted from licit sources, burglaries of veterinary clinics being the most frequently reported source.
Special-K is usually snorted or swallowed as a powder or injected as a liquid intramuscularly. Sometimes, it is put on tobacco or marijuana and smoked. It is distributed as powder in small “personal use” cocaine-like bottles, ziplock bags, capsules, or paper, glassine or aluminum ‘folds’, or as a liquid in small vials or bottles. Specialized “puff pumpers”, small bottles with a small inhaler screw-on top designed to deliver approx. 40 mg of ketamine crystals, have been sold in “Rave” clubs. A 10 ml vial of veterinary product containing one gram of ketamine sells, on average, for $100 on the street. A typical street package of powder (100 – 200 mg) sells for about $20. In the past, other drugs were not usually mixed with ketamine, now however, MDMA, amphetamine, methamphetamine, cocaine, carisoprodol, and flunitrazepam have been encountered.
Ketamine as “Special K” or “K” has become a staple at ‘rave’ parties. It produces a dose-related progression of effects from a state of dreamy intoxication to delirium accompanied by the inability to move, feel pain or remember what has occurred while under the drug’s influence.
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What are the effects of Ketamine?
I.M. (intra-muscular injection) Ketamine generally takes 1-5 minutes to take effect. Snorted ketamine takes a little longer at 5-15 minutes. Depending on how much and how recently one has eaten, oral ketamine can take between 5 and 30 minutes to take effect. The primary effects of ketamine last approximately an 30-45 minutes if injected, 45-60 minutes when snorted, and 1-2 hours if used orally. The Drug Enforcement Administration reports that the drug can still affect the body for up to 24 hours.
Hallucinations- it blocks chemical messengers in the brain that carry sensory input; the brain fills the resulting void with visions, dreams, and memories
Visual distortions
Lost sense of time, senses, and identity
Euphoria
Confusion
Smells and tastes seem muted
Visual perception and sense of touch are amplified
May feel floaty- slightly or far away from your body
Numbness in your extremities
K Hole- comparatively similar to a near death experience, with the sensation of rising above one’s body, inner peace, and radiant light.
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What are the side effects of Ketamine?
The use of Ketamine can result in profound physical and mental problems including delirium, amnesia, impaired motor function and potentially fatal respiratory problems. Panic, rage and paranoia may also occur. Some people feel paralyzed by the drug, unable to speak without slurring, while others either feel sick or actually throw up. While using Ketamine one is less likely to feel pain and in turn could end up inflicting injury or harm to themselves without even knowing it. In addition, one can be submerged in their hallucinations without realizing that they are hallucinating. Eating or drinking before taking the drug can cause vomiting.
Information regarding the long-term effects of Ketamine is mainly anecdotal. Flashbacks of experiences and hallucinations while under the influence of the drug have been reported. There have also been suggestions that long-term use of Ketamine can damage the memory and eyesight of the user, as well as reducing attention span. Frequent use can cause disruptions in consciousness and lead to neuroses or other mental disorders.
A BBC report in May 2000 claimed that medical research had shown that controlled tests on Ketamine users had revealed impaired memory and mild schizophrenia several days after taking the drug.
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Two psychological difficulties which seem to come up for those who use Ketamine regularly are paranoia and egocentrism. There are many reports of regular users starting to see patterns and coincidences (synchronicities) in the world around them which seem to indicate that they are somehow more important or integral to the world than others. This same sense of the world focusing on the user can also feed into a sense of paranoia.
A main characteristic of Ketamine is a stupor similar to extreme drunkenness. This is commonly known as “being in the K-hole.”
increase heart rate
slurred speech
paralyzed feeling
nausea
unable to move
hallucination
numbness
impaired attention, memory and learning ability
delirium, amnesia, impaired motor function, high blood pressure, depression and potentially fatal respiratory problems at higher doses
Can you overdose on Ketamine?
Yes, an overdose of Ketamine will knock you out as if in an operating room. If repeatedly taken in large doses, Ketamine can induce unconsciousness and failure of the cardiovascular system, leading to death. There are at least seven Ketamine related deaths known nationally.
Is Ketamine addictive?
Yes, Ketamine can cause a tremendous psychological dependence and may be physically addicting as well. The dissociation from one’s consciousness experienced with Special K (the entrance to “K-Land”) can be highly seductive, and there are many cases of Ketamine addiction. If used regularly, users of Special K can quickly build a tolerance to the drugs effects. Special K is illegal and possession can result in long prison terms.
What are the slang terms used for Ketamine?
Special K, Ketalar, Ketaject, Ketaset, Super-K, “K”, Ket Kat, Cat Valium, Vitamin K
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What is the history behind Ketamine?
Abuse of Ketamine (pronounced Kee-ta-meen) goes hand in hand with gamma hydroxy butyrate (GHB) and MDMA (Ecstasy). Where you find one, you will likely find the others. All three are very popular with the RAVE party crowd. Ketamine hcl, a cat tranquilizer and the most commonly used anesthetic in the Vietnam War. It was popular in the 70’s. Ketamine is a psychedelic anesthetic classified medically as a dissociative anesthetic, discovered by Dr. Cal Stevens of Wayne State University in 1961. Heavily used on the battlefields of Vietnam, it is used today for short-term surgical procedures in both animals and humans. It is sold only to hospitals and physicians. Since it does not depress critical body vitals, it is often used in procedures with burn victims for example.
Special K has exploded in the past few months onto the suburban drug scene. In February, the U.S. Drug Enforcement Administration warned that use is increasing at teen “rave” parties, the marathon dances that have spawned a new youth subculture. Anti-drug czar Barry McCaffrey’s office added K to its list of “emerging drugs” in 1995; the office’s latest “pulse check” of the nation found K “all over.” St. Louis, Mo., Tampa, Fla., and suburban New Jersey have seen a rash of animal-hospital break-ins by thieves hunting for Ketamine.
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Consumption and Standard Dose
Ketamine is typically sold as a white powder or liquid, in small vials.
Ketamine is typically snorted in small lines or bumps.
In liquid form, it is dried to make the powder to be snorted.
It can also be injected into a muscle (never a vein), smoked if mixed with tobacco or cannabis, or swallowed in a capsule.
The Buzz
Numbs and alleviates physical pain
In small doses it can initially give you a small boost of energy
In moderate doses, it induces feelings of relaxation, relief
from pain, numbing, and a state disconnected and
disassociated from your body, which feels like you are
floating outside or above your body
In higher amounts it induces psychedelic journeys, called
“trips” during which some people hallucinate meeting spiritual beings, aliens or travel inter-dimensionally or through a tunnel of light
Effects last 40-90 minutes after snorting, and up to 3 hours if injected or swallowed
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Overdose and other negative effects
Dizziness, disorientation, confusion
K-Hole: a state of paralysis in which it can be hard to breathe and feel claustrophobic, and can last up to 90-minutes. Get people in K-Holes away from crowded areas with bright lights and loud noises, and reassure them that they will soon be okay. K-Holes wear off in time. Do not leave people in K-Holes alone.
Vomiting while in a K-Hole can cause choking. Make sure people are in recovery position if they have gone to the floor or are laying down.
Falling over, and being unable to stand, which can cause physical injury
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Blurry vision, slurred speech
Nausea, especially when mixed with alcohol, or if food is eaten before using.
K-Pains: urinary tract pain, and bladder problems, kidney and liver problems. These symptoms usually stop or lessen if use is stopped. Continuing to use after the onset of urinary problems can lead to much more serious and permanent bladder problems.
Physical addiction and tolerance can build up with K
Injecting brings the risk of infection, abscess, vein damage, blood clots, all of which can lead to serious health complications. Click here to learn how to inject more safely. K needs to be injected intramuscularly not intravenously.
Use new, unused syringes. Prepare for injection on a clean surface. Use ascorbic acid to dissolve your drug for injection. You can get unused injection drug gear through any site associated with The Works through Toronto Public Health.
Dangerous Drug Combinations
Mixing with other downers like GHB can dangerously suppress your breathing
Mixing with alcohol will make you vomit
MDMA mixed with K can increase blood pressure to dangerous levels
Tobacco/Cannabis, although useful for rolling with K into a cigarette creates a fire hazard if you cannot respond to something that is burning, due to going to into a sedated state while smoking.
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Sex on Ketamine
Can increase horniness, but makes it hard to get or keep an erection
K can help relax your ass, and make it easier to have rough sex or get fisted, but this can make it harder to register if you’ve injured your rectum. Learn how to engage in butt play such as fisting, or using larger toys prior to dosing on K.
K can make it less likely that you remember to practice safer sex
Ongoing consent is an important consideration as it can be difficult to communicate with sex partners once high
Psychedelic drugs effect sex drive and sexuality activity very differently for different people
HIV Medications & Ketamine
Protease Inhibitors (PIs) can increase the intensity and duration of K’s effects, with increased duration of sedation and higher blood pressure.
Elvitegravir/Cobicistat/TDF/FTC (Stribild) also has this effect.
If you use K and are on PIs you can go into a K-hole more easily.
Ritonavir/Norvir can increase risk of drug-induced hepatitis.
If ketamine makes you throw up within an hour of taking HIV medication, it is recommended to that you take a dosage of your HIV meds again.
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