Ketamine is a complex drug. It has anaesthetic, stimulant and psychedelic properties. Often people describe feeling ‘disassociated’ from their environment, as if they’re not part of it.

In the UK, the drug is licensed for use in human and animal medicine.

The non-medical use of ketamine became popular in the UK in the early 1990s’ rave scene, when the drug was sold as a tablet known as ecstasy. Nowadays, the street form of ketamine usually comes as white crystals or powder.

How is ketamine used?

You usually sniff ketamine up the nose through a small tube such as a straw or rolled-up bank note. In clubs, users often dip the end of a key into the ketamine bag and sniff a small amount from the tip.

What are the effects of ketamine?

Like all drugs, the ketamine experience can vary depending on several things, including the strength of the drug, how much you take, how you’re feeling and where you are.

Generally, in small doses, ketamine acts as a stimulant, making you feel high. In larger doses, you can have an out-of-body experience (known as a K-hole), hallucinations, a sense of calm and a distorted notion of time. But ketamine can also make you feel panicky, have unpleasant feelings and nightmare-like experiences.

When you snort it, the effects begin within a few minutes and last around 30 to 45 minutes, depending on how much you take.

What are the problems with ketamine?

PERSONAL SAFETY

The effects of ketamine can leave users in a confused state and vulnerable to assault, traffic accidents, drowning and burns. Ketamine is a very powerful anaesthetic, so you might hurt seriously injure yourself without realising.

PHYSICAL HEALTH

Bladder problems

Prolonged and frequent ketamine use can cause serious long-term and irreversible harm to the bladder (known as Ketamine Bladder Syndrome) and can cause kidney and liver-related problems.

Typical signs and symptoms of harm to the bladder include a greater need to pee (urinate), an inability to hold it, passing blood when you do, and being in pain when you pee because of ulceration, shrinkage or scarring of the bladder. The damage can sometimes be so severe that surgery is needed and the bladder might even need to be removed.

Doctors at the NHS London service called Club Drug Clinic are more likely to see serious ketamine bladder symptoms in people who are using most days for several months. Occasionally, some people with lower use also develop symptoms – possibly because of existing medical conditions or vulnerability.

People who’ve taken ketamine frequently have reported abdominal pain, sometimes called K-cramps.

Snorting Ketamine

Snorting Ketamine can cause damage to the nasal passageways. Long-term use can lead to sinus inflammation/infection, septum perforation, damage to the structure of the nose and impaired smell.

Injecting Ketamine

Injecting ketamine can increase the risk of transmitting blood-borne viruses, damage to the site of injection and an increased risk of overdose.

MENTAL HEALTH

Ketamine use can result in unwanted psychological effects such as anxiety, panic attacks, flashbacks, insomnia, nightmares, paranoia, delusions and hallucinations. Some of which can become long term.

MIXING DRUGS

Few people use one drug on its own, and ketamine is no exception. Ketamine is often used on a night out alongside a range of substances, including alcohol. Mixing drugs increases risks, so you should avoid doing it as the outcome is difficult to predict. 

Synthetic opioids

Some drugs have been contaminated with the synthetic opioids fentanyl and nitazenes, increasing the chance of overdose.

DEPENDENCY

Ketamine isn’t considered to be physically addictive, but you can build up a tolerance quickly, and so higher doses are needed to achieve the desired effects.

Reducing risks

The best way to avoid the risks associated with drugs is not to use drugs. But if you are using, or considering using ketamine, the advice below will help minimise the risks to your health.

If you need to pee more often than usual, and/or pass blood when you do, and/or experience pain when peeing, stop using ketamine and consult your GP and let them know you use ketamine.

When you’re using, do it in a safe place where you and a friend can keep an eye on each other.

Start low and slow: take a small amount and wait. Don’t take more because you can’t feel anything yet. It could be a different substance or a different strength than last time. Be patient and give it time to work.

Don’t mix ketamine with other drugs, especially depressants like alcohol and GHB/GBL. These will slow your breathing down to dangerous levels. This can lead to dependence on several drugs and increase your risk of overdose. Mixing ketamine with alcohol increases the risk of unconsciousness, vomiting, choking and overdose. Mixing it with cocaine increases the risk of potentially fatal cardiovascular complications.

Ketamine and other drugs, such as illicit oxycodone, Xanax, and synthetic cannabis (spice), are increasingly mixed with synthetic opioids like fentanyl and nitazenes. These substances significantly increase the risk of overdose. If using ketamine, start with a small amount before taking more, and avoid using drugs alone so someone can help if something goes wrong.

IN CONTROL

Only buy what you’re going to use during a session. Don’t buy ‘some for later’, as later has a habit of becoming now.

Don’t use alone so you can look after each other.

Stay hydrated, drinking water before and after use.

Eat healthily and get enough sleep, as drugs can put a strain on your body and affect your physical and mental health.

If you start to feel agitated, confused or anxious, stop using, go and chill out somewhere quiet and take a friend to keep an eye on you.

Avoid taking baths if you’ve recently used ketamine and want to soothe related cramps as there’s a risk of being unable to get out, and an increased risk of falling asleep and drowning.

Don’t share drug paraphernalia such as straws, notes and injecting equipment.

Wash your nose out with water after snorting ketamine, to prevent nasal damage from the chemicals.

Don’t use it every day. Repeated ketamine use reduces the ‘high’ you felt when first used it. You might end up using more to chase that high, leading to a damaging habit.

If someone’s breathing is slow and shallow and they don’t respond when you talk to them, it’s best to be cautious and put them in the recovery position. Lie them on their side, so they don’t choke if they vomit. Call an ambulance.

Ketamine and the law

Ketamine is a Class B drug. It is illegal to possess, produce or supply the drug.

Possessing ketamine is punishable by up to five years imprisonment and an unlimited fine.

Supplying ketamine (including giving some to a friend) is punishable by up to life imprisonment and an unlimited fine.

For more detailed information, visit the Release website