What to expect
At lower doses, ketamine may cause numbness, a tingling body high (especially in the hands, feet, and head), jerky movements, rapid breathing, and dizziness. These effects are often accompanied by euphoria, relaxation, a feeling of weightlessness, mild visuals, and blurred or roving vision. Users may also experience introspective thoughts and enhanced appreciation for music.
At higher doses, visual, auditory, and even gustatory (taste-oriented) hallucinations are common, with some reporting a metallic flavor in the mouth. Hallucinations may be extremely realistic, including conversations with friends who aren’t there
At high doses, awareness of the physical environment and body dissolves. Out-of-body or near-death experiences are common, as are vivid internal experiences and a distorted sense of time. A high dose starts at approximately 1.5 mg/kg injected.
Some negative effects include paranoia, nausea, amnesia, and depersonalization—some of which may persist after frequent use.
Ketamine is a water-soluble PCP derivative. As a chiral molecule, it has two enantiomers: an S(+) isomer, or “esketamine,” and an R(-) isomer, or “arketamine.”
In clinical use, it is available as ketamine hydrochloride in liquid or powder form for intravenous injection and is marketed under the brand name Ketalar. Esketamine, which has a slightly different molecular makeup than ketamine, was approved for use by the FDA in 2019 and is marketed under the brand name Spravato. It is administered as a nasal spray.
Ketamine antagonistically binds to, or blocks, NMDA (N-methyl-D-aspartate) receptors. This interaction prevents signals passing between the brain and spinal column and is responsible for the molecule’s analgesic effect. Ketamine also interacts with opioid receptors and monoamine, cholinergic, purinergic, and adrenoreceptor systems.
Safety and Toxicity
Ketamine appears to be relatively safe for occasional users. However, frequent use carries the potential long-term risk of neurodegeneration. Prolonged intravenous exposure to the drug (over 9 or 24 hours) has led to brain cell death in rhesus monkeys. A similar effect has been seen in neonatal rats. In the monkeys’ case, however, continual exposure over a shorter period of three hours had no adverse effects.
Frequent use among people has also led to signs of cognitive impairment affecting thought and memory. However, occasional users (i.e. those who take ketamine once or twice a month) have not.
Schizotypal symptoms—including delusions, superstitious thinking, dissociation, and flashbacks—have also been observed in frequent users. Symptoms have also been shown to persist for some.
Bladder pain is another common complaint among frequent users, often accompanied in the long term by reduced bladder volume, incontinence, passing blood in urine, and cystitis. More research is needed to understand the relationship between ketamine and urological problems, but in some cases, it has been necessary to surgically remove the bladder.
In 2009, there were 529 ketamine-related emergency department visits in the US—compared to 36,719 for PCP and a total of 973,591 for any illicit drug. Only 12 ketamine-related deaths were recorded worldwide between 1987 and 2000, and only three involved ketamine alone. The cause of death in each case was an overdose by injection. More often, ketamine-related deaths are caused by interactions with other drugs, leading to respiratory depression and cardiac arrest.
Interactions with other substances
Only a limited amount of data exists around ketamine’s interaction with other drugs, whether good or bad, but it’s best to be cautious when mixing any two substances. Here’s what we do know.
- Psilocybin: Many users have anecdotally reported that mixing psilocybin and ketamine brings out the best of both drugs. Out of body experiences are common, and ketamine helps diminish any anxiety and brings on a sense of euphoria.
- LSD: LSD increases ketamine’s ability to induce out of body experiences, which could be an important part of their therapeutic effect. Some users have also reported that small amounts of ketamine can “ground” the trippier aspects of the LSD experience.
- Cannabis: There have been no reported problems with this combination. Ketamine can amplify some cannabis effects, most notably closed-eye visuals.
- Caffeine: No known problems.
- Barbiturates (Amytal, Butisol, Nembutal)
- Benzodiazepines (Xanax, Klonopin, Ativan)
- Zolpidem (Ambien)
What Is The Proper Way Of Dosing Ketamine
It is always not recommended to resort to self-medication when dealing with ketamine. This is because ketamine is heavily dosed dependent and as such you have to be careful how you take it. It is highly recommended that you do not exceed microdose which is about 0.02 mg beneath the tongue. It is also advisable that you do not take it more than once in a sitting. Chances are that you may feel tempted to do this because side effects tend to wear off quite quickly, however, the effects of multiple doses will always show.
Does Ketamine Show When You Go For A Drug Test
There are certain blood and urine tests that are strong enough to detect the presence of ketamine in your body. However, a standard urine drug test may probably not pick it up. Therefore, even though ketamine continues to be a vital ally to surgeons and other health practitioners.
How Can I Reduce The Associated Risks Of Taking Ketamine
It should be restated that there is no safe way you can use ketamine recreationally. However, if you must use them, there are a few tips that should help you out in that regard.
1. Understand what you are taking
You should know that ketamine is a controlled substance that can be quite difficult to get. Due to this reason, there is always going to be a chance that the drug you think is ketamine is nothing but a counterfeit drug that contains some other substances. Drug testing kits are the best way to ascertain its authenticity.
2. The dietary guide
Ensure that you do not eat for at least an hour before you take the drug. Nausea is one of the most notable side effects of using ketamine and vomiting cannot be ruled out. This can be quite dangerous especially if you are unable to move or even or ensure you are sitting upright. In addition to this, ensure that you avoid eating for two hours before you take the drug to reduce the occurrences of symptoms.
3. Select a safe setting
Being in a K-Hole may lead to confusion and as such make it quite difficult for you to communicate or move and this places you in a vulnerable position. Due to this reason, ketamine is often deployed as a date rape medication. Also, ensure that you do not use it regularly because it has a risk of addiction and dependence.
4. Safe hygiene is vital
Good hygiene is very important if you seek to lower the risk of injury or infection. if you are snorting ketamine, ensure that you do this on a clean surface using something sterile. Make sure you rinse your nose using water whenever you are done. If you are injecting it into your system, make sure you use a new and sterile needle and do not share them. Also, when taking the drug, ensure that you do not do so alone. The reason for this is that no one can tell how the drug will affect them. Hence, have someone with you especially someone that would not be using the drug with you even though he or she is familiar with effects.
5. Take proper care of yourself after
Usually, the main effects of ketamine are known to wear off quite fast even though everyone is quite difficult. Some people may experience mild effects for hours or days after. You should stay hydrated, eat well and get enough exercise so that you can feel better.
How Addictive Is Ketamine
Even though ketamine is not entirely an addictive drug like other drugs of abuse such as stimulants, opioids, alcohol or stimulants, chronic users may usually develop a pattern of compulsive ketamine abuse which can be quite hard to quit.
Research shows that ketamine users may develop a strong level of tolerance which means they will require higher volumes if they want to get high and this may increase their level of dependency. This is particularly so if they use the ketamine in a binging pattern and this may lead to the manifestation of withdrawal symptoms. Even though dependence and tolerance do not serve as real indicators of the presence of an addiction, they are usually the two major signs that someone is struggling with an addiction