ketamine
Ketamine (Special K)

WHAT IS IT?

Chemical name(s):
Ketamine hydrochloride.

Legitimate use
It is an anesthetic sold under the trade names Ketalar (for use on humans in surgery) and Ketacet/Ketajet (for use in veterinary practice).

How is it used?
For the most part, users inhale dehydrated ketamine in small doses known as "bumps". It is frequently inhaled with a "bullet," a special inhaler used for powdered drugs.

What else is it called?
K or Special K. Ketalar, Ketacet, and Ketajet are brand names.

What does it look like?
Ketamine is produced as a clear liquid. Recreational users later bake or dehydrate the liquid into a white powder.

What can it be cut with?
It can be cut with any powdered substance. From what we've looked at, ketamine does not seem to be commonly cut with other substances, but it is quite conceivable that it could happen. And all brands of ketamine are not identical. Ketalar contains a preservative that has mental effects. Other brands (German Astrapin) contain other preservatives, which have toxic effects in some animals. Brands other than Ketalar and Ketaset have slightly different molecular structures---which cause faster loss of consciousness, are more likely to suppress breathing, and have a faster recovery time (Jensen 2000).

WHAT DOES IT DO?


What does it do to you?
Ketamine is a dissociative anesthetic; it is similar to PCP (phencyclidine, aka "angel dust") and nitrous oxide (laughing gas). Saying it is dissociative means that the drug anaesthetizes by dissociating the mind from the body-as a result, it tends to create out-of-body experiences at recreational doses. It works on your brain by blocking something called the N-Methyl D-aspartate (NMDA) neuroreceptor. Neuroreceptors are the parts of your brain cells that pick up neurotransmitters; the NMDA neuroreceptor picks up a neurotransmitter called glutamate. Normally the neurotransmitter glutamate travels from one brain cell to the next and acts as a kind of key. After glutamate leaves one cell and reaches another cell, it binds with that cell and portions of the cell open up, allowing various ions (calcium, sodium) to pass in and out of the cell wall. When this occurs, the cell normally sends its own store of neurotransmitters to other neighbouring cells-and in the process creates and allows for consciousness.

When ketamine blocks the NMDA neuroreceptor, the cell is unable to absorb glutamate; without glutamate the cell will not permit the passage of calcium or sodium ions through its membrane. As a consequence, this cell does not pass information to any neighbouring cells. The effect of this lack of communication is anaesthetization-or the high you experience after inhaling ketamine. Other effects of this lack of communication are changes in the normal production of other neurotransmitters--a decrease in production of gamma-aminobutyric acid (GABA) and an increase in the transmission of dopamine.

How does it make you feel physically?
In the context of a club or dance event, a recreational dose of ketamine is likely to make you feel somewhat euphoric-and the right amount can send you on a trip, where light and music become particularly intense. Your feet may feel a bit heavy, and dancing might become a bit awkward-even though you have a great deal of energy. There is a tendency to have a very tight focus-attending only to that which is directly in front of you.
Some people experience panic and fear as the ketamine starts working. If you start to feel anxious, grab a friend or starnger and ask them to keep an eye on you. You might need help dealing with the effects.

How does it affect you after you use it?
Most users report day-after effects of moderate depression, anxiety, and occasionally headache. Special K causes an increase in dopamine transmission and at any given time, you only have so much dopamine stored up in your body. Once your body's stores are used up, it'll take time for these stores to be replenished. In the meantime, you'll likely feel depressed and anxious.

How long will the effects last?
A "bump" of ketamine will likely last you anywhere from 60 to 90 minutes-and you should feel the onset in about 5 to 10 minutes. If you don't feel the effects immediately, then wait a while longer. The effects may take longer and you probably don't want to stack your doses. It's better to be less high for a while than to be so high that you pass out.

WHAT ARE THE RISKS?

Short-term Risks?


K-Hole: In terms of recreational use, the most problematic acute risk associated with Special K is doing too much at once, moving from a recreational dose to an anesthetic dose, and ending up in a K-hole. The experience can be quite frightening if you are alone or are unprepared for it-the dissociative quality of this drug will leave you feeling confused, disoriented, and unable to communicate with others. This can lead to any number of problems-vomiting, passing out, being scared shitless, being a burden on any friends who have to look after your, or ending an otherwise great night. If you want to avoid a K-hole, take some time to figure out what the correct dose is for you.

You need about 2.2 mg of ketamine per 1 kg of body weight to put you into a K-hole-give or take, depending on who you are and the conditions under which you take your drugs. A bump of ketamine from a bullet is anywhere from 30 to 50 mg-although this can vary greatly from bullet to bullet (read more at erowid). If you are going to use ketamine, it's a good idea to figure out the math, so that you have an idea of where your lines are. For example, if a 77 kg person is using a bullet to inhale a bump of ketamine he or she would be consuming anywhere from about .38mg/kg to about .65mg/kg. A single bump is liable to give this 77kg person a buzz of some kind-the intensity will depend on a host of factors-the size of the bullet, the temperature, the person's tolerance. A second or third bump would bring the dosage close to what is required for a K-hole-particularly close if you've been dancing for a while, are dehydrated, overheated, or have taken other drugs. Under these conditions, the threshold for a K-hole could be much lower. In practical terms, this means that doing multiple bumps for most of us is probably not a good idea. Unless you're into passing out.

For those who don't do metric: a K-hole is about 1mg of ketamine per pound of body weight.

Seizures
This stuff can also lead to seizures. There is no way to predict who may or may not be affected this way, but if you are prone to seizures-say through epilepsy-it's probably a better idea to avoid this drug.

Seizures are the result of the way ketamine inhibits the production of the GABA neurotransmitter. GABA is an inhibitory neurotransmitter-it keeps brain cells quiet and operating within their normal limits of activity. With no GABA around to protect it, cells are easily activated by any stimulus (in this case, the presence of other neurotransmitters). In short, the cell gets all fired up and doesn't have a chance to relax or recoup. When this occurs, the cell ends up using all its recourses and eventually dies. We experience the death of brain cells as seizures.

Other significant short-term risks (which may or may not be part of a k-hole) include hallucinations, vivid dreams, rapid heart rate and high blood pressure. Also be ware that a severe overdose would result in coma with respiratory depression (decreased breathing) and possibly apnea (no breathing) - not simply a "k-hole".

Medium-term Risks
Medium term risks involve a decrease in the amount of available dopamine in your brain. Special K causes an increase in dopamine transmission and at any give time, you only have so much dopamine stored up in your body. Once your body's stores are used up, it'll take time for these stores to be reproduced. In the meantime, you'll likely feel depressed and anxious.

Long-term Risks


Brain Damage
There is a body of research indicating that dissociative anesthetics related to ketamine, (dizocilpine, nitrous oxide, PCP) carry a very real potential for brain damage in rats. Some of this appears to be reversible; some does not appear reversible. Jensen (2000) offers a summary of some of this research. In rats, "NMDA receptors must be blocked for at least two hours to cause reversible changes and at least 24 hours to produce some cell death, but ketamine has a short half life so many injections are needed, over a prolonged period to produce persistent change" (p. 426).

Brain damage associated with ketamine is in the form of what are called Olney's lesions (also called NMDA antagonist neurotoxicity or NAN). These lesions occur in particular areas of the brain (posterior cingulate cortex and retrosplenial cortex) that are associated with multi-sensory thinking, new learning, visual perception, and possibly sense of smell. Differently, these parts of the brain support higher functioning and thinking-the ability to process complex information and what is called long term potentiation (i.e., the ability to learn new ideas).

In animal studies, the dose at which irreversible brain damage occurs is around 40 milligrams of ketamine per 1 kilogram of body weight (Olney et al. 1989; Allen et al. 1990, Jensen 2000). Jensen (2000) summarizes research on ketamine and brain cell death in relation to primates, noting that there is no evidence that ketamine causes brain damage at the cellular level in primates. He cites research, which found no permanent effects on cell structure were found at doses of 10mg/kg of body weight.

Read more about ketamine here.
Having said this, there are two things to keep in mind. First, most of the research on ketamine has been done on anesthetic doses and not on recreational or club doses (Jensen 2000). Jensen (2000) suggests that a club dose is about 200mg/kg, while erowid.org suggest that club doses range between 15 to 250 mg, all of which are between 10% and 25% of an anesthetic dose. Paradoxically, while an anesthetic dose of ketamine (what a physician will inject into your body in order to do surgery) will shut your brain down such that the chances of neurotoxicity are lessened, a little bit of ketamine seems to send the brain into overdrive. Recreational or subanesthetic doses tend to cause excitation in the brain rather than sedate the brain and are "more likely to have adverse effects on mental health" (Jensen 2000: page). Recreational doses excite brain cells-and it is this overactivity that causes cell death in rat brains.

So while there is no evidence that ketamine causes cell death in primates, bear in mind that this research is based on anesthetic doses, not recreational doses. Recreational doses lead to over-active neurological processes-and it is this overactivity that causes cell death.

Second, while there is not much clear evidence of cellular change in primate brains, there is evidence of persistent changes on primate brain functioning. Ketamine leads to changes in the regulation of the neurotransmitters dopamine and glutamate, which help in the production of memory systems. "Repeated chronic doses of ketamine result in persistent alterations .that might result in a loss of efficiency in memory systems that is not apparent as a change in cell structure"(Jensen 2000: 427). The effects of ketamine appear to be worse for women and gets worse as you get older (Jevtovic-Todorovic et al. 2000).

WHAT ARE THE HARM REDUCTION TECHNIQUES FOR THIS DRUG?


What are the general harm reduction techniques?
Whenever you're taking drugs, it's always sensible to start with a little and take more only if you need it - remember, some drugs sneak up on you. If you are going to use it, there are a few things you can think about to reduce short, medium, and long-term risks.

Think about frequency, duration, and dose and your body weight. Be conscious about what is acceptable to you given the dose guidelines we've suggested. This can take any number of forms: taking only so much K with you, taking smaller bumps, or limiting yourself to a pre-determined number of bumps. Limit you dose to once every two days (yes, every two days-this is the length of time it took lab animals to return to "normal").

Taking minor sedatives might help in reducing the risk of brain damage-although we don't recommend you take drugs to reduce the dangers associated with other drugs. A healthy diet and nutrition might be useful. As a rule, don't bother megadosing on vitamins or herbals-what your body doesn't use goes to waste. And when it comes to herbals, there is simply no research or evidence indicating how Special K interacts with herbals.

Snorting your drugs has risk too.

How will I feel at first if I'm starting to get into trouble?
Like the effects of most drugs, a K-hole comes on quite suddenly. You are likely to feel a bit dizzy and wobbly, unable to hold yourself upright, and close to passing out. If you think you are going to pass out, tell someone-anyone-immediately. Chances are they won't really understand what you are saying because too much ketamine slurs speech. But they'll get the drift if they know what you are on-so tell people ahead of time that you are taking a bump. A K-hole can be particularly frightening if you've never experienced one before-you'll feel disconnected from you body and unable to talk to others around you. Try to remain calm and relax-the effects will eventually pass. In the end, you'll have to trust those around you to look after you.

What are the contraindications? What drugs shouldn't I mix with this drug?
Combining any drug with any other drug is a bit of a crap shoot. While there is some evidence to suggest that taking ketamine with tranquilizers reduces the risk of brain damage, you're best off avoiding ketamine if you are taking tranquilizers or sedatives. Taking drugs to make drugs less harmful is pretty short sighted (Kim et al. 1999). Depressants like alcohol and GHB can lower the threshold of ketamine's effect and can make seizures more susceptible.

Anti-depressants of any kind are not a good idea when it comes to ketamine. Anti-depressants work either by limiting a brain cell's absorption of some neurotransmitters or by reducing the rate at which neurotransmitters are broken down. In the end, what this means is that while using anti-depressants, your brain is floating in a lot of neurotransmitters already - taking ketamine will only complicate or exacerbate the effects of these neurotransmitters on your brain cells. For example, some anti-depressants lead to an increase in the amount of dopamine your brain cells are exposed to - with this increased dopamine level and the decreased GABA production associated with ketamine, you are more prone to experience brain damage.

Taking ketamine with large amounts of sugars may increase free radical damage - bear this in mind as you're drinking cranberry juice.

If you are at all susceptible to seizures for any reason, put the K away and think about something else.


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