Ketamine might be best known as a “club drug” or as a “date rape drug.” The drug is also commonly used as a horse tranquilizer. It actually began as a medical drug used for pain relief and anesthesia for humans and animals. Not only is it legal for use in medical settings, it may also be a promising treatment for severe depression. Illicit ketamine use increased as it became known as a party drug in the 1980s. It produces feelings similar to phencyclidine (PCP) that can be severe. People using ketamine describe the effects as a feeling of floating or being separated from their bodies. It can also produce hallucinations and sensory detachment. In addition to the high that ketamine use produces, it’s also associated with numerous short- and long-term effects. Ketamine users are at risk of developing a tolerance to the drug. Ketamine misuse and addiction typically require professional help because of the seriousness of possible withdrawal symptoms. What Is Ketamine? PCP was developed as an intravenous (IV) anesthetic in the 1950s. Because it produced severe side effects, researchers developed ketamine as a replacement. It’s been approved for use as an anesthetic in the United States since the 1970s. Ketamine’s drug class is a Schedule III drug, meaning it’s approved for use in controlled medical settings. Schedule III drugs have a lower potential for abuse than drugs like heroin, methamphetamine, peyote, and cocaine, all of which are Schedule I or II drugs. There’s still a risk of low physical or high psychological dependence. Other drugs in ketamine’s drug schedule include anabolic steroids and medications with more than 90 mg of codeine per dose. Ketamine can be used for both humans and animals. Veterinary use may be part of the reason ketamine became known as a horse tranquilizer. It’s also likely why the drug is sometimes called “cat valium” on the street. Beyond its legitimate medical uses, ketamine is a street drug that became popular with teenagers and young adults. People misusing ketamine take it for the trance-like, floating feeling it can produce. It can also create extreme drowsiness at high doses. In addition, ketamine is one of the more common date rape drugs. Predators can slip the drug into people’s drinks without the victims’ knowing. It can cause loss of consciousness and anterograde amnesia, leaving the victim vulnerable to sexual assault and often unable to identify their assailant. Is Ketamine Legal? Is ketamine legal? Yes, but only when prescribed by a doctor for its intended use in a controlled medical setting. In March 2019, the U.S. Food and Drug Administration (FDA) approved it to treat depression in patients who have unsuccessfully tried other medications. This nasal spray has the potential to help patients who haven’t found relief using standard treatments. Ketamine prescriptions are only available from certified doctors and clinics. Recreational ketamine use is illegal. Ketamine is considered a controlled substance. The U.S. Drug Enforcement Administration (DEA) notes that illegal ketamine distribution largely comes from Mexico. In addition to illegal ketamine that’s smuggled over the border, the drugs that people misuse recreationally may come from international pharmaceutical organizations. The DEA was part of the effort to dismantle one such organization in 2005. The organization was smuggling illegal ketamine into the U.S. from India. What Is Ketamine Used For? The World Health Organization (WHO) has included ketamine on its Essential Medicines list since 1985. Legitimate ketamine uses include anesthesia and pain relief in adults and children at low doses. The WHO also notes that it’s among the safest anesthetics and pain relievers because it doesn’t slow breathing or lower blood pressure. This makes it suitable for global use in areas without reliable running water, oxygen and electricity. It also works with sedatives to reduce the need for stronger, more addictive painkillers like morphine. More rarely, doctors may also use ketamine for pain that’s associated with conditions like: Fibromyalgia Cancer Neuropathy Phantom pains Sickle cell disease Spinal injury The FDA has already approved ketamine as a treatment for depression, with the chief psychiatrist at Yale Medicine calling it a “game-changer.” It works differently than other psychiatric medications to help regrow connections in your brain. This gives patients the opportunity to develop new positive behaviors and thoughts, without the rebound effects that other medications like valium might have. The depression treatment is a nasal spray called esketamine. Researchers found that 70% of depression patients improved after taking an oral antidepressant and esketamine. Ketamine uses in veterinary medicine also include pain relief for animals. The drug is frequently used as an anesthetic because it acts quickly and doesn’t depress breathing. Dosage and Administration Ketamine is an effective anesthetic because it blocks a receptor in the brain to sedate the person and induce loss of consciousness. In addition to blocking key receptors in the brain, it also works on a molecular level to increase key chemicals like dopamine and noradrenaline. Ketamine doses vary depending on the patient, the purpose for using it and the way a doctor is administering the drug. For example, adult ketamine anesthesia doses may start at anywhere from 1 mg to 4.5 mg per kg in an IV drip. If doctors are using other drugs together with ketamine, the dosage may be lower. If the doctor gives the drug via intramuscular injection, the common dosage starts at 6.5 mg to 13 mg per kg. For children, the dosage is lower. When used for pain relief, doctors may prescribe ketamine pills. More commonly, patients receive an IV ketamine drip given through a pump. Other methods include topical use and ketamine injections. Newer research into ketamine and depression has led to the ketamine nasal spray. This gives patients the freedom of outpatient treatment instead of having to go into the hospital or doctor’s office for a ketamine drip or injection. There are several types of patients who are a good fit for ketamine treatment. These include patients with chronic pain who have not responded well to other types of pain treatments and chronic pain patients who are about to undergo surgery. Recreational ketamine users often snort, ingest or inject ketamine. Snorting is the most common method. The DEA notes that the average dose for recreational users is about 100 mg. Those who use it orally may take higher doses. What Does Ketamine Look Like? Ketamine pills, injections, IV infusions and recreational forms differ in their appearance. Liquid ketamine comes in glass vials. The liquid is clear. It’s usually sold illegally as a pill or powder. White or off-white ketamine powder may come in capsules, plastic bags or little foil packs. The powder is colorless and odorless when dissolved in liquid. Street Names The brand name for ketamine is Ketalar. Ketamine is the generic name for the same drug. Ketamine street names include: Street Names for KetaminePurple Vitamin K Special K Super C Honey Oil Cat Valium Jet Kit Kat K Super Acid Effects of Ketamine Ketamine slang names don’t stop at nicknames for the drug — there are terms for the effects, too. One of the serious effects of ketamine on the body is called a “k hole.” This state is brought on by a high dose of the drug. Someone experiencing a k hole has taken a high enough dose to impair their bodily control and awareness of their surroundings. Someone in a k hole may be completely unable to move or their eyes may move slightly. Difficulties with speech and a profound feeling of disconnection are two other effects related to k holes. Ketamine effects aren’t limited to k holes, either. Other common short-term ketamine effects include: Ketamine Short-term EffectsIntense happiness Relaxation, sleepiness Sedation, loss of consciousness Confusion Hallucinations Rapid heart rate Increased blood pressure Nausea, vomiting Effects like loss of judgment and coordination can last for as long as 24 hours. Long-term effects include memory loss, stomach pain and bladder problems. Misusing ketamine puts you at a higher risk of unwanted effects such as: Ketamine Long-term EffectsPsychosis Memory loss High blood pressure Breathing problems Seizures Addiction How Long Does Ketamine Stay in Your System? Ketamine leaves most healthy adults’ systems within 11 to 17 hours, but some of the metabolites created while your body processes the drug can last longer. Ketamine can be detected in urine for about 14 days and hair follicles for 90 days. Additionally, there are factors that affect how long ketamine stays in your system. These include: Factors That Affect How Long Ketamine Stays in Your SystemAge Body mass Liver function Genetics Overall health Is Ketamine Addictive? Is ketamine physically or psychologically addictive? According to its drug classification, ketamine has a low risk for physical dependence and a high risk for psychological dependence. Long-term use increases the likelihood that someone will face an addiction. Using ketamine recreationally also increases the risk of developing a ketamine addiction. Prolonged use can increase your tolerance for ketamine. This means you might start taking more or take it more frequently to get the same effect. Having a dependence on ketamine can lead to withdrawal symptoms like: Ketamine Withdrawal SymptomsAnger Depression Anxiety Heartbeat irregularities Chills, sweats Loss of appetite Extreme tiredness If you are living with a ketamine addiction, you don’t have to face it alone. Treatment is just a phone call away at The Recovery Village Palm Beach at Baptist Health. Call today to discover the options available. SourcesCESAR University of Maryland. “Ketamine.” Accessed October 21, 2019. U.S. Food and Drug Administration. “FDA Approves New Nasal Medication for Treatment-Resistant Depression; Available Only from a Certified Doctor’s Office or Clinic.” March 5, 2019. Accessed October 21, 2019. Drug Enforcement Administration. “Ketamine.” August 2013. Accessed October 21, 2019. World Health Organization. “Fact File on Ketamine.” March 2016. Accessed October 20, 2019. Chen, Jennifer. “How New Ketamine Drug Helps with Depression.” Yale Medicine, March 21, 2019. Accessed October 21, 2019. Medscape. “Ketamine (Rx).” Accessed 20 Oct. 2019. Wadehra, Sunali; and von Gunten, Charles. “Ketamine for Chronic Pain Management: Current Role and Future Directions.” Practical Pain Management, December 4, 2018. Accessed October 21, 2019. Medical Disclaimer: The Recovery Village® aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.