Ketamine was first synthesized in the early 1960’s and after the usual animal and preclinical trials as first used as a general anesthetic. Most commonly, Ketamine is used in Veterinary Practices.

 

Usage in a clinical setting is for a variety of conditions including: Anesthesia, Pain, Asthma and Depression.  In Australia Ketamine is a prescribed medication, however both India and China produce vast quantities of this drug and as a result it is quite easily available over the internet. 

 

 

Overview

Ketamine was first synthesized in the early 1960’s and after the usual animal and preclinical trials as first used as a general anesthetic towards the end of the Vietnam War.

 

It is also used as a general pain killer (notably in emergency departments) and sedative in a hospital ICU setting and there is some evidence that can be an effective bronchodilator in cases of severe asthma.  

 

It is because Ketamine does not have any deleterious effect on respiratory function, its use is widespread in the medical community.

 

 

Pharmacology

Ketamine is classed as a Dissociative Agent that acts as a NMDA receptor antagonist and potentiates opioid receptor activity. It also acts numerous other sites in the body, including opioid receptors and monoamine transporters has meant that it usage in a clinical setting is for a variety of conditions including;

 

• Induction and maintenance of general Anesthesia

• Pain management including analgesia in patient with respiratory compromise or hypotension

• Asthma 

• Depression 

 

Ketamine can be absorbed subcutaneously (usually to induce analgesia), orally (often as lozenges or “gummies” after initial subcutaneous use), intravenously, intramuscularly and topically, although IM and IV are the preferred mode. Most commonly, Ketamine is used in Veterinary Practices.

 

 

Metabolism

Ketamine has a short half-life in the human body (2-3 hours) and undergoes extensive first pass metabolism by the liver where it is converted into dehydronorketamine (principal metabolite) and norketamine which are excreted in the urine, is metabolised by the liver with the excretion being in urine. Its short half-life means detecting this drug is difficult if the sample is not taken soon after ingestion (less than 48 hours). 

 

 

Recreational Use

By the early 1907’s there were documented cases of Ketamine abuse. As well as its obvious sedative effective the other noted outcome of its usage is its hallucinogenic properties.

 

Users have reported as “seeing God” and being “transported to another world” (“the K-Hole effect”). It acts very quickly once ingested and is typically taken in an oral form with the hallucinogens hallucinatory effects lasting much shorter than other hallucinogens like LS,  typically lasting  around 1 – 2 hours.

 

In Australia Ketamine is a prescribed medication, however both India and China produce vast quantities of this drug and as a result it is quite easily available over the internet.

 

Ketamine is available illegally on the street, where it is sold under various names including “K”, “Special K”, Cat Valium and “purple”.

 

Ketamine is often snorted in powder form, drunk or smoked, whereas the liquid form is more often injected. While usually taken in isolation, it may also be taken combined with Ecstasy (MDMA).

 

 

Prevalence

The 2010 National Drug Strategy Household Survey reported a prevalence of around 0.2% for the whole population, but use was found to be substantially higher in specific population subgroups.

 

Ketamine abuse has been found to occur principally in the predominantly male late teen and young adult population, with high levels of abuse among the gay community and the party scene subculture.

 

The Victorian Random Roadside Oral Fluid Testing Survey detected ketamine use in ~ 1.5% of drivers tested in 2010.

 

 

Side Effects

Ketamine is a relatively benign compound if taken within a medical setting. In a recreational use environment the inconsistent quality and uncontrolled ingestion means that the side effects are varied and these include arrhythmia, tachycardia, rashes, vomiting, anorexia, nausea and cystitis.

 

Long term use/abuse has been linked to brain damage and fatalities. Emergence reactions, manifesting as vivid hallucinogenic dreams and delirium may occur in up to 10% of moderate–to-high dose usage.

 

 

Summary 

Ketamine is readily available in Australia, in particular in the “party scene”, and the fact that it is quickly metabolised means that most of its usage is with people with full time employment who are sufficiently aware of the limitations of most of the commonly used drug testing methods.

 

 

Source: Safe Work Laboratories