Ketamine

• Ketalar

Ketamine is structurally and pharmacologically related to phencyclidine. Ketamine is a dissociative psychedelic used medically as a veterinary and human anaesthetic.Onset of effects are rapid. However, effects are short-lived following therapeutic dosing and depend on method of administration. It is one of the few addictive psychedelics. - If snorting alternate nostrils, and clean your nostrils after each session to minimise damage. - Regular users build up tolerance and larger doses are needed to achieve the same effect. - There is a risk of bladder problems and kidney damage with regular use. Long-term ketamine use has been shown to damage the bladder and urinary tract, causing ‘ketamine cystitis’ or ‘ketamine bladder’. - Ketamine impairs coordination, so minor accidents like bumping into objects are common. - Ketamine is an anaesthetic and because you feel no pain, you are at more risk of injuring yourself. - Combining ketamine with alcohol or other depressant drugs as the effects can be unpredictable and may lead to overdose. - Make sure you have more days where you don’t use, than days where you use. - Use in a safe environment, especially if you are an inexperienced user as where you are can influence you trip. - Have a person you trust with you in case things go wrong. - Tell someone you are with what you are taking

Deaths have been reported in adults following doses of 500-1000 mg when given intravenously (Long, 2003; Licata et al, 1994).

Mild effects of the use of Ketamine include an initial 'rush' with nausea, vomiting, slurred speech, blurred vision, numbness, dizziness and ataxia. Other adverse reactions to Ketamine include hallucinations, delirium, irrational behaviour, blurred vision, nausea, vomiting, drowsiness, loss of coordination, confusion, hallucinations, dissociation -'out-of-the-body' feelings, anxiety, panic attack and/or collapse, respiratory stimulation or depression, tachycardia or bradycardia, hypertension or hypotension, seizures and cardiac arrhythmia. Paralysis and muscle rigidity have been reported where the user cannot move or speak but is fully conscious and can see.

Long term use may interfere with memory, learning and attention. Flashbacks have been described. (Jansen, 1993). Chronic ketamine abuse has been complicated by lower urinary tract pathology including diminished functional bladder capacity with bladder muscle overactivity, acute renal failure with bilateral hydronephrosis possibly secondary to retroperitoneal fibrosis (Chu et al, 2007) and ulcerative cystitis (Shahani et al, 2007).