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Recreational use of ketamineFrom Wikipedia, the free encyclopediaJump to: navigation, search 

Ketamine poured onto glass and left to dry. For general information on this drug, including medical usage, see ketamine.

Ketamine, a dissociative anesthetic with a relatively safe clinical profile, is often usedas a recreational drug.

It is typically used at subanesthetic doses and in both private settings and at club venues,where it initially gained popularity. Originating in the United States in the 1970s, therecreational use of ketamine has since spread to Europe, Asia, and Australia, primarilyin the context of raves and parties. Despite its emergence as a club drug, a majority of the users have since relegated their use to more private settings.[1]

Due to the complexity of its synthesis, ketamine is diverted from licit medical sources;however, there have been reports of industrial-scale illicit ketamine manufacture inChina.[2]

Contents

• 1 History

• 2 Epidemiology

o 2.1 North America

o 2.2 Europe

o 2.3 Australia

o 2.4 Asia

• 3 Illicit sale

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• 4 Detection of use

• 5 Effects

• 6 Dependence

• 7 Slang terms

• 8 References

History

Recreational use of ketamine was documented in the early 1970s in undergroundliterature (e.g. The Fabulous Furry Freak Brothers[3]  ). It was used in psychiatric andother academic research through the 1970s, culminating in 1978 with the publishing of 

 psychonaut John Lilly's The Scientist and Marcia Moore and Howard Alltounian's

 Journeys into the Bright World , which documented the unusual phenomenology of ketamine intoxication.[4] The incidence of nonmedical ketamine use increased throughthe end of the century, especially in the context of raves and other parties.[5][6][7][8][9] However, its emergence as a club drug differs from other club drugs (e.g. MDMA) dueto its anesthetic properties (e.g., slurred speech, immobilization) at higher doses;[9] inaddition, reports of ketamine being sold as "ecstasy" are common. [10]

The use of ketamine as part of a "post-clubbing experience" has also been documented.[11] Ketamine's rise in the dance culture was most rapid in Hong Kong by the end of the1990s.[9]

Epidemiology

North America

United States

According to the ongoing Monitoring the Future study conducted by University of Michigan, prevalence rates of ketamine abuse among American secondary schoolstudent (grades 8, 10, and 12) have varied between 0.8-2.5% since 1999, with recentrates at the lower end of this range.[12] The 2006 National Survey on Drug Use and 

 Health (NSDUH) reports a rate of 0.1% for persons ages 12 or older with the highestrate (0.2%) in those ages 18-25.[13] Further, 203,000 people are estimated to have usedketamine in 2006, and an estimated 2.3 million people used ketamine at least once intheir life.[13] A total of 529 emergency department visits in 2009 were ketamine-related.[14]

Europe

Cases of illicit ketamine use in club venues have been observed in the Czech Republic,France, Italy, Hungary, and the United Kingdom.[15] Additional reports of use and

dependence have been reported in Poland

[16]

 and Portugal.

[17]

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Australia

Australia's 2010 National Drug Strategy Household Survey report shows a prevalenceof recent ketamine use of 0.3% in 2004 and 0.2% in 2007 and 2010 in persons aged 14or older.[18] In a recent survey of random roadside oral fluid testing in Victoria,

Australia, 1.5% of drivers tested positive for ketamine use.[19]

Asia

Hong Kong

Established by the Hong Kong Narcotics Division of the Security Bureau, the CentralRegistry of Drug Abuse (CRDA) maintains a database of all the illicit drug users whohave come into contact with law enforcement, treatment, health care, and socialorganizations. The compiled data are confidential under the The Dangerous Drugs

Ordinance of Hong Kong, and statistics are made freely available online on a quarterly basis.[20][21] Statistics from the CRDA show that the number of ketamine users (all ages)in Hong Kong has increased from 1605 (9.8% of total drug users) in 2000 to 5212(37.6%) in 2009.[22] Increasing trends of ketamine use among illicit drug users under theage of 21 were also reported, rising from 36.9% of young drug users in 2000 to 84.3%in 2009.[22]

Taiwan

A survey conducted among school-attending Taiwanese adolescents reported prevalencerates of 0.15% in 2004, 0.18% in 2005, and 0.15% in 2006 in middle-school (grades 7

and 9) students; in Taiwanese high-school (grades 10 and 12) students, prevalence was1.13% in 2004, 0.66% in 2005, and 0.44% in 2006.[23] From the same survey, a large portion (42.8%) of those who reported ecstasy use also reported ketamine use.[23] Ketamine was the second most abused illicit drug (behind ecstasy) in abscondingTaiwanese adolescents as reported by a multi-city street outreach survey.[24] In a studycomparing the reporting rates between web questionnaires and paper-and-pencilquestionnaires, ketamine use was reported a higher rate in the web version. [25] Urinesampling at a club in Taipei, Taiwan showed high rates of ketamine use at 47.0%; this

 prevalence was compared with that of detainees suspected of drug abuse in the general public, of which 2.0% of the samples tested positive for ketamine use.[26]

Illicit sale

500 mg ketamine hydrochloride

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Ketamine dried and scraped

Ketamine sold illicitly comes either from diverted legitimate supplies and semi-legitimate suppliers, or from theft of legitimate suppliers.

In 2003, the US Drug Enforcement Administration conducted Operation TKO, a probeinto the quality of ketamine being imported from Mexico.[27] As a result of operation

TKO, US and Mexican authorities shut down the Mexico City company LaboratoriosTtokkyo, which was the biggest producer of ketamine in Mexico. According to theDEA, over 80% of ketamine seized in the US is of Mexican origin. In 2011 it is nowmostly shipped from places like India as cheap as $5/gram.[27] The World HealthOrganization Expert Committee on Drug Dependence, in its thirty-third report (2003),[28] recommended research into its recreational use/misuse due to growing concernsabout its rising popularity in Europe, Asia and North America.

In the 1993 book  E for Ecstasy[29]  (about the uses of the street drug Ecstasy in the UK)the writer, activist and Ecstasy advocate Nicholas Saunders highlighted test resultsshowing that certain consignments of the drug also contained ketamine. Consignments

of Ecstasy known as "Strawberry" contained what Saunders described as a "potentiallydangerous combination of ketamine, ephedrine and selegiline", as did a consignment of "Sitting Duck" Ecstasy tablets.[30]

The former chairman of the British Advisory Council on the Misuse of Drugs, David Nutt, suggested that Ketamine should be upgraded from a class C drug due to the harmit can cause to users.[31]

Detection of use

Ketamine may be quantitated in blood or plasma to confirm a diagnosis of poisoning inhospitalized patients, provide evidence in an impaired driving arrest or to assist in amedicolegal death investigation. Blood or plasma ketamine concentrations are usuallyin a range of 0.5-5.0 mg/L in persons receiving the drug therapeutically (during generalanesthesia), 1–2 mg/L in those arrested for impaired driving and 3–20 mg/L in victimsof acute fatal overdosage. Urine is often the preferred specimen for routine drug usemonitoring purposes. The presence of norketamine, a pharmacologically-activemetabolite, is useful for confirmation of ketamine ingestion.[32][33][34]

Effects

See also: K-hole

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This section requires expansion.

Ketamine produces effects similar to phencyclidine (PCP) and dextromethorphan (DXM). Unlike the other well-known dissociatives PCP and DXM, ketamine is veryshort-acting, its hallucinatory effects lasting sixty minutes when insufflated or injected

and up to two hours when ingested, the total experience lasting no more than a couple of hours.[35] Like other dissociative anaesthetics, hallucinations caused by ketamine arefundamentally different from those caused by classical hallucinogens. At low doses,hallucinations are only seen when one is in a dark room with one's eyes closed, while atmedium to high doses the effects are far more intense and obvious.[36]

Ketamine produces a dissociative state, characterised by a sense of detachment fromone's physical body and the external world which is known as depersonalization andderealization.[37] At sufficiently high doses (75-125 mg IM), users may experience whatis called the "K-hole", a state of dissociation whose effects are thought to mimic the

 phenomenology of schizophrenia.[38] Users may experience worlds or dimensions that

are ineffable, all the while being completely unaware of their individual identities or theexternal world. Users have reported intense hallucinations including visualhallucinations; perceptions of falling; fast and gradual movement and flying; "seeingGod"; feeling connected to other users, objects and the cosmos; experiencing psychoticreactions; shared hallucinations and thoughts with adjacent users. John C. Lilly,[39] Marcia Moore[40]  and D. M. Turner [41]  (amongst others) have written extensively abouttheir own spiritual/ psychonautic use of ketamine. (Both Moore[42] and Turner [43] died

 prematurely in a way that has been linked to their ketamine use.)

Users may feel as though their perceptions are located so deep inside the mind that thereal world seems distant. Some users may not remember this part of the experience after regaining consciousness, in the same way that a person may forget a dream. Owing tothe role of the NMDA receptor in long-term potentiation, this may be due todisturbances in memory formation. The "re-integration" process is slow, and the user gradually becomes aware of surroundings. At first, users may not remember their ownnames, or even know that they are human, or what that means. Movement is extremelydifficult, and a user may not be aware that he or she has a body at all.

Dependence

Radar plot showing relative physical harm, social harm, and dependence of ketamine [44]

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This section requires expansion.

Ketamine's potential for dependence has been established in various operantconditioning paradigms, including conditioned place preference and self-administration;further, rats demonstrate locomotor sensitization following repeated exposure to

ketamine.[45] Increased subjective feelings of 'high' have been observed in healthyhuman volunteers exposed to ketamine.[45] Additionally, the rapid onset of effectsfollowing insufflation or intramuscular injection is thought to increase the drug's abuse

 potential. The short duration of effects promotes bingeing, tolerance develops quickly,and withdrawal symptoms, including anxiety, shaking, and palpitations, present in somedaily users following cessation of use.[45]

Slang terms

Production for recreational use has been traced to 1967, when it was referred to as

"mean green" and "rockmesc".[46]

Recreational names for ketamine include "K ",[47][48]

 "Ket",[49] "Special K ",[48] "K2",[47] "Vitamin K ",[48][49] "Super K ",[48] "Jet" (Texas),[48][50] "Super acid",[48] "Mauve",[48] "Special LA coke",[48] "Purple",[48] "Cat Valium",[50] "Blind Squid"[51] "Keller",[51] "Kelly's Day",[51] "New ecstasy",[52] "Psychedelic

heroin",[52] "bump",[53] "honey oil".[53] A mixture of ketamine with cocaine is called"Calvin Klein" or "CK1".[54] In Hong Kong, where illicit use of the drug is popular,ketamine is colloquially referred to as "kai-jai".[9]

References

1. ^ "Reported drug abusers by age group by locality of abusing drugs".Hong Kong Narcotics Division, Security Bureau. Retrieved 11 January 2012.2. ^ "Transnational drug market analysis". World Drug Report 2010.

Retrieved 13 January 2012.

3. ^ Shelton, Gilbert (2008). The Freak Brothers omnibus. London:Knockabout Comics. pp. 144. ISBN 0-86166-159-1.

4. ^ Alltounian, Howard Sunny; Marcia Moore (1978). Journeys into the

bright world . Rockport, Mass: Para Research. ISBN 0-914918-12-5.[ page needed ]

5. ^ Awuonda, Moussa (1 July 1996). "Swedes alarmed at ketamine

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6. ^ Curran, HV; Morgan, C (2000 Apr). "Cognitive, dissociative and psychotogenic effects of ketamine in recreational users on the night of drug useand 3 days later.". Addiction (Abingdon, England) 95 (4): 575–90.DOI:10.1046/j.1360-0443.2000.9545759.x . PMID 10829333.

7. ^ Gahlinger, PM (2004-06-01). "Club drugs: MDMA, gamma-hydroxybutyrate (GHB), Rohypnol, and ketamine.". American family physician 69 (11): 2619–26. PMID 15202696.

8. ^ Jansen, KL (1993-03-06). "Non-medical use of ketamine.". BMJ 

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9. ^ a b c d  Joe-Laidler, Karen; Hunt, Geoffery (1 January 2008). "Sit Downto Float: The Cultural Meaning of Ketamine Use in Hong Kong".  Addiction

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10. ^ Parker, Fiona Measham, Judith Aldridge, Howard (2001). Dancing on

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11. ^ Moore, Karenza; Measham, Fiona (1 January 2006). "Ketamine use:minimising problems and maximising pleasure". Drugs and Alcohol Today 6 (3): 29–32. DOI:10.1108/17459265200600047 .

12. ^ "Trends in Use of Various Drugs, Table 2". Monitoring the Future.Retrieved 17 January 2012.

13. ^ a b "Use of Specific Hallucinogens: 2006". The NSDUH Report .Substance Abuse and Mental Health Services Administration. Retrieved 17

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 DAWN Series D-35. Substance Abuse and Mental Health ServicesAdministration. Retrieved 17 January 2012.

15. ^ Kalsi, Sarbjeet S.; Wood, David M., Dargan, Paul I. (15 April 2011)."The epidemiology and patterns of acute and chronic toxicity associated withrecreational ketamine use". Emerging Health Threats Journal  4 (0).DOI:10.3402/ehtj.v4i0.7107.

16. ^ Błachut, M; Sołowiów, K, Janus, A, Ruman, J, Cekus, A,Matysiakiewicz, J, Hese, RT (2009 Sep-Oct). "[A case of ketaminedependence].". Psychiatria polska 43 (5): 593–9. PMID 20214100.

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19. ^ Chu, Mark; Gerostamoulos, Dimitri, Beyer, Jochen, Rodda, Luke,

Boorman, Martin, Drummer, Olaf H. (1 June 2011). "The incidence of drugs of impairment in oral fluid from random roadside testing". Forensic Science

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20. ^ Cheung, Yuet. "DRUG POLICY AND HARM REDUCTION INHONG KONG: A SOCIO-HISTORICAL EXAMINATION*". Retrieved 12January 2012.

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23. ^ a b Chen, Wei J; Fu, Tsung-Chieh, Ting, Te-Tien, Huang, Wei-Lun,Tang, Guang-Mang, Hsiao, Chuhsing, Chen, Chuan-Yu (1 January 2009). "Useof ecstasy and other psychoactive substances among school-attendingadolescents in Taiwan: national surveys 2004–2006". BMC Public Health 9 (1):27. DOI:10.1186/1471-2458-9-27.

24. ^ Wang, Shi-Heng; Chen, Wen-Chun, Lew-Ting, Chih-Yin, Chen,Chuan-Yu, Chen, Wei J (1 January 2010). "Running away experience and

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25. ^ Wang, Yi-Ching; Lee, Ching-Mei, Lew-Ting, Chih-Yin, Hsiao,Chuhsing Kate, Chen, Duan-Rung, Chen, Wei J. (1 October 2005). "Survey of substance use among high school students in Taipei: Web-based questionnaireversus paper-and-pencil questionnaire". Journal of Adolescent Health 37 (4):

289–295. DOI:10.1016/j.jadohealth.2005.03.017.26. ^ Lua, Ahai Chang; Lin, Huei Ru, Tseng, Yong Te, Hu, An Ren, Yeh,

Pei Chi (1 September 2003). "Profiles of urine samples from participants at rave party in Taiwan: prevalence of ketamine and MDMA abuse". Forensic Science

 International  136 (1-3): 47–51. DOI:10.1016/S0379-0738(03)00261-5 .

27. ^ a b "SI.com - The Mexican Connection - Jul 18, 2007". CNN . Retrieved7 May 2010.

28. ^ Untitled-59

29. ^ Saunders N, Heron L (1993). E for Ecstasy. London: N. Saunders.ISBN 0-9501628-8-4.[ page needed ]

30. ^ See: [1] for details online.

31. ^ Doward, Jamie (1 November 2009). "Ministers face rebellion over drug tsar's sacking | Politics | The Observer". London: Guardian. Retrieved2010-01-22.

32. ^ Feng N, Vollenweider FX, Minder EI, Rentsch K, Grampp T,Vonderschmitt DJ. Development of a gas chromatography-mass spectrometrymethod for determination of ketamine in plasma and its application to human

samples. Ther. Drug Monit. 17: 95-100, 1995.

33. ^ Parkin MC, Turfus SC, Smith NW, Halket JM, Braithwaite RA, ElliottSP, Osselton MD, Cowan DA, Kicman AT. Detection of ketamine and itsmetabolites in urine by ultra high pressure liquid chromatography-tandem massspectrometry. J. Chrom. B 876: 137-142, 2008.

34. ^ R. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 8thedition, Biomedical Publications, Foster City, CA, 2008, pp. 806-808.

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"Phencyclidine and the dissociatives". Psychiatric Medicine 3 (3): 197–217.PMID 2893430.

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37. ^ Giannini AJ, Underwood NA, Condon M (November 2000). "Acuteketamine intoxication treated by haloperidol: a preliminary study". American

 Journal of Therapeutics 7 (6): 389–91. DOI:10.1097/00045391-200007060-00008. PMID 11304647.

38. ^ Giannini AJ (1999). Drug Abuse. Los Angeles: Health InformationPress. p. 104. ISBN 1-885987-11-0.[ page needed ]

39. ^ Lilly, John Cunningham (1997). The scientist: a metaphysical 

autobiography. Berkeley, CA: Ronin Pub. ISBN 0-914171-72-0.[ page needed ]

40. ^ Alltounian, Howard Sunny; Marcia Moore (1978). Journeys into the

bright world . Rockport, Mass: Para Research. ISBN 978-0-914918-12-7.[ page needed ]

41. ^ Turner, D. M. (1994). The essential psychedelic guide. San Francisco,CA: Panther Press. ISBN 0-9642636-1-0.[ page needed ]

42. ^ Jansen, Karl (2001). Ketamine: Dreams and Realities.Multidisciplinary Association for Psychedelic Studies. p. 50. ISBN 0-9660019-3-1.

43. ^ Jansen, Karl (2001). Ketamine: Dreams and Realities.Multidisciplinary Association for Psychedelic Studies. p. 89. ISBN 0-9660019-3-1.

44. ^ Nutt D, King LA, Saulsbury W, Blakemore C (2007). "Developmentof a rational scale to assess the harm of drugs of potential misuse". Lancet  369 (9566): 1047–53. DOI:10.1016/S0140-6736(07)60464-4 . PMID 17382831.

45. ^ a b c Morgan, Celia J. A.; Curran, H. Valerie (1 January 2012)."Ketamine use: a review". Addiction 107 (1): 27–38. DOI:10.1111/j.1360-0443.2011.03576.x. PMID 21777321.

46. ^ Jansen, Karl (2001). Ketamine: Dreams and Realities.Multidisciplinary Association for Psychedelic Studies. p. 24. ISBN 0-9660019-3-1.

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48. ^ a b c d  e  f   g  h i  "Center for Substance Abuse Research: KetamineTerminology". Retrieved 3 January 2012.

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