Ketamine
Ketamine is a dissociative that has analgesia and anaesthetic properties, used for medical purposes on both humans and animals. It is not a central nervous system depressant. It was developed in the mid 1960s and used primarily for veterinary anaesthesiology. Ketamine is liquid in its original form but it is commonly sold as a white powder for recreational use. Ketamine is used for therapeutic, psychedelic and recreational purposes. Because ketamine’s effect is dissociative, the psychedelic experience is different to many other psychedelic drugs. People who use Ketamine can find themselves completely disconnected from their surroundings, their body and sensations. A well-known effect of ketamine at higher-range doses is the ‘K-hole’, where the user is removed from reality and set adrift in an introspective dream-like world, often involving complete dissociation, visuals and out-of-body experiences.
Know Your Body & Mind — ‘Set’
Know Your Environment — ‘Setting’
Know Your Drug — Practice Harm Reduction
ADMINISTRATION
Most commonly snorted but can also be swallowed, intramuscular injected (less commonly intravenous) as well as plugged (liquid administered rectally using a syringe with no needle attached, not the same as ‘shelving’).
DURATION OF EFFECTS
Total duration: 1-2 hours
Snorted Onset: 5-15 minutes
Oral Onset: 15-25 minutes
Injected Onset: 1-5 minutes
Snorted Peak: 20-60 minutes
Oral Peak: 10-75 minutes
Injected Peak: 1-2 hours
Coming down: 30-60 minutes
Hangover/after effects: 1-3 hours
Half life: The felt effects of the drug wear off after approx 2 hours, but it’s still active in your system for 3 hours. Remember this if mixing with other drugs.
DRUG TESTS
Roadside Police: Roadside saliva tests do not look for ketamine but other substances can be detected that might have been cut into your ketamine. It is illegal to drive under the influence of any illicit drugs, including ketamine and any driver may be subject to a roadside behavioural impairment test. Wait at least 24 hours before driving.
Workplace: OHS law gives employers rights to test employees for drug use. This should be contained in workplace policy, it should be reasonable, and a risk assessment should be done to determine whether testing of employees is appropriate.
Urine: 1 – 4 days; Hair: Up to 90 days; Blood: up to 2 days.
‘Pill Testing’/Drug Checking: Lab-quality testing has been trialled in Australia and is not available as a health service yet but DIY reagent testing is an option. Mandolin gives a reaction. Marquis and Mecke don’t, which can be a helpful process of elimination. [See photos of testing results here > verbinding.110110]
SAFER HANDLING
Carrying ketamine and paraphernalia (e.g. injecting/snorting/plugging equipment) puts you at risk of criminal charges including trafficking, even if you don’t deal.
Know your local laws e.g. the Drugs Misuse Act 1986 (Qld), the Drugs Poisons and Controlled Substance Act 1981 (Vic).
EFFECTS
Effects vary from person to person. Check out our table below that has listed the potential physical, psychological and emotional effects.
SAFER DOSING
Taking drugs is never without risk. In an unregulated market it’s impossible to know the purity or dose of any drug. ‘Dose’ depends on the form a drug is in (liquid, powder, pill, crystal) and how you have it (snort, eat, inject).
Depending on administration and purity, a standard dose of ketamine is anywhere from 15 to 300mg. Because of this huge variation, it is best to:
- Start with a very small amount to test the strength.
- Give it time to feel the effects before redosing, it can quickly become too much.
- Due to its potency, ketamine is commonly used in small doses (‘bumps’) rather than larger amounts (‘lines’).
- If injecting- especially IV- only have SMALL amounts as it comes on IMMEDIATELY and you usually k-hole right away. Make sure you do with a sober friend around to keep an eye out for you.
Intranasal (Snorting)
- Light dose: 15-30 mg
- Common dose: 30-75 mg
- Strong dose: 75-150 mg
- Heavy (“K-hole”): 150+ mg
Oral
- Light dose: 50-100 mg
- Medium dose: 100-300 mg
- Strong dose: 200-450 mg
- Heavy (“K-hole”): 450+ mg
Intramuscular Injection
- Light dose: 15-30mg
- Medium dose: 25-50mg
- Strong dose: 40-100mg
- Heavy (“K-hole”): 60-125mg
Intravenous Injection
- Light dose: 10-20mg
- Medium dose: 20-30mg
- Strong dose: 30-80mg
- Heavy (“K-hole”): 40-100mg
Physical effects
COMMON
- Analgesia, numbness
- Pleasant body high
- Increased energy
- Ataxia (loss of motor skills and coordination)
- Neutral/slightly increased heart rate
- Dilated pupils
- Slurred speech
- Nasal discomfort after snorting
- Susceptibility to accidents from loss of coordination and change in perception of body and time
LESS COMMON
- Loss of consciousness
- Increased or decreased blood pressure
- Nausea/vomiting
- Reduced heart rate & breathing. Risk increases with increased dose or when combined with CNS (central nervous system) depressants
- Urinary tract infection symptoms,
- Heart palpitations
- Stomach pain (most common when swallowed)
RARE
- Seizure
- ‘Ketamine Bladder Syndrome’ more common with long term use.
- Urinating blood caused by mild to severe urinary tract infections.
Emotional effects
COMMON
- Disconnection from the world (beings or objects) like a peculiar feeling of separation
- Euphoria
- Meaningful spiritual experience
LESS COMMON
- Enhances sense of connection with the world (beings or objects)
- Frightening or untimely distortion (or loss) of sensory perception
- Anxiety/Panic
Psychological effects
COMMON
- Sense of calm and serenity
- Pleasant mental high
- Abstract thinking
- Distortion or loss of sensory perceptions
- Open and closed eye visuals
- Dissociation of mind and body
- An amusing sense of confusion/disorientation
LESS COMMON
- Dissociation, out-of-body experiences
- Significant distortion of time perception
- A distressing sense of confusion/disorientation
- Visual hallucinations
- Amnesia
- ‘K-Hole’- intense mind-body dissociation
RARE
- Significant shift in reality perception
- Risk of psychological dependency
- Severe amnesia
- Severe confusion/disorientation
- Paranoia, egocentric megalomaniac (with regular use)
- Severe dissociation, depersonalisation
- Nightmares
- Delirium or Psychosis
SAFER USING
- Use around friends/people you trust and in a safe environment – somewhere you feel comfortable
- Eating within 1½ hours prior to using ketamine can cause nausea & vomiting
- Have a sober friend present
- Be seated, especially with higher doses due to the effects on coordination
- If redosing, wait at least 2 hours
- Ketamine can increase the chance of developing problems with your urinary tract.
- Moderation is advised for those sensitive to urinary tract infections.
- Do not use ketamine if you have a urinary tract infection
SNORTING
- Crush the powder so there’s no crystals (sparkles can cause little cuts).
- Snort a small amount of water before and after to avoid damaging the protective lining in your nose
- Use your own clean straw/spoon for snorting to prevent the risk of infection or blood borne virus transmission ‘BBV’ (e.g. hepatitis C, HIV) via microscopic amounts of blood
- Do not use money – it is covered in bacteria.
- Repeated snorting can damage the membranes of the nose leading to blood noses and possible permanent damage to the septum. Switch nostrils regularly and give your nose a break
ORALLY
- Ingesting ketamine results in slightly different effects to snorting or injecting. If taken as a ‘parachute” (wrapping a dose in a cigarette paper) the effects take longer to feel and the experience will last longer. Taking ketamine orally usually results in a less intense experience.
- Drinking is another way of doing it. You can dissolve the crystals/powder in a small amount of water and acidic juice (e.g. citrus or apple).
- Gumming is another less common way of doing it. A small amount is applied on the inside of the lips or gum. This can damage your gums and lips. Gumming is not a common way of taking ketamine as most users find the taste very unpleasant.
LONG TERM EFFECTS
- Psychological dependency
- Can lead to cognitive impairments including memory problems, learning and attention.
- Possible severe degeneration of the bladder.
- Be cautious with ketamine if you are sensitive to urinary tract infections or bladder problems. These issues are more commonly linked to frequent – long-term use and frequent – heavy use.
SHELVING (dry)/ PLUGGING (wet mix)
- Use lubrication to avoid tearing the skin
- Use a condom or latex/vinyl glove to avoid internal scratches
- Wash your hands before and after using
- Find a discreet and safe place to do it
- Dispose of used condom / glove responsibly.
INJECTING
- Intramuscular: Typically 1mg/lb body mass for IM injection is quite sufficient for a full dissociative experience. Doses of .5-.75mg/lb are more “threshold” and cogent experiences. Doses exceeding 1mg/lb body mass usually result in full anesthesia with little recall of the experience and may take longer to recover. There may be short-term memory loss with higher doses.
- Intravenous: Intravenous injection is possible with ketamine. The doses are the same as for intramuscular injection. However, with intravenous injection, the user can become fully anesthetized before she is able to remove the needle from her body. For this reason alone intravenous injection of ketamine is discouraged. Additionally, intramuscular injection provides a near-identical experience with the only major difference being a shorter (< 1 minute vs < 2 minutes) come-up.
- Avoid Blood Borne Viruses ‘BBVs’ (eg. Hepatitis C, HIV) by using new & sterile syringes & equipment.
- Use sterile water to mix up.
- Wash your hands thoroughly before and after, you can also use an alcohol swab to clean your fingertips.
- Alcohol wipes can reduce the risk of skin infections if they are used correctly. For maximum effect, swab once, in one direction on the injection site, and leave to dry naturally.
- Dispose of syringes & equipment responsibly in a yellow disposal bin, all NSPs have bins available.
It is not recommended to use ketamine if you have or are at risk of:
- Increased spinal fluid pressure
- Heart conditions
- Increased pressure in the eye
- Blood pressure issues
- Head trauma or injury or bleeding in/on the brain
- Eye injury
- Thyroid conditions
- Recent stroke
Drug combinations
Polydrug use has many possible outcomes. What could be fun for one person could be dangerous for another. We do not endorse any of these combinations and recommend you proceed with caution.
Unsafe combinations
- Alcohol: nausea and vomiting at low doses. It can lead to more serious effects and be fatal at higher doses.
- Depressants (GHB, GBL, Opioids): Can cause vomiting and a loss of consciousness, difficulty breathing & respiratory failure. If the user falls unconscious while under the influence there is a severe risk of vomit aspiration if they are not placed in the recovery position.
Cautionary combinations
- Amphetamines – Increase in blood pressure.
- Benzodiazepine – Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
- Cocaine – Increase in blood pressure.
Low risk effects
- Psychedelics: Can intensify psychedelic experience.
- MAOIs e.g. antidepressants & DMT/’changa’ mix: Can intensify psychedelic experience.
Check out the TripSit drug combinations chart here for info on other combinations.
Call 000 if experiencing adverse effects, feel unwell or concerned in any way
Disclaimer
This educational resource has been developed collaboratively by healthcare workers and people who use drugs for their peers and the wider community. The role of Hi-Ground is to provide practical, evidence-based, unbiased information to assist you to make educated choices and to promote harm reduction, community care, and wellbeing.
In an unregulated market it’s impossible to know the purity or dose of any substance. Taking drugs from an unregulated market carries its own risk, and you can educate yourself and practice harm reduction to reduce this risk.
Knowledge is power.
This resource is produced by DanceWize & Hi-Ground