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General overview

Ketamine is a medication used for many medical indications. It can be used to provide and maintain anaesthesia, as a pain reliever, as a sedative and even for mental health issues such as major depression and treatment resistant bipolar mood disorder.

When administered by a healthcare professional, ketamine is a very good medication to be used for painful procedures in an emergency setup. It's safer to use than sedatives such as benzodiazepines as it doesn't depress the respiratory system and it protects the cardiovascular system from issues such as reduced blood pressures.

From the late 1970's it has been used as a recreational drug which has forced countries to regulate this medication more strictly. Ketamine can't be marked as an illegal drug since it is a core medicine in the healthcare system according to the World Health Organization's Essential Drug List (WHOEDL).

Side effects 

Ketamine can have some unwanted side effects though. These are mentioned as follows:

  • Irregular heart rhythms.
  • Raised intracranial pressure.
  • Nausea and vomiting.
  • Increased skeletal muscle tone, slurred speech.
  • Double vision, nystagmus, increased intra-ocular pressure and/or tunnel vision.
  • Increased bronchial secretions, laryngospasm.
  • Dependence.

Illicit use of ketamine 

The illicit use of ketamine can cause dependence of this drug. It's hallucinogenic effect can take place within 10 minutes after administration and can last for up to an hour when injected intravenously or inhaled/snorted and up to two hours if taken orally.

At sub-therapeutic levels, that is to say at dosages less than is used for medical protocols, ketamine can cause a dissociative state. This is a sort of "out-of-body-experience" that the user would experience and this is the main reason why people would use it illicitly, together with the fact that it causes a feeling of euphoria as well. 

At higher doses, the user would experience a more severe dissociative state coupled with auditory and visual hallucinations. This could resemble a person experiencing psychosis where they are out of touch with reality and they could become a danger to themselves and/or others.

Ketamine can have an amnesic effect and can also cause confusion which could make the user vulnerable to the possibility of date rape.

Ketamine leading to fatalities

It is well documented that the illegal use of ketamine has resulted in many deaths worldwide, whether directly or indirectly. In excess of 90 fatalities in Wales and England were reported between 2005-2013. These deaths included drowning, accidental poisonings, traffic accidents and suicides. 

Two individuals, namely Marcia Moore and D.M. Turner had written about their own experiences of using ketamine. Both of them died due to hypothermia and drowning, respectively, during the use of this drug.

Ketamine can increase the effect of other products when used together. The most important of which to take note of are alcohol, opioids, benzodiazepines and barbiturates. The combination of these can lead to unwanted side effects, complications and even death.

If there is a dependence to ketamine, then one needs to discuss this with their healthcare profession to help them be referred to a drug rehabilitation centre for further management.

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