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What is Ketamine | Ketamine Myths | Side Effects of Ketamine
What is Ketamine?
Ketamine is a medication that has become a popular club drug over the past few decades. It’s used as an anesthesia and for relaxation or pain relief in medical settings. When used as a recreational drug, ketamine causes extreme hallucinations, disassociation, and tranquilizing effects. Recently it’s also been used as a controversial form of treatment for depression.
Ketamine is a beneficial medication in controlled, medical environments. Low doses ease pain and are a great alternative to stronger alternatives like opioids. It limits the need for painkillers which reduces the possibility of developing an addiction to prescription opioids.
Outside of prescribed medical use, though, ketamine use is dangerous and unpredictable. It can cause problematic mental and physical reactions and long-term use can lead to tolerance and eventual psychological addiction. Ketamine misuse alters the perception of sight and sound and it also decreases reaction time. It can even cause total disconnection from reality.
What is ketamine and how is it used? Why do people turn to this powerful substance for recreational use and when does it go too far? As the president of the American Society of Anesthesiologists, John Abenstein, MD, said, “Outside of the clinic, ketamine can cause tragedies, but in the right hands, it is a miracle.”
Who Discovered Ketamine and When?
Ketamine originated in Detroit, Michigan in the 1950s at the Parke-Davis and Company’s laboratories. Starting with cyclohexylamines, chemists were looking for the ‘ideal’ anesthetic medication that also relieved pain.
One chemist, Maddox, discovered the first process to synthesize phencyclidine (PCP) on March 26th, 1956. Two years later, on September 11th, 1958, pharmacologist Dr. Chen received Maddox’s compound. Along with Dr. Domino, Chen studied the effects of PCP on animals and later humans
After a few years of clinical studies the doctors realized phencyclidine wasn’t a reasonable option as a human anesthetic. Hallucinations were too severe and frequent even with supervised medical use. Research continued in an effort to discover a similar anaesthetic but with fewer PCP-like side effects.
A Parke-Davis chemical consultant, Dr. Calvin Lee Stevens, was the first to synthesize ketamine in 1962. He fused a ketone with an amine, thus its name ketamine. Ensuing studies showed that Stevens’ new compound effectively produced anaesthetic, analgesic, and cataleptic effects, without the undesirable hypnotic effects of PCP.
It was patented for use in both humans and animals in 1966 by Parke-Davis. Human ketamine trials continued through the 1960s and into the 1970s in countries around the world. Teams in Germany, Italy, Brazil, Japan, and the Netherlands contributed literature on their own research on the drug’s effects.
What is Ketamine Made Of?
Ketamine came from the need for a medication that anesthetized patients while also relieving pain. Though PCP was used for a brief time, the unpleasant hallucinations ensured its time as a medical solution was short-lived. Dr. Stevens decided that a series of phencyclidine derivatives would be a beneficial path to explore.
Ketamine is made of a ketone combined with an amine. In chemical forms, it’s noted as Cl-581, or 2-(O-chloro-phenyl)-2-methyl-amino cyclohexanone. This chemical combination created a potent anesthetic and analgesic but one with a much shorter duration and lower potency than its counterpart, PCP.
Chemistry of Ketamine
Ketamine is a derivative of cyclohexanone and is a chiral compound. It’s created from an intensive process involving numerous chemicals. The drug is used in medical settings as an anesthetic, sedative, and analgesic. It also has hallucinogenic properties when misused or abused.
Medical experts still don’t fully understand ketamine’s method of action on the nervous system. It is an effective anesthetic agent for many medical procedures but researchers are still trying to learn about its mode of action.
Recent research from the University of Pennsylvania, conducted by R.G. Eckenhoff, revealed that ketamine interacts with olfactory receptors in mice. They believe their discovery will lead to more anesthetics that target the olfactory receptors. Still, more research on the chemistry of ketamine needs to be conducted.
Is Ketamine Legal?
Ketamine is legal under supervision for specific medical procedures. It’s widely used as a veterinary anesthetic but it’s also a helpful part of human medicine, too. The World Health Organization has included ketamine in its Essential Medicine List since 1985.
Doctors can use it as an anesthetic or analgesic. Used properly, ketamine doesn’t slow breathing or decrease blood pressure, making it one of the most used anesthetics in the world. Overdoses under medical supervision are very rare. Ketamine is also beneficial for patients experiencing inflammation, mild to moderate asthma symptoms, and for depression.
While ketamine is legal for specific medical uses, recreational ketamine use is not legal. It should not be misused or abused and doing so puts users at risk of developing addiction. Its in the club and the rave scene makes it an illicit substance.
Ketamine is a controlled substance with the Drug Enforcement Administration. It’s classified as a Schedule III substance along with drugs like codeine and anabolic steroids. The DEA recognizes its abuse and dependence potential, but also acknowledges its benefits in medical settings.
Are Ketamine Infusions FDA Approved?
Ketamine infusions are a newer medical practice for patients with chronic pain and depression. It’s been in use as part of an alternative form of treatment in ketamine clinics for a few years. It was finally approved to treat depression by the US Food and Drug Administration last March.
FDA approved ketamine infusions to help individuals who don’t respond well to existing treatments. They specifically approved esketamine, the more active half of the ketamine chiral compound. Patients who seek ketamine treatment suffer from severe depression that ordinary modalities aren’t as effective at treating. It offers a fast-acting way to approach treatment.
There is a caveat to their approval, though; clinicians must administer the drug as a nasal spray in certified clinics. Patients must also be actively taking an antidepressant medication. They also need to have unsuccessfully tried two other types of antidepressants before receiving treatment with ketamine.
Can Ketamine Be Prescribed?
Ketamine cannot be prescribed for take-home use and picked up at a local pharmacy like other antidepressant medications. It’s only approved for use in certified ketamine clinics under the supervision of trained medical personnel. At-home ketamine use is considered illicit misuse and is not legal.
Ketamine clinics must undergo a risk evaluation and mitigation strategy program. They require proof of medical licensing as well as approval from the DEA to dispense a controlled substance. Requiring specialized certification ensures that ketamine treatment clinics provide safe and effective care for anyone seeking an alternative solution.
Prescribing ketamine for take-home use still comes with too high a potential for abuse, though. At-home ketamine use may be allowed at some point in the future but for now all patients must receive it via nasal administration at an approved clinic.
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Ketamine Myths & Facts
There is plenty of misconception and misunderstanding surrounding ketamine. As alternative treatments using the drug grow in popularity, it’s crucial to understand some ketamine myths and facts. Not everything you hear about the substance is true.
It’s difficult to know myth from fact with so much information available on the internet these days. The following breakdown of ketamine myths and facts should clear up some confusion surrounding the drug and its uses.
Ketamine is not/is always addictive
Some believe ketamine is not addictive while others believe using it always leads to addiction. Both of these are myths. There’s no blanket statement that encompasses all use. Not everyone who uses ketamine becomes addicted, either immediately or in the long run. At the same time, developing ketamine addiction is very much possible.
It’s difficult to know whether someone will become addicted to ketamine. The drug affects people differently depending on a few factors. For example, those with addictive tendencies or a history of substance abuse are more likely to develop ketamine addiction. But to say it’s always addictive, or that it’s never addictive, is a myth.
Treatment with ketamine can solve any mental health issues
As ketamine infusion treatments become more popular, some may claim that it can solve any mental health issue. There are no studies or research to back up the claims that ketamine can treat any existing mental illness. Although there is some anecdotal evidence for certain individuals that doesn’t mean their experience applies to the masses.
The best way to treat mental health issues is at specialized treatment facilities. Programs focused on helping individuals manage and overcome their mental illness are proven effective in many studies. They incorporate multiple approaches to treatment rather than relying on a single modality or one-size-fits-all understanding.
Ketamine is used for legitimate medical purposes
Despite its popularity among club-goers and ravers, ketamine is still in use for real medical procedures today. It’s not only used for recreational purposes. It has legitimate medical uses. Ketamine is a powerful anesthetic and analgesic, offering an alternative to opioid painkillers while in medical treatment facilities.
Doctors use ketamine as an option when anesthetizing patients for surgical procedures to this day. Clinicians still find it beneficial to use despite its classification as a controlled substance. That doesn’t make it safe to use in a recreational setting, though.
Ketamine harms the bladder
Frequent ketamine use and abuse can cause damage to the bladder. The condition is called Ketamine Bladder Syndrome or Ketamine Cystitis. The drug well as its metabolites damage the epithelial cells in the bladder lining. These cells are responsible for containing urine but ongoing damage weakens the cells which causes urine to seep through.
Urine that seeps through the inner lining into the outer layers of the bladder causes deeper damage and worsening symptoms. These symptoms include needing to urinate more often, increasing the sense of urgency, and pain or pressure behind the pelvic bone. Continued use may cause incontinence, blood in urine, shrunken bladder capacity, or erectile dysfunction.
Ketamine Street Names
Ketamine’s popularity as a recreational drug has led to many different ketamine street names. In the past, the drug was frequently referred to as Special K. Today that name isn’t as common and people usually just call it “K”. Some other street names for ketamine include:
- Kit Kat
- Cat Valium
- Super C
- Super Acid
- Vitamin K
Medical Uses of Ketamine
Unlike many illicit, recreational substances, there are multiple legitimate medical uses of ketamine. Firstly, it’s known for its widespread use as a horse tranquilizer in veterinary practice. It’s not only useful for equine patients, though. Ketamine also has multiple medical uses in human patients as well.
It’s important to note that any treatments involving ketamine should only be used under professional medical supervision. Self-medicating with ketamine, or with any other type of substance, is dangerous and could result in serious long-term health consequences. Never take any drugs without the direct recommendation of your qualified medical physician.
These various medical uses of ketamine do show evidence of their efficacy in controlled environments. Recreational or self-determined use does not qualify as a legitimate treatment use. Nor should these uses be seen as benefits of use; ketamine as a tool for treatment is just that.
The serious effects of the medical uses of ketamine (ex. anesthetic, analgesic) should be all the more reason to avoid recreational use of the drug. It comes with some properties that could cause long-term problems. Ketamine should never be used outside of a clinical or medical environment under direct care and instruction.
Ketamine for Anesthesia
The most common medical use for ketamine is for anesthesia. High doses of ketamine render patients unconscious for the purpose of intense, invasive medical procedures. Ketamine for anesthesia is officially approved by the Food and Drug Administration. This is true for both ketamine on its own as well as combined with other anesthetic drugs.
Ketamine for Depression
Newer studies are considering the effectiveness of ketamine for depression. These studies look at controlled doses administered in supervised ketamine clinics. There
Ketamine for Pain
Another common use is ketamine for pain. The drug acts similar to other pain relievers without the more dangerous effects of respiratory depression or low blood pressure. This reduces the need for expensive patient-monitoring equipment, making it useful in situations like disaster relief or conflict zones. In fact, the World Health Organization placed it on its Essential Medicines List for this reason.
Ketamine for Seizures
The drug has both proconvulsant and anticonvulsant properties so using ketamine for seizures comes with significant risk. For example, some studies show that it led to seizures in some epileptic patients. It should only be used to treat seizures in those who have no predisposition to episodes. Only knowledgeable medical professionals should attempt to treat seizure patients using ketamine.
Ketamine for Sedation
Ketamine for sedation is incredibly effective, particularly in pediatric patients. Used at low doses, it functions as a fast-acting sedative. Results from one study reported that 30 children who were administered ketamine intravenously experienced sedation within 2 minutes. Another study revealed that 98% of patients, among a study of 431 children, experienced rapid sedation.
Recreational Use of Ketamine
In addition to its use in veterinary and some human medicine practices, the recreational use of ketamine is also common. It’s often associated with the rave and festival scene because of its hallucinogenic effects. As one article describes it, ketamine is a “triple-threat” because of its three main effects: sedative, stimulating, and psychedelic.
People enjoy using it and say it amplifies their experience with and connection to the music. Ketamine isn’t only used within the music scene, though. It’s also growing in popularity among clubbing and other city-dwelling partiers. Some users mix ketamine with cocaine for an even more stimulating experience. The mix is usually referred to as revolutionary or Calvin Klein lines.
Some also partake in recreational use of ketamine because they experience what they describe as a spiritual high. Like other hallucinogenic drugs, ketamine alters the user’s perception of time and space and can cause dissociation.
How Does Ketamine Work?
Ketamine is an incredibly potent drug. There is a fine line between what some consider an enjoyable ketamine high and a dissociative experience that’s known as a “k-hole.” Where that line lies is different for everyone, too, depending on various factors.
Although it has stimulating properties it’s not the same intense high as other stimulants like cocaine. While coke causes a jarring, almost anxiety-inducing high, ketamine comes with a more fluid, loose high in lower doses.
How exactly does ketamine work, though?
How Does Ketamine Affect the Brain
Ketamine isn’t as straightforward as other substances like opioids or stimulants. For example, opioids interact with opioid receptors throughout the body and cause relaxing, pain-relieving effects. The exact ways ketamine affects the brain are still somewhat unclear and require additional research on greater numbers of people.
Current research indicates that ketamine affects the brain in multiple ways. It doesn’t appear to target one single system. Instead, it interacts with many different body systems, such as opioid receptors, serotonin production, and the glutamate system.
This widespread understanding is backed by the numerous ways people use ketamine. It functions not only as an anesthetic but an analgesic and an antidepressant as well. The drug also has hallucinogenic, psychedelic properties in higher doses, too. More research needs to be done before scientists have a deeper understanding of how exactly ketamine affects the brain.
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Side Effects of Ketamine
There are dozens of side effects of ketamine use that affect various parts of the body and mind. The exact effects of using ketamine depend on factors such as the amount used, the method of ingestion, or whether it was combined with other substances.
Psychiatric side effects of ketamine include:
- Agitation or irritation
- Frustration or anger
- Difficulties concentrating
Gastrointestinal side effects of ketamine include:
- Upset stomach
Cardiovascular side effects of ketamine include:
- Decreased heart rate
- Irregular heartbeat
- Increased blood pressure
Respiratory side effects of ketamine include:
- Slowed or stopped breathing
Ophthalmologic side effects of ketamine include:
- Involuntary eye movements
- Double vision
Neurologic side effects of ketamine include:
- Decreased motor function