Ketamine AUSTRALIAN DRUG FOUNDATION
11 HOW DRUGS AFFECT YOU
This pamphlet is part of the “How Drugs Affect You� series. It aims to provide the facts about ketamine for anyone interested in understanding more about this drug. It has been written for the general public, including employees, employers, health professionals and their clients. Other titles in this series include alcohol, amphetamines, analgesics, benzodiazepines, caffeine, cannabis, cocaine, drugs and their effects, ecstasy, GHB, hallucinogens, heroin, inhalants, ice and tobacco.
11 HOW DRUGS AFFECT YOU
What is ketamine? Ketamine hydrochloride is an anaesthetic that produces hallucinogenic effects.
It is used in medical and veterinary settings as a short-acting anaesthetic. Some people use ketamine to get “high”. Ketamine has also been implicated as a drug used in drink spiking. Hallucinogenic drugs such as ketamine are drugs that change the way a person perceives the world. Hallucinogens affect all the senses, altering a person’s thinking, sense of time and emotions. They can cause a person to hallucinate—seeing or hearing things that do not exist or are distorted. Other names Special K, K, ket, kitkat, super K.
What it looks like When sold illegally, ketamine is usually a white crystalline powder. It can also be made into tablets and pills or dissolved in a liquid.
How is it used? Ketamine can be swallowed, snorted or injected. Sometimes it is smoked with other substances such as cannabis or tobacco.
Ketamine in Australia According to the National Drug Strategy Household Survey1, in 2013:
»» 1.7 per cent of Australians aged over 14 years had used ketamine at some stage in their life
»» 0.3 per cent had used it in the previous 12 months. Australian Institute of Health and Welfare (AIHW) 2014
1
2013 National Drug Strategy Household Survey: Key Findings, Canberra: AIHW.
Effects of ketamine The effects of any drug (including ketamine) vary from person to person. How ketamine affects a person depends on many things including their size, weight and health, also whether the person is used to taking it and whether other drugs are taken around the same time. The effects of any drug also depend on the amount taken.
Immediate effects The effects of ketamine may be experienced within 30 seconds if injected, 5-10 minutes if snorted and 20 minutes if swallowed. The effects of ketamine can last approximately 45 to 90 minutes. Low to moderate doses Some of the effects that may be experienced after taking ketamine include: See diagram
Higher doses A high dose of ketamine can cause a person to overdose. This means that a person has taken more ketamine than their body can cope with. The risk of overdose increases if the strength or purity of the ketamine is not known. High doses of ketamine can intensify some of the effects experienced at lower doses. People may also experience:
»» drowsiness »» semi-consciousness »» erratic, hostile
»» increased body
»» depression »» amnesia »» muscle rigidity »» increased saliva
physical sensations with increased risk of injury »» convulsions »» coma »» “near death” experiences.
or bizarre behaviour
temperature
»» irregular heartbeat »» anaesthesia—reduced
Body » sweating » reduced sensitivity to pain » inability to move
Mouth » slurred speech
Psychological effects » feelings of euphoria and relaxation » feelings of dissociation (being detached from the body) —sometimes known as “falling into a k-hole” » hallucinations and distorted perception, including visual, auditory, physical, time and space » disorganised thoughts, confusion and difficulty concentrating, thinking or maintaining attention » anxiety, agitation, paranoia and feelings of panic
Stomach » nausea and vomiting
Lungs » increased but shallow breathing rate
Heart » increased heart rate and blood pressure
Muscles » lack of coordination
Eyes » blurred vision » constricted (small) pupils
Low to moderate doses
Coming down As the effects of ketamine begin to wear off, a person may experience a range of effects. These effects can last approximately 24 hours and can include:
»» memory loss »» impaired judgement »» poor coordination
»» general aches and pain
»» disorientation.
Long-term effects The long-term effects of ketamine use can include:
»» headaches »» flashbacks »» loss of sense of smell (due to snorting)
»» impaired memory and
»» personality and mood changes
»» depression »» impaired concentration.
difficulty concentrating or thinking
Ketamine bladder syndrome Large, repeated doses of ketamine have been found to cause ‘ketamine bladder syndrome’, a painful condition that requires on going treatment. Symptoms associated with the syndrome include difficulty holding urine and incontinence, which can cause ulceration in the bladder. It is essential that any person suffering from ketamine bladder syndrome cease using the drug and see a health professional. Tolerance and dependence There is evidence that people who use ketamine can develop dependence and tolerance to it. Tolerance means they need to take larger amounts of ketamine to get the same effect. Dependence on ketamine can be psychological, physical, or both. People who are dependent on ketamine find that using the drug becomes far more important than other activities in their life. They crave the drug and find it very difficult to stop using it. People who are psychologically dependent on ketamine may find they feel an urge to use it when they are in specific surroundings or socialising with friends. Physical dependence occurs when a person’s body adapts to ketamine and gets used to functioning with the ketamine present.
Withdrawal If a dependent person stops taking ketamine, they may experience withdrawal symptoms because their body has to get used to functioning without ketamine. People may experience withdrawal symptoms for approximately 4-5 days. Some of the withdrawal symptoms that may be experienced include:
»» chills »» intense cravings »» restlessness »» nightmares »» anxiety »» tremors
»» sweating »» irregular and rapid
beating of the heart
»» depression »» tiredness »» decreased appetite.
Ketamine and driving It is dangerous to drive after using ketamine. The effects of ketamine, such as impaired coordination, blurred vision and distorted perception, can affect driving ability. People with distorted perception may be less aware of reality, which can increase the chance of an accident. The symptoms of coming down and withdrawal can also affect a person’s ability to drive safely.
Ketamine and the workplace Under occupational health and safety legislation, all employees have a responsibility to make sure they look after their own and their co-workers’ safety. The effects of ketamine such as distorted perception and impaired coordination can affect a person’s ability to work safely and effectively. The symptoms of coming down and withdrawal can also affect a person’s ability to work safely and effectively.
Pregnancy and breastfeeding Many drugs can cross the placenta and affect an unborn child. In general, using drugs when pregnant can increase the chances of going into labour early. This can mean that babies are born below the normal birth weight. If a mother uses ketamine while breastfeeding, the drug may be present in her breast milk. This may have an effect on the health of the baby. Check with your doctor or other health professional if you are using or planning to use ketamine or any other drugs during pregnancy or while breastfeeding.
Ketamine and other drugs The effects of mixing ketamine with other drugs, including alcohol, prescription medications and over-the-counter medicines, are often unpredictable. The dissociative effects of ketamine can make a person less aware of the effects of other drugs, such as the depressant effects of alcohol and opiates. Mixing ketamine and depressants can cause nausea, vomiting, decreased breathing rate, coma and death. Combining ketamine with alcohol can result in a person vomiting, falling asleep or collapsing, which can result in them choking on their own vomit. Using stimulant drugs such as amphetamines, ecstasy and cocaine with ketamine can further increase the heart rate and place the body under extreme stress.
Ketamine and social problems All areas of a person’s life can be affected by drug use.
»» Disagreements and frustration over drug use can cause family arguments and affect personal relationships.
»» Legal and health problems can also add to the strain on personal, financial and work relationships.
Ketamine and the law Legally produced ketamine is a restricted substance and only a doctor or vet may prescribe or administer it. All other ketamine is illegal in Australia. Federal and state laws provide penalties for the illegal use, possession, production or sale of ketamine. There are also penalties for driving under the influence of ketamine. Penalties can include fines, imprisonment and disqualification from driving. Some states and territories have programs that refer people with a drug problem to treatment and/or education programs where they can receive help rather than going through the criminal justice system. For more information contact a legal aid service in your state or territory.
Treatment options In Australia, there are many different treatment options for drug problems. Some aim to help a person to stop using a drug, while others aim to reduce the risks and harm related to their drug use. Treatment is more effective if adapted to suit each person’s situation. Some of the different options include individual counselling, group therapy, medication (pharmacotherapy), residential therapy and supervised/home withdrawal.
Preventing and reducing harms Many Australians take at least one psychoactive drug on a regular basis—they might take medication (i.e. over-the-counter or via a prescription), drink alcohol, smoke tobacco or use an illegal drug. All drugs have the potential to cause harm. As use increases, so does the potential for harm. Australia’s national drug policy is based on harm minimisation. Strategies to minimise harm include encouraging people to avoid using a drug through to helping people to reduce the risk of harm if they do use a drug. It aims to reduce all types of drug-related harm to both the individual and the community.
There is no safe level of drug use Use of any drug always carries some risk—even medications can produce unwanted side effects. It is important to be careful when taking any type of drug.
What to do if you are concerned about someone’s drug use If you are concerned about someone’s drug use, there is confidential help available. Contact the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet.
What to do in a crisis If someone overdoses or has an adverse reaction while using ketamine, it is very important that they receive professional help as soon as possible. A quick response can save their life.
»» Dial triple zero (000) to call an ambulance.
Ambulance officers are not obliged to involve the police.
»» Stay with the person until the ambulance arrives.
Find out if anyone at the scene knows cardiopulmonary resuscitation (CPR). »» Ensure that the person has adequate air by keeping crowds back and opening windows. Loosen tight clothing. »» If the person is unconscious, don’t leave them on their back—they could choke. Turn them on their side and into the recovery position. Gently tilt their head back so their tongue does not block the airway. »» If breathing has stopped, apply CPR. »» Provide the ambulance officers with as much information as you can—such as how much ketamine was taken, how long ago and any pre-existing medical conditions. For further tips on how to reduce the risks of using ketamine, call the alcohol and drug information service in your state or territory. The telephone numbers are listed on the back of this pamphlet.
For information, counselling or other assistance, contact the alcohol and other drug service in your state or territory.
ACT (02) 6207 9977
Tas. 1800 811 994
NSW (02) 9361 8000 (Sydney) 1800 422 599 (NSW)
Vic. 1300 85 85 84 (information)
NT 1800 131 350
QLD 1800 177 833 SA
1300 131 340
1800 888 236 (counselling)
WA (08) 9442 5000 (Perth) 1800 198 024 (WA)
Produced by the Australian Drug Foundation Š 2014. Celebrating more than 50 years of service to the community, the Australian Drug Foundation is Australia’s leading body committed to preventing alcohol and other drug problems in communities around the nation. www.adf.org.au For further copies of this pamphlet: Post: PO Box 818, North Melbourne, Vic 3051 Street: Level 12, 607 Bourke Street, Melbourne Vic Email: druginfo@adf.org.au Web: www.shop.adf.org.au