Medical Uses of Ketamine
- Ketamine induces a state of medical amnesia. This state means that a person receiving a ketamine injection has no memory of the medical procedure. This effect is helpful for people who are anxious about the psychological effects of surgery.
- Ketamine, compared to other sedating agents, does not cause respiratory depression.
- Ketamine is used to control pain in burn injuries and has been used on the battlefield during the Vietnam war to ease the pain of wounded soldiers.
- Ketamine works with other sedatives to maintain anesthesia in surgical procedures.
- It can be used as an alternative for patients who are allergic to other anesthetic agents.
- Doctors prescribe ketamine for patients suffering from chronic pain.
- More recently, healthcare workers have prescribed ketamine as an alternative treatment for treatment-resistant depression.
- In veterinary medicine, it is the drug of choice for sedation in animals undergoing surgical procedures.
Related readings: https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673
History of Ketamine
In the 1950s, Parke-Davis and Company conducted studies on the efficacy of a newly synthesized substance called phencyclidine or PCP. This substance was tested on animals in 1958, which paved the way for human trials. In the same year, human trials commenced with the drug under the trade name of Sernyl. These clinical trials, later on, revealed that although PCP had anesthetic effects on patients, it was not safe for human use.
Building on these findings, Dr. Carl Bratton, head of pharmaceutical research at Parke-Davis, synthesized other compounds. His work later led to the development of the drug known today as ketamine. This formulation is where ketamine gets its name from. After being patented in Belgium, this new substance yielded promising results and was initially marketed as a veterinary anesthetic. It was not until 1970 that the FDA approved ketamine to be used for human sedation.
How Ketamine Works
Now that the question: “What is ketamine?” has been answered, it is time to understand how it works. Ketamine binds to the NMDA receptors in the brain. This reaction causes an increase in the production of the neurotransmitter glutamate. This sets off a series of events in the brain leading to loss of cognition, memory, and pain perception. This also causes hallucinations and a feeling of dissociation from the physical world.
Side Effects of Ketamine
Even in the clinical setting, ketamine can cause both minor and major side effects, which include:
- Skin rashes or discoloration at the injection site.
- Anaphylactic reaction characterized by facial swelling, hives, difficulty breathing, and tongue swelling.
- Nausea and vomiting.
- Tonic-clonic seizures.
- Nystagmus (uncontrolled movement of the eyes).
- Amnesia and confusion.
- Respiratory and cardiac arrest.
A study published on NCBI by Rosenbaum et al. also states that ketamine can be lethal in chronic alcoholics and those suffering from acute alcohol intoxication. When paired together, the effects of alcohol and ketamine can likely result in death.
Recreational use of ketamine is within the range of 75 to 300 milligrams, depending on the route of administration. When ingested in high doses, users may experience vivid hallucinations, which can be described as an “out-of-body experience.” This experience may be the reason for addiction in many ketamine users. Consuming ketamine in high doses may lead to irreversible coma and, eventually, death. Other effects experienced through recreational use of ketamine include the following:
- A general feeling of calmness and detachment from pain.
- Slurred speech.
- Slow reflexes.
There has been no development of a ketamine overdose antidote to date. Any case of ketamine overdose should be treated as an emergency and should be taken to the nearest healthcare facility for management and urgent care.
Signs of Ketamine Abuse
The use of ketamine as a street drug started almost instantly after it was patented for release. Hippies and ravers began marketing the drug in powder form. This new street drug was sold in clubs and was widely available for drug users to buy.
The effects of ketamine as a party drug were similar to that of LSD, which was also widely prevalent. This popularity led to an increased prevalence of ketamine addiction, with ketamine users looking for the hallucinogenic “trip” that a ketamine high could provide. The term “K-holing” was the street name for the high ketamine users kept going back for.
There are hallmark signs of ketamine abuse. If you think that someone that you know is suffering from ketamine substance abuse, these are the signs that you have to look out for:
- Decreased pain sensitivity
- Detachment from reality
- Increased salivation
- Panic and anxiety
- Confusion and disorientation
- Out of body experiences
- Feelings of intense strength and power
- Constantly craving the drug
- Inability to stop using the drug despite financial constraints and concern from loved ones
- Increased tolerance to the drug
- Marked psychological dependence on the drug
Prevalence of Ketamine and Hallucinogen Use in the US
A report published by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2019 sheds some light on the prevalence of hallucinogen use in the US. This report includes recreational use of hallucinogens, including ketamine, LSD, PCP, psilocybin, ecstasy and other recreational drugs classified as hallucinogens.
The study participants were aged 12 and older, with the highest prevalence rate of hallucinogen use in the 18- to 25-year-old age bracket.
- 5.6 million people aged 12 and older were users of hallucinogens.
- 376,000 people aged 12 to 17 reported using hallucinogenic drugs in the past year. This figure translates to 1.5 percent of the adolescent population.
- 2.3 million people between the ages of 18 to 25 used hallucinogens. This number makes up 6.9 percent of the young adult population.
- 2.9 million adults aged 26 and older have reported hallucinogen use over the past year. This figure is 1.3 percent of the adult population aged 26 and older.
The National Center for Biotechnology Information (NCBMI) also reported that 3 million people over the age of 12 had used ketamine in their lifetime.
Long-Term Ketamine Use: Effects on Cognition
Ketamine is a potent dissociative anesthetic acting on the receptors in the brain—short-term use of the drug results in amnesia, dissociation and hallucinations. But long-term substance use can have a significant, irreversible impact on the brain. This impact on the brain can affect a person’s cognitive abilities, and the damage can be irreversible.
A study performed by Celia Morgan and associates in University College, UK, involved studying 11 long-term ketamine users and correlating ketamine use with its effects on cognition. The study involved scanning the participants’ brain activity using an fMRI. These scans were performed while the participants were hooked to a virtual reality machine and were asked to perform specific tasks.
The study concluded that long-term ketamine use (at least three times a week) led to a remarkable impact on brain activity, especially in the hippocampus. This area of the brain is where spatial memory processes occur, explaining why frequent ketamine users have problems remembering certain tasks and planning a specific course of action to complete a task.
Long-term ketamine use can also have the following effects:
- Damage to nerves and tissues due to long-term ketamine injection
- Snorting ketamine can damage nose cartilage and tissues
- Bladder damage
- Kidney and liver damage
- Increased blood pressure
- Respiratory problems
Related readings: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255515/
Signs of Ketamine Withdrawal
Unlike other recreational drugs, there is little known about the physical effects of ketamine withdrawal infrequent ketamine users. The psychological effects of withdrawal are the ones that have to be looked out for. Typically, ketamine withdrawal symptoms kick in within 24 hours after using the drug. The withdrawal effects can last anywhere between four days and two weeks.
Those who are suffering from acute ketamine withdrawal are susceptible to suicidal ideations and will need frequent monitoring. During this time, it is essential to have psychological support. Other signs of ketamine withdrawal can include the following:
- Intense cravings for the drug
- Tremors and seizures
- Suicidal thoughts
- Mood swings
The severity of withdrawal symptoms depends on how long the user has been taking the drug. The withdrawal effects will also vary in relation to the amount the user has been taking. Long-term users may experience stronger withdrawal symptoms.
Getting Through Addiction: How to Help
The first step to addressing the issue of substance dependence is accepting the need for help. You or someone you may know may have difficulty taking this first step. However, this is an important part of the recovery process. Taking the first step towards recovery can be scary, but you can complete the journey with the proper support and resources.
- Build an environment of trust. When someone confides in you their struggles with substance abuse and addiction, make them feel validated and heard. When people think that they are in a safe environment, it is easier to address their problems.
- Be honest. Substance abuse affects relationships with loved ones. Be honest about how you feel about the current situation. If you are seeking help for your addiction, let others know how you feel about the process.
- Listen. You may not always know how to react when someone you know confides in you about their addiction problem. It is crucial to listen always. Be a listening ear and understand as much as you can. By listening to the problem, you can come up with the best solution.
- Be compassionate. Try to be as understanding about the situation as possible. Recognize that there is a need to help or be helped. Like other physical ailments, addiction is a complex brain disorder that needs to be treated.
- Offer to help. Knowing that there is someone ready to help can encourage a substance user to get on the road to recovery. Offer as much assistance as you can, when you can.
- Criticize. Please resist the urge to criticize someone for their addiction problem. This criticism can lead to feelings of shame or guilt. When a person feels ashamed of their actions, they are less likely to seek treatment.
- Delay. When you or someone you know is suffering from substance abuse, it is crucial to act fast. Don’t delay treatment until the last minute, as this can potentially cause irreversible health damage.
- Threaten. Don’t set ultimatums or deadlines to address the issue of addiction. Threatening someone to do something, such as seeking treatment for substance abuse, can lead to negative effects. When someone is threatened, they may be defensive of their actions and are less likely to be effective in seeking treatment.
- Be hasty. Expect recovery to be a gradual process. Don’t expect change to happen overnight, as this sets up unrealistic expectations for you and your loved ones. Be patient in the recovery process and show your support all the way.
Understanding ketamine addiction and identifying the steps to recovery are essential in helping curb ketamine addiction.
If you or someone you know needs help with ketamine substance abuse, reach out to Windward Way Recovery for treatment options today.