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    Ketamine and its effects

    Let's talk about ketamine and its differences from other psychoactive substances.

    Ketamine is a dissociative substance and a hallucinogen.

    Dissociative substances (dissociatives) are psychoactive substances; they disrupt the normal functioning of consciousness and perception of the outside world. The most common effects of dissociatives are: sensory dissociation, hallucinations, mania (this can be expressed in various audio and visual distortions, unusual perception of things around you and your body), as well as pain relief, loss of sensitivity, amnesia.

    Ketamine is a rarelyused synthetic anesthetic developed in the mid-1960s. The legal purpose of its use is mainly for anesthesia in veterinary services, as well as in medicine, in particular in cases of heavy bleeding. Ketamine raises blood pressure (by 20-30%), accelerates heart rate, increases cardiac output.

    Now there is research investigating the potential of ketamine as an antidepressant.

    Ketamine is widely used as a recreational psychoactive substance.

    Ketamine is distributed in the form of powder and liquid.

    DOSAGE AND EFFECTS

    WARNING! Such factors as individual perception, body weight, and metabolism are always important to consider when using psychoactive substances! Start with a small dose, especially if you are an inexperienced user.

    Orally

    • Light dose: 50-100 mg
    • Common dose: 100-300 mg
    • Strong dose: 300-450 mg

    Insufflated

    • Light dose: 10-30 mg
    • Common dose: 30-75 mg
    • Strong dose: 75-150 mg

    Typically, the ketamine effects begin:

    • when taken orally – in about 20 minutes
    • intranasally – from 5 to 10 minutes
    • injection – from 30 seconds to 1 minute

    The trip lasts 45-90 minutes, depending on the dose and the way of consumption.

    The after effects of ketamine can last up to 3 hours after the end of the primary effects.

    In general, with low doses come intoxication and relaxation, reminiscent of the feelings after a small dose of alcohol.

    When taken in large doses, the K-hole effect can be achieved, a condition characterized by hallucinations and very specific physical sensations (“out-of-body experience”). At the same time loss of ability to feel taste and smell, decrease in sensitivity to pain, numbness of the body are possible. Very high doses (overdose) can cause sudden loss of consciousness (mostly with eyes open; the eyes become dry), seizures and coma.

    Short-term side effects (often occur at the time when the substance begins to kick in, but has not yet fully come in effect):

    • increase or decrease of blood pressure and heart rate
    • nausea and vomiting (especially when moving)
    • loss of control over the coordination of physical movements and muscle movements (ataxia)
    • anxiety, motor restlessness
    • weakness
    • impaired vision, dizziness
    • increased salivation

    Long-term side effects:

    • memory problems
    • development of tolerance
    • psychological dependence
    • paranoia and egocentrism
    • sleep problems (nightmares, delirium)
    • frequent use can cause urological and nephrologic lesions such as hematuria (blood in the urine), acute renal failure, non-infectious cystitis, interstitial cystitis (painful bladder syndrome) and hydronephrosis (a disease characterized by increased kidney size, density, with complication of urine outflow from the kidney). Be careful with ketamine if you are sensitive to urinary tract or bladder infections!
    • there are cases of endocrine lesions, such as high cortisol or prolactin, as well as liver damage.

    WHAT IS A K-HOLE

    K-hole, K-holing, ketamine hole is a strong and specific effect of ketamine use.

    Physically, it happens like this: ketamine blocks glutamate, a neurotransmitter in the brain. In turn, this blocks the signals between consciousness and other parts of the brain, which leads to a dissociative sense of separation from the outside world.

    Usually this condition comes with a large dose of the substance, but not always. Sometimes a person catches a K-hole with a small dose, because each organism responds to any psychoactive substance individually. Keep in mind: there is always a chance that the substance will affect you completely differently from what you expected.

    Mostly K-hole is described as an out-of-body experience, a feeling of separation of consciousness from the body. People talk about how they “rise above their bodies”, “teleport to other places”, “dissolve in the world around them”, “unite with the universe”, and so on. Individual perceptions of this experience are different. For some people the trip is interesting and bright, for others it’s extremely unpleasant.

    Unpleasant psychological effects can include panic and anxiety, anxious hallucinations, paranoia, disorientation, feelings of helplessness, inability to speak. On the physical level it's inhibition, numbness, dizziness, nausea, high blood pressure, increased pulse.

    Mostly because of these unusual effects, ketamine is popular. At the same time a bad trip can be very severe and traumatic.

    MIXING WITH OTHER PSYCHOACTIVE SUBSTANCES

    Mixing psychoactive substances is always more dangerous than using only one substance!

    It’s important to remember that psychoactive substances are not only recreational drugs, but also other chemicals, for example medicine. Very often, when mixed with other chemicals, medical supplies can affect your body in unexpected ways.

    Ketamine’s effects are variable, sometimes unpredictable. The unpredictability makes this drug dangerous. Never combine it with alcohol and other depressants.

    Ketamine + alcohol, GHB/GBL, opioids, tramadol, benzodiazepines: substances enhance each other's effects; there’s a high risk that the person will vomit and lose consciousness. There is a serious danger of suffocation from vomit, if you do not put the person in the correct position (turn him or her to the side; under the back you can put a pillow or clothes to avoid suffocation). Difficulties with breathing and respiratory failure are possible.

    Ketamine + amphetamine, cocaine, MDMA: risks of increasing blood pressure. At high doses, the risk of physical injury increases.

    A known mix of ketamine and cocaine is called Calvin Klein (also Cable, CK1). This mixture is a potent substance; it can significantly impair brain function. This combination increases the feeling of euphoria, but at the same time often leads to a bad trip, terrible hallucinations, as well as increase in blood pressure and cardiac arrhythmia. Unfortunately, there are even fatal outcomes from such a mix, so it is better to refrain from it.

    Ketamine + psychedelics: possible enhancement of psychedelic experience and high possibility of a bad trip.

    REDUCING RISKS

    1. All experiments should be in an appropriate setting. After taking ketamine dizziness or numbness in the extremities are possible. Therefore, you need to be in a comfortable place and with reliable people. Due to the effect of this substance on coordination, you should have the possibility to sit or lie down if necessary. It is better to have a sober friend or an experienced user nearby.

    2. NEVER USE KETAMINE WHILE DRIVING or in another situation requiring concentration and attention!

    3. Do not eat for at least 1.5 hours before the trip. One of the most common side effects of ketamine is nausea and sometimes vomiting. This can be dangerous because a person sometimes loses the ability to move normally. Stop eating 1.5-2 hours before the trip.

    4. Be careful with dosage. Start with a small dose, especially as a beginner. Don’t be tempted to re-dose quickly. Be careful with re-dosing, as your perception of the effects may be distorted. Never make the next dose higher than the previous one!

    5. People with renal insufficiency, problems with the urinary tract, prone to bladder infections, high blood pressure, epilepsy, glaucoma should avoid ketamine.

    6. If you consume ketamine intranasally – don’t forget to take care of your nose:

    • use only your own clean sniffer (to avoid viruses transmitted through blood, such as hepatitis C – through microscopic droplets of blood)
    • don’t use banknotes (they are very dirty and contain a lot of bacteria)
    • regularly moisturize the nasal mucosa (common nasal spray)

    7. Avoid injecting any substance; this is the most dangerous way of consuming drugs! When injecting, use a new sterile needle and never share the syringe with others, even your partner. Sharing needles increases the risk of contracting a number of diseases: hepatitis B, C and HIV.

    8. Be prepared for possible troubles. Research information about the effects of the substance and possible unpleasant consequences. Remember about all the factors that may affect the experience: dose, exposure to other substances, general health state (both physical and psychological).

    9. Make sure the substance is not a counterfeit. With a special test kit you can check a sample of a psychoactive substance. You can see here how to do it.

    HELP IN CASE OF AN OVERDOSE

    @OverdoseHelpBot is available on Telegram. There you can find information about what an overdose by various substances looks like and how to provide first aid to a person in such a situation.

    The main symptoms of a ketamine overdose:

    • Disorientation
    • Drowsiness
    • Cardiac arrhythmias (slow or fast heartbeat and pulse; to count breathing movements, put your hand on the chest; count with your other hand or a timer; the average heart rate of an adult should be 60-80 beats per minute)
    • High blood pressure
    • Nausea, vomiting
    • Unpleasant hallucinations
    • Chest pain
    • Spasms in the throat
    • Respiratory failure

    In case of a ketamine overdose, a fatal outcome is possible as a result of respiratory failure!

    Don’t be afraid to call an ambulance – somebody’s life may depend on it. If, for some reason, you are very afraid to call an ambulance, call the parents or relatives of the injured person.

    You can call a free ambulance via the phone numbers 103 or 112.

    There is no criminal liability for calling an ambulance in case of an overdose. Contrary to popular belief, ambulance doctors are not required to report to the police about the cases of drug use. Police is called only if the ambulance crew has witnessed a criminal offense involving drug use.

    Before the ambulance arrives:

    • If the injured person is conscious – do not let him or her lose consciousness: call his or her name, speak in a loud voice; free the injured person’s neck and chest from tight clothing.
    • If the injured person is unconscious – place him or her on the floor or other hard flat surface to the side, making sure he or she doesn’t roll over on the back; under the back you can put a pillow or clothes.
    • Watch for breathing and pulse; be ready to give first aid if they stop.
    • In case of vomiting, do not let the injured person turn on the back. Turn the person to the side, under the back you can put a pillow or clothes to avoid suffocation by vomit.
    • In case of breathing stop and/or pulse stop, start artificial respiration and cardiopulmonary resuscitation.

    How to do artificial respiration: https://www.youtube.com/watch?v=hHK93xcDrHk

    Cardiopulmonary resuscitation: https://www.youtube.com/watch?v=1wrdcnuBTBw

    When the ambulance arrives, tell the doctors what the person consumed or could have consumed. This will help to more accurately provide special medical care.


    REFERENCES

    https://knowdrugs.app/substances/ketamine

    https://www.verywellmind.com/what-is-a-k-hole-21861

    https://bit.ly/3wstqvJ

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    IULA PAN
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