Author: Alex Thompson

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Monitoring includes the patient’s airway, breathing, and circulation, as ketamine can potentially cause cardiopulmonary compromise, especially when taken in combination with other drugs. If the patient vomits, the patient should be positioned to lean forward or lie on the left side with the head facing down to avoid airway compromise and aspiration. The patient’s vital signs, especially temperature, should also be monitored for other symptoms, especially hyperthermia. If the patient develops severe symptoms or complications, the patient should be placed on a monitor and admitted for observation. Poly-substance abuse is often a factor in ketamine overdose and many abusers report using various substances regularly including alcohol, marijuana, cocaine, meth, Ecstasy, MDMA, GHB, heroin, and other opioids.

Ongoing research explores the potential applications of ketamine in psychiatry across all isomeric forms. At elevated doses, ketamine operates primarily as a sedative rather than an analgesic agent. Ketamine toxicity can cause a variety of neurological, cardiovascular, psychiatric, urogenital, and abdominal symptoms, which are dose-dependent, and depend on whether ketamine administration was in an iatrogenic or illicit context. For example, some experts have attributed the higher incidence of ulcerative cystitis in recreational users to the adulterants with which the drug is mixed. Emergency medicine providers should be aware of the various mechanisms to treat ketamine toxicity and to prevent acute complications such as rhabdomyolysis, seizures, and chronic complications such as psychiatric disturbances and ulcerative cystitis. Typically, only supportive care is necessary for patients with ketamine toxicity.

Mechanism of Action

Unnecessary stimulation should be avoided, and the patient’s room should be dim and quiet. If necessary, the health care team may provide physical restraints to initiate IV access and secure the patient’s safety. If sedation does not adequately manage hyperthermia, evaporative cooling can decrease heat production. A wealth of evidence indicates the value of ketamine in treating severe pain, including conditions such as trauma, fractures, abdominal and flank pain, low back pain, and extremity pain.

Ketamine abuse continues to increases in certain drug abusing populations including those who attend “raves” or all night dance parties, homosexuals, poly-substance and injection abusers, and workers in the medical or veterinarian practices. Before Spravato was approved in 2019, ketamine was prescribed off-label for the treatment of depression. Other off-label uses of ketamine include treating bipolar disorder, post-traumatic stress disorder, as well as substance use disorder. It can have effects within seconds, and the effects wear off within 15 to 20 minutes.

Ketamine Slang Terms

Individuals who are unfamiliar with ketamine dosing may inadvertently take excessive doses of the drug, which could lead to an overdose. The signs and symptoms of a ketamine overdose or toxicity can vary depending on how much ketamine someone uses, whether they’ve used any other drugs, and if the drugs were laced with adulterants. When abused, it is typically insufflated (“snorted” up the nose) in social situations. It is also injected, consumed orally as a liquid (mixed into drinks), or smoked in marijuana or tobacco. It is frequently abused in combination with other substances, such as cocaine, MDMA or amphetamines. Ketamine is a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, and it blocks HCN1 receptors.

1. Especially in the presence of altered mental status, CNS infections such as meningitis and encephalitis, and CNS malignancies also merit consideration.
2. This action can differ for people who have medical issues, such as liver disease or kidney impairment.
3. If the patient vomits, the patient should be positioned to lean forward or lie on the left side with the head facing down to avoid airway compromise and aspiration.
4. Dosing varies according to the desired effect, the patient’s age, and underlying conditions.
5. The medication is highly effective for brief medical procedures that do not necessitate skeletal muscle relaxation and can be utilized as a pre-anesthetic for the induction of general anesthesia when combined with other general anesthetic agents.

Ketamine is not a first line treatment for status epilepticus, and it is generally used when other treatments are contraindicated or when they have not effectively stopped a prolonged seizure. Additionally, ketamine can cause you to be briefly confused after waking up from surgery. Most people do not remember the early or late phases of ketamine on thinking and memory and can’t recall having had hallucinations or confusion. If your anesthesiologist administers ketamine as part of your anesthesia regimen, you may have hallucinations when you are falling asleep for your procedure. She helps brands craft factual, yet relatable content that resonates with diverse audiences. Widely known for its medicinal properties, ketamine’s effects have made it a popular addition to the party scene.

Symptoms of Ketamine Addiction

The onset of action occurs within approximately 10 to 30 seconds, while the duration of action lasts about 5 to 15 minutes. Ketamine hydrochloride, commonly known as ketamine, is a medication approved by the United States Food and Drug Administration (FDA) for use as a general anesthetic either on its own or in combination with other medications. The medication is highly effective for brief medical procedures that do not necessitate skeletal muscle relaxation and can be utilized as a pre-anesthetic for the induction of general anesthesia when combined with other general anesthetic agents. Furthermore, ketamine is FDA-approved for enhancing the effects of low-potency substances such as nitrous oxide.

Most surgeries also require anesthetics that reduce muscle tone and movement. It is used in major and minor surgeries and for planned and emergency procedures. Ketamine reduces certain nervous system functions by inhibiting normal N-methyl-D-aspartate (NMDA) receptor activity. Normally, NMDA receptors, which are located on the surface of nerve cells, bind to neurotransmitters to modulate the actions of the nervous system. Where possible, the support of friends and family is also fundamental when recovering from ketamine addiction.

This article will also look into trusted treatments that can help overcome ketamine misuse. Via comprehensive addiction treatment services, patients can stop using ketamine and other substances and get on the path to a healthy, balanced life in recovery. For those who abuse ketamine via insufflation (“snorting”) adverse reactions may be less serious, but still present. Fast heart rate, high blood pressure, hallucinations, and impaired consciousness upon presentation to the emergency department may be most common effects with “snorting”. Abuse of large doses can also lead to powerful visual hallucinations that are intensified by environmental stimuli. When higher doses of ketamine are abused, or during emergence, it is reported to produce vivid dreams and an “out-of-body”, “K-hole” or “near-death” hallucinogenic experience, often reported as terrifying (similar to bad LSD trip).

What is Ketamine?

It has also joined the ranks of GHB (gamma hydroxybutyrate) and Rohypnol (Flunitrazepam) as a date rape drug. In 2020, 1.3% of 12th graders were found to have misused the drug for recreational purposes—this number was at 0.7% only a year prior. Mr. Perry had publicly acknowledged his long struggle with alcohol and drug use, but the report said he had been sober for 19 months and little was known about his relationship to ketamine.

How is Ketamine Abused?

Developed as a battlefield anesthetic in the 1960s, ketamine has been legal since 1970 for use in both people and animals. It is frequently used as an anesthetic for children, especially in the developing world. At Oxford Treatment Center, our drug and alcohol rehab facility in Etta, Mississippi, offers multiple levels of addiction care that utilize quality, evidence-based therapies.

In the United Kingdom, where ketamine has been classified as a Class C drug since 2006,[9] ketamine misuse has also decreased during the 21st century. According to the World Health Organization fact file on ketamine, the percentage of adults and young adults in the United Kingdom who used ketamine decreased from 0.6% to 0.4% and from 1.8% to 0.8%, respectively, between 2011 and 2013. Nurses and pharmacists can play a crucial role during ordering and administration, guarding against improper dosing and checking for adverse events and drug interactions. Important discharge education includes informing patients not to drive, use heavy machinery, or perform potentially hazardous activities for 24 hours after the administration of ketamine. Critical care supervision is necessary for patients under mechanical ventilation.

Also, providers should consider intoxication with alcohol, amphetamine, cocaine, LSD, MDMA, and salicylate, as well as delirium tremens from alcohol withdrawal. Malignant hyperthermia that develops after succinylcholine or volatile anesthetics such as halothane, and side effects from antihistamines like diphenhydramine and anticholinergics such as benztropine, can also mimic signs of ketamine intoxication. Ketamine does not cause any persistent problems when it is used for anesthesia.