Warning regarding recreational ketamine use

Key messages Ketamine use has become increasingly popular in recent times, but, as with all drugs, it poses health risks. Ketamine-induced uropathy, for example, is a growing problem, particularly among young adults, reports a Dutch research team led by Sabrina Marongiu (Department of Clinical Pharmacy, OLVG Hospital, Amsterdam). A popular “party drug” Ketamine is an anesthetic and analgesic that has gained prominence due to its very rapid-acting antidepressant effect. In the United States, a nasal spray containing esketamine (the S-enantiomer of ketamine) is used for treatment-resistant depression. Unlike conventional antidepressants, the antidepressant effect of this substance occurs within a few days, making the active ingredient also indicated for acute attacks. Due to its relaxing and mildly euphoric effect at low doses, ketamine has been abused in recent years as a ” party drug .” Recreational users often use it intranasally in powder or crystal form, although intravenous or intramuscular injections in liquid form, as well as oral intake of powder or crystals, are also reported. Among the most famous ketamine users, Elon Musk himself is said to have stated, according to a report by science journalist Shayla Love of the American magazine The Atlantic , that he regularly takes ketamine to combat depression. The Wall Street Journal reported that Musk also uses the substance recreationally. Meanwhile, American journalist Ronan Farrow reported in 2023 in the New Yorker that Musk’s ” collaborators ” are worried that ketamine ” in addition to his isolation and increasingly strained relationship with the press, couldcontribute to his tendency to make chaotic and impulsive statements and decisions .” Another health hazard It remains to be seen whether Elon Musk’s ketamine use actually has these unpleasant effects. However, it is clear that the drug can have adverse health effects. According to data from Sabrina Marongiu and her colleagues, the toxicological profile of ketamine is dose-dependent, and its effects can be influenced by the simultaneous use of other substances. Recreational use (e.g., 60–250 mg intranasally, 200–300 mg orally, or 50–100 mg intravenously) results in hallucinations, motor disturbances, altered pain perception, cognitive impairment, euphoria, and dissociation. Higher doses can cause a so-called ” black hole ” (or ” k-hole ,” an acute ketamine high), characterized by immobility and pronounced dissociation, similar to near-death experiences (dissociation is a state in which different aspects of consciousness separate. Affected individuals may feel as if their thoughts, feelings, memories, or perceptions do not belong to them, or as if they are experiencing a dreamlike reality that is alien to them). Such dissociation is often reinforced by hallucinations. Ketamine users describe, for example, the following phenomena: dissociation of the body; crossing a tunnel; perception of a light source; entering a light; feeling of deep peace.