Ketamine

What is ketamine?

Ketamine (Special K, Vitamin K, or Ket) is a dissociative drug with hallucinogenic properties. 

Effects

The effect a substance will have depends on the characteristics of the substance, but also on the set and setting of the user. This section describes the effects of ketamine in general.

Ketamine is a dissociative hallucinogen. Dissociation is another word for separation: during ketamine use you can experience a separation between your mind and body. At a dose of up to 50mgs you will experience a clouded, “vague” mental state. At a dose above 50mgs, the effects can become more intense and psychedelic in nature. The higher your dosage is, the stronger and longer the effects will last.

Positive effects (negative) Side effects

Dissociative effects

Dissociation describes the separation of body and mind.

This can present with the following effects:

  • The feeling that your hands no longer belong to your body
  • Your sense of touch is altered, with skin feeling as if it were made of wood, rubber or plastic.
  • Body parts feel much bigger or smaller than they actually are
  • Losing sense of where your limbs are
  • The density of your body decreases, feeling as if it ‘dissolves’ in your environment
  • No longer being able to differentiate between whether a limb is your own or someone else’s
  • Feeling like the mind is in a different dimension than the body
  • Out-of-body experience
  • Visual hallucinations (especially with eyes closed) and altered perception of time, insights into the cosmos, existence and being are also frequently mentioned by users.

K-hole

A k-hole is a very strong ketamine experience. During this, you are often unable to move or talk. Contact with the outside world is no longer possible. It is difficult to differentiate between what is real and what is only in your mind. It can be a very interesting or informative experience, but it could also be very frightening. Make sure you have the opportunity to lie down if you plan on taking a lot of ketamine. In summary, it could be either a positive or negative experience for you.

Altered sensory perception

How you perceive your environment changes, this can affect all of your senses. Sometimes, this could make it seem as if your surroundings differ from reality. More information about tripping and hallucinations can be found here.

Nausea/vomiting

An uneasy and tense feeling in the abdomen, which may cause discomfort. Nausea often precedes vomiting.

(Nederlands) Verandering in tijdsperceptie

The passage of time could feel altered during drug use. Some parts of the evening fly by, while some parts feel a lot slower. When you are feeling comfortable, it can be nice that the feeling does not seem to stop. But if you feel uncomfortable, this can be a bothersome experience. So this effect can work both ways.

Impaired coordination

Drug use can negatively affect the coordination of your body parts.

Changes in thought patterns

You more quickly form logical and illogical associations, but your thoughts may also become more chaotic and confused. For the user, this could be either a positive or negative experience.

Confusion

Not fully understanding the environment and situation. Temporarily impaired orientation with respect to time, place, or person.

Insightful experiences

Some experiences from substances may give you new insights. Because your brain activity is altered, different thoughts may arise and you might gain new perspectives.

Impaired short-term memory

Short-term memory does not work properly after taking some drugs. This makes you remember things less well. For example, it often happens that during a conversation you forget what you were talking about, or that you forget the reason you walked somewhere. The next day you often don’t know very well what happened the night before.

Relaxation

Reduction of stress, uneasiness, sadness, panic, and feelings of depression.

Paranoia and delusions

Anxiety, paranoia and delusions (e.g. the idea that people are talking about you).

Double vision

Not being able to focus your eyes properly.

Dose and mode of use

Ketamine is often insufflated.
It can also be found in liquid form, which can be injected into muscle tissue for a very intense experience. The liquid can also be boiled off, leaving a crystalline powder. Ketamine is rarely taken orally (for example, in pill form). When taken orally, a higher dose is needed to feel the same effect as other methods. The liver will metabolize quite a lot of ketamine from the intestines before it can reach the brain.

The vast majority of ketamine that is used recreationally is produced by the pharmaceutical industry and subsequently ends up in the illegal circuit.

Determining a dosage can be difficult. How high the dose is at which you achieve the desired effect, depends on the experience you are looking for. Do you just want to feel a little vague and clouded, fall into a k-hole, or somewhere in-between? Additionally, your experience is dependent on many other factors besides intake dose.

One of these factors is the relatively quick tolerance for the ‘psychedelic effect’ of ketamine. As a result, you will need increasingly higher doses to achieve the same effect. If you have not used ketamine for a longer period after previous frequent use, make sure to start with a lower dosage when you decide to take ketamine.

Snorting dose
Light 10 – 30 mg
Medium 30 – 70 mg
High 70+ mg

At a dose of 50mg or more, sitting or lying down is recommended.
Ketamine in powder or crystalline form may be adulterated, make sure to always have your ketamine tested.

Duration

If you snort ketamine you will feel the first effects within 3-10 minutes. The experience lasts approximately 1-1.5 hours in total. (Note: ketamine is more potent than, for example, cocaine. This means that for the same dose, ketamine will have a more profound effect).

After injecting ketamine you will start to feel the effects after 3-5 minutes, with the experience lasting between 30-45 minutes.

Risks

Short-term risks of use

  • Confusion and difficulty coordinating movements. This creates a risk of falling and tripping, which could lead to accidents.
  • Ketamine dulls your senses, meaning you are less aware of pain and you can injure yourself without noticing.

Choking on vomit

When someone loses consciousness (e.g. passing out or a k-hole), there is a chance that they will choke on their own vomit.

In such an event, make sure to put that person in a recovery position: the vomit will then be able to flow freely out of the mouth. When they are free from immediate danger, call 112 (emergency services) for help.

(Nederlands) Triggeren (drugs-) psychose

Sorry, this entry is only available in Nederlands.

Bad trip

It can happen that you become overwhelmed by the intensity of the experience. Such an experience can be frightening, especially for inexperienced users, and is called a ‘bad trip’. A bad trip can manifest, for example, in confusion due to a too high dosage, but can also occur because someone loses control of their thoughts.

In these situaions, it’s important to reassure the person and make them feel at ease. Make it clear that the situation they find themselves in is a result of the drug’s effects and that it will get better shortly.

Give the person as much rest as possible, preferably in a familiar environment. Accepting the situation is often the first step someone needs to take to ride out the trip in calmer waters. Using psychedelics when you’re not feeling entirely well or when you’re in an unfamiliar or busy environment increases the chance of unpleasant experiences during the trip and is therefore not recommended.

Long-term risks of use

Kidney & bladder problems

The kidneys, together with the liver and the intestines, are the great ‘cleaners’ of your body. The kidneys work hard to remove the (harmful) substances from drugs. Waste products go to the bladder via the kidneys. There, the bladder stores the urine for a while before you pee.

If you use a lot of ketamine, this can cause problems in the urinary tract. The urinary tract runs from the kidneys, via the bladder to the urethra. Ketamine causes the bladder to become inflamed. This inflammation makes the bladder less flexible and therefore smaller. For example, you have to urinate more often because the bladder can store less urine, with the result that the bladder overflows, as it were. The more and the longer you use, the worse this gets. The pain can be very intense.

If you numb the bladder by snorting ketamine, it seems as if the symptoms decrease. But that is because you numb the pain with the ketamine. The symptoms only come obvious when you have not used ketamine for a while. The problems in the bladder are there, but you don’t feel them or you feel them less.

Even with less than daily use there are already signals that there may be complaints.

Click here for a detailed explanation of ketamine and bladder problems.

Psychological addiction

Psychological addiction means that you feel like you can’t live without a substance.

You can however stop taking this drug, without your body experiencing any issues.

Interactions

Combining different types of drugs can be risky and unpredictable. When you combine drugs you can have a higher risk of health problems. In the following paragraphs you can read about the effects and the risks of a number of combinations that occur frequently and also a about few that are extra hazardous. Also check our theme combining drugs.

Ketamine and alcohol

Ketamine and alcohol are both downers. They cause less activity in your brain. They reinforce each other’s effect. Some people like a low dose of both. At higher doses, the chance of unpleasant effects is considerably greater. Many people report feeling nauseous and vomiting. They are also more likely to become disoriented. They no longer understand what is happening and how to react to it.

Especially after a lot of alcohol it is not recommended to take ketamine. The chance of throwing up is high. If you first take ketamine and then drink alcohol, you are better able to control how you feel. But then still it is possible you’ll feel nauseous.

You can pass out of the combination. If you also feel nauseous and have to vomit, you could choke on your own vomit because you can’t control your body anymore. So always avoid passing out. Passing out is not ‘taking a nap’. It requires medical care. If someone has passed out of alcohol and ketamine, it is important to see whether someone responds to painful stimuli. If someone does not respond, call the ambulance immediately or take someone to the emergency room. If someone still responds to painful stimuli, keep a close eye on that person. And continue to administer pain stimuli until the person is awake again. Lay the person on their side so that vomit does not block the airway.

Alcohol reduces how deeply and how often you breathe. Combining alcohol with ketamine enhances that effect. Especially if you take even more downers (eg GHB or benzodiazepines, sleeping pills) then the chance of respiratory depression is greater. You then get too little oxygen, which can lead to a coma and in extreme cases you can die.

Ketamine and cannabis

Combining cannabis and ketamine increases the risk of nausea and vomiting. If you then have trouble moving because of the ketamine, in the worst case you can choke on your own vomit if you lie on your back. Cannabis can also make the effect of ketamine even more vague. Which is not always positive.

Ketamine and GHB

Ketamine and GHB are both downers. They cause less activity in your brain. They reinforce each other’s effect. Some people like a low dose of both. The combination increases the chance of unpleasant effects, especially at higher doses. Many people report feeling nauseous and vomiting.

You can pass out of the combination. If you also feel nauseous and have to vomit, you could choke on your own vomit because you no longer have control over your body. So always avoid passing out. Passing out is not ‘taking a nap’. It requires medical care. If someone has passed out of GHB and ketamine, it is important to see whether someone responds to painful stimuli. If someone does not respond, call the ambulance immediately or take someone to the emergency room. If someone still responds to painful stimuli, keep a close eye on that person. And continue to administer pain stimuli until the person is awake and awake again. Put the person on their side so that vomit does not block the airway.

With both drugs, people often suffer from memory problems when they are under the influence. You can no longer remember names, for example. Or you don’t remember what you just did. The combination enhances that effect. Writing down when you took something can prevent you from accidentally overdosing.

If you choose to combine, take less of both drugs. Or wait until one of the two has significantly decreased in strength. If you have no experience with GHB or ketamine, make sure you first have experience with both drugs separately.

There is a chance that the combination will make you more impulsive. Something stupid or dangerous seems like a good idea. A sober tripsitter can keep you from doing weird things.

Ketamine and ecstasy/MDMA

It changes the XTC/MDMA experience. After using MDMA, many people indicate that they already have some hallucinations (crash barriers, bar tables, sunglasses, etc.). Ketamine increases the risk of hallucinations. This can be fun, but also scary. The experience becomes much more vague. Some take ketamine after the MDMA to take the sharp edges off the end.

With both drugs, people often suffer from memory problems when they are under the influence. You can no longer come up with names, for example. Or you don’t remember what you just did. The combination enhances that effect. Writing down when you took something can prevent you from accidentally overdosing.

There is a chance that the combination will make you more impulsive. Something stupid or dangerous seems like a good idea. A sober tripsitter can keep you from doing risky things.

If you choose to combine, take less of both drugs. Or wait until one of the two has significantly decreased in strength. If you have no experience with MDMA or ketamine, make sure you have experience with both drugs separately.

Both ketamine and MDMA increase heart rate. This can put an extra burden on your heart and blood vessels. If you have heart problems, the combination is not recommended.

Unity tips

Using hallucinogens is inherently risky because of the chance of a bad trip occurring and because of intensifying psychological problems. If you do intend to use hallucinogens, you can limit the risks by:

  • Carefully dosing ketamine, because the effective dose of ketamine is much lower than that of other insufflated drugs.
  • Be careful with ketamine at parties, you may become disoriented and unstable, dancing is often no longer possible, and you may trip or fall on the dance floor. Think about whether or not you wish to experience this on the dancefloor.
  • If you’re using ketamine for the first time, make sure to take it in a controlled/safe environment (not at a party), start with a low dose and make sure there’s someone around who has experience with ketamine.
  • You often get nauseous when using ketamine. To prevent this, it is best not to eat for at least 3 hours beforehand.
  • If you end up having a bad experience with ketamine, keep in mind that you will feel fairly normal within an hour or so. This time may seem to last very long to you because the passage of time seems altered by the drug.
  • Stop taking ketamine when you notice bladder problems after use.
  • Do not combine using ketamine together with nervous system depressants, such as alcohol or GHB, this increases your chances of losing consciousness.
  • If you have insufflated ketamine, make sure to clean your nose before going to sleep. You can do this by removing the remains that are still in your nose with a damp cotton swab, a nasal douche, spraying with saline water, or using your fingers while in the shower.
  • If you inject ketamine into the muscles, expect an intense experience. Make sure you are able to lie down and use only sterile materials!

Unity tips for using drugs
  • When using a drug for the first time, take only a small dose to see how your body reacts to the substance
  • Only use drugs when you are feeling well
  • Use drugs recreationally, not to combat psychological issues like fatigue
  • Avoid using drugs if you have (had) psychological afflictions or if you have a family history of psychological diseases (such as depression) in your family
  • Test your drugs before use at a drugs-testing service
  • Make sure to prepare a good set and setting for drug use
  • Only use drugs sparingly. Keep track of your use over time.
  • Decide in advance how much you are planning to use over the evening, and stick to that. 
  • Do not combine drugs with other substances or medicines
  • Do not participate in traffic after drug use
  • Prevent infectious diseases; Use your own snorter/sniffer and do not share paraphernalia with others
  • After insufflating, rinse your nose well with lukewarm saline water (for example, by using a nasal spray or nasal douche)
  • Are you, or one of your friends not feeling well? Keep an eye out for one another, take care of each other and visit the first aid (if one is available)
  • Call 112 in a life-threatening situation
  • Eat healthy before and after drug use. In particular, foods with lots of antioxidants and vitamins (blueberries, raspberries, blackberries, grapes, raisins, oranges, kiwi, broccoli). This is perhaps the most important tip! It can be difficult to eat during and after drug use, but make sure to try to eat something anyway. Eating well is a great way to reduce the hangover! If you can’t hold in solid foods, try juices, breakfast drinks, and smoothies.

Unity tips for using psychedelics
  • When taking a psychedelic for the first time, try to have your experience in nature or at home
  • Do you want to trip at a party or festival? Adjust your dose to be smaller than what you are used to.
  • Prevent nausea by eating something easily digestible at least 2 hours before taking your drugs
  • Make sure to always have a sober person (a trip sitter) around when tripping.
  • Pay close attention to the effects you experience: if you feel that they are too strong or unpleasant, ingesting vitamin C, dextrose or sweet drinks may help to alleviate this.
  • Do not fight any unpleasant feelings during the trip, but let yourself float on the flow of the trip
  • Do not combine psychedelics with other drugs (including alcohol) and medications. Cannabis in particular can greatly intensify and prolong the effect of psychedelics.
  • Make sure you are free from responsibilities the day after using, take some time to process the experience
  • Do not use psychedelics if you suffer from epilepsy or have a cardiovascular disease.

Unity tips for using sedatives
  • Do not use sedatives (downers) in combination with other sedatives (alcohol, GHB, sleeping pills, opiates) or ketamine. This is dangerous because you can fall unconscious and suffocate on your vomit.
  • Write down the time of intake and your dose, text the dose and time to each other or put it in your phone to keep track of it yourself.
  • If you feel that you are getting falling asleep, you can try to keep moving to avoid falling asleep. But beware; if moving takes a lot of effort, there is a chance that you may fall or trip, so be careful.
  • An overdose is more likely on an empty stomach, a full stomach increases the chance of vomiting.
  • Less is more; taking a small, extra dose later because you did not feel anything after your first dose is better than taking too much and having an overdose.
  • Ensure that the people around you are aware of what you are going to use and have been using.

FAQ

 

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