Ketamine

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.

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 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.

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.

Ketamine makes the bladder wall more easily inflamed. If you snort ketamine often, your bladder wall may be constantly inflamed. The pain this causes is also known as k-cramp. Because of the pain, people tend to use more, which in turn causes more physical problems.
The constant inflammation can make your bladder wall less flexible due to scar tissue. You have to urinate more often. The inflammation can get so bad that the bladder is permanently destroyed and you need a stoma.

There are not that many acute risks for ketamine. Most accidents happen because someone trips over something or bumps into something. Ketamine can make it more difficult for you to move and you’ll feel disoriented. For example, using ketamine at a party can make dancing more difficult.
Ketamine also has an anesthetic effect, so you may hit yourself and hardly feel anything. Therefore, make sure that you sit or lie down when using ketamine to prevent you from falling or tripping.

Ketamine is one of the few downers that hardly affects breathing. This makes it very suitable for use as an anesthetic. Ketamine for medical applications is called ‘esketamine’ and is only available medically. Ketamine has an inhibitory effect on the nervous system. Pain stimuli are not (properly) passed on. As a patient you no longer feel pain. The doctor can then anesthetize you or perform short-term operations without too many risks. It is mainly used in the anesthesia of the elderly and children because breathing is extra important to monitor during the operation.
If you want to start using ketamine, it is important to realize that it affects your orientation and the functioning/movement of your body. Dancing or partying is often no longer there and you can easily trip or fall on the dance floor. So using ketamine at a party may not give you the effects you’re looking for. Knowing more? Check: unity.nl/nl/drug/ketamine for more information!

You can’t become physically addicted to ketamine, although the frequent use of ketamine does have adverse effects. When you stop using there are no physical withdrawal symptoms. With regular use of ketamine, you run a high risk of becoming mentally addicted though. Tolerance will soon set in. This means you have to take a higher dose to achieve the same effect.

The temptation to take ketamine increases when you want to escape reality. The drug takes control of your life. Frequent use makes you lose sight of reality and can cause fear, panic and delusions if you don’t use. It is therefore difficult to stop independently. If you are concerned about your own use, discuss this with friends or with your doctor.

A k-hole is a very strong ketamine experience. K-holing is often compared to a near-death experience: out-of-body experience and going through a tunnel towards a light. You can’t move and you can’t talk.
We think it’s because multiple areas in the brain can no longer communicate with each other due to the blockage of NMDA receptors. For example, because the area that controls your muscles does not transmit information to those muscles, you can’t move and you can’t talk.
It can be a very interesting or educational experience, but also very scary. Therefore, make sure you can lie down if you plan to take a lot of ketamine. It is good to know that ketamine is a powerful drug. You need much less of it compared to other substances that are snorted. So pay attention to how much you take and think carefully about this in advance!

It differs per person how much you need and how quickly you will feel the effects. Therefore, it is difficult to answer this question. But with ketamine you will become a bit vague at a dose of 5 to 50 mg. At doses above 50 mg, the effects can become more psychedelic and very intense. The more you take, the stronger and longer the effects last. Ketamine is a strong drug and you need less of it compared to other drugs that are snorted. So pay attention to how much you take and think carefully about this in advance!

The testing service regularly tests ketamine that contains contamination from other substances such as levamisole or caffeine. You can find the most recent information about cuttings in the DIMS annual report.
To avoid unnecessary risks, it is always good to have your ketamine tested. You can do this at various places in the Netherlands, often for free! Check drugs-test.nl for a location near you.

Always make sure that you are and remain safe yourself. If you are in danger, you cannot help the person in need.
Find a quiet place with the one who is having a hard time. Don’t try to deny that he/she is having a bad trip. Try to reassure him/her: he/she has taken drugs and the effects and thus the bad trip always wear off. Ask the person about what they are experiencing and try to talk the trip on a positive side without downplaying it. For example, by giving a positive meaning to the things he/she sees. Try to do things that make him/her feel comfortable, such as moving or singing. See if it makes sense to talk about pleasant things. Distraction can also help, for example by drawing. Let your voice sound calm and reassuring.
Make sure that the user does not end up in dangerous situations such as traffic. Call emergency services if it becomes unsafe for the user or his environment or if the bad trip is too intense to solve it yourself.

Some complaints after using drugs can last longer, A medical explanation or even treatment may then be necessary. The Brijder has set up a national consultancy for party drugs related medical complaints. If you have medical complaints after the use of party drugs, you can call the consultancy: 088 – 358 29 40. This service is only available in the Netherlands.

When someone close to you uses a substance often it is normal to worry. There are risks: to physical health; that he/she will gradually use more and more and become dependent. When only using it on weekends, there is the possibility that he/she is able anymore to go out without using. It can then be useful to have a conversation with each other in an open, non-judgmental way. Mention the impact the use has on you as a person, for example that you are worried. If you would like tips or advice for this, please contact the addiction care institution in your region.

There are several versions of the ketamine molecule. There is a left-handed (L), a right-handed (R) version and the combination of both versions. We call the latter racemate or a racemic version (left and right 50-50). The levorotatory ketamine is called esketamine. The dextrorotatory ketamine is called arketamine. The atoms on the molecule are exactly the same but they are mirrored. Just like your hands are exactly the same, yet not: they are each other’s mirror image.
The appearance of the ketamine does not tell you anything about which one you have. Ketamine can be crystallized in rods, spheres, sugar, needles, etc. So what it looks like does not provide information about which ketamine you have.

It is difficult to determine exactly which version is on the Dutch drug market, but it seems that ketamine is racemic on the recreational drug market. Half left-handed and half right-handed. This is apparent from information that we have received via the DIMS (Dutch test service, Trimbos Institute). Research in Austria also shows that 99% of the Austrian market is racemic. It is very expensive to investigate which version you have (left, racemic or right), which is why the DIMS does not analyse it. Only if you have real pharmaceutical grade ketamine in liquid form do you know which form you have: left-handed ketamine. But that liquid ketamine is very rare.