Harm reduction

Harm Reduction & Overdose Prevention: Ketamine

Ketamine, also known as K, Special K, Vitamin K, and Ket, is a dissociative drug that some consider a psychedelic.

In moderate doses, ketamine helps reduce physical pain, and tends to slow the mind, though it often leads to an accelerated heartbeat. Some people describe the effects of ketamine as kind of a “drunk” feeling. It can cause double vision, and some nausea.

At higher doses, it tends to produce dissociation and hallucinations, and can lead to numbing to the point of not being able to move. Some people have vivid dream-like hallucinations. Some refer to this as a “K-hole,” during which the brain is functioning, but the body is unable to function. Ketamine inhibits the NMDA receptors to provide dissociative anesthetic activity. This means that it blocks the perception of pain.

Ketamine comes in a clear liquid and as a white powder. Powdered ketamine (100 milligrams to 200 milligrams) typically is packaged in small glass vials or small bags.

Ways of using (+ harm reduction)

Most commonly, powdered ketamine is snorted in bumps or lines, or booty bumped. It can also be smoked. Liquid ketamine can be injected or mixed into drinks. You’ll feel the effects of ketamine within 10 minutes if snorted and even quicker if injected.

A typical “bump” of ketamine in a recreational setting is just a fraction of a gram, and a dose of about 100 milligrams can produce a full dissociative state. Ketamine is generally found at parties and clubs in the form of a white powder, often in gram baggies. A gram can generally get several people high.

Try to avoid or reduce mixing ketamine with other drugs, which can be dangerous. Try to leave at least 30 minutes between doses, if you’re worried about taking too much.

Mixing ketamine with depressants (e.g., alcohol, benzos) can contribute to an overdose. You may become dizzy, pass out, and/or stop breathing. Mixing ketamine with stimulants can further increase heart rate and blood pressure, putting pressure on the heart’s functioning.

On its own, ketamine can make you disoriented. That means if you’re taking ketamine before or during sex work, or if you’re out on the street, or at a bar or club, you may be more vulnerable to people who wish to do you harm. It can help to use ketamine with people you know and trust.

Eat at least two hours before you use ketamine. Stay hydrated by drinking plenty of water or electrolyte drinks.

If you have mixed ketamine into a drink, make sure to remember which one, and make sure it does not get into the hands of someone who is not intending to consume it.

If you inject ketamine, use safer injection techniques and try to avoid sharing needles with others. Inject ketamine into the muscle only.

If you snort ketamine, try to avoid sharing snorting devices with others.

Using ketamine can cause serious harm to the bladder. If you notice bladder pain or blood in urine after ketamine use, or if your need to pee increases significantly, seek medical help. Staying really well hydrated when using ketamine can help prevent damage to your bladder – so drink plenty of water!

While overdose deaths on ketamine are very rare, using too much of it can lead to significant disorientation, loss of balance, confusion and sometimes unconsciousness or inability to move. Start with a small amount and give it time before you decide whether you want to do some more.

If you booty bump ketamine: You can dissolve the drug in water and then use a syringe without the needle to “bump” the solution into your butt. Or, you can push some of the drug on your fingertip into your butt. Either way, the drug is absorbed by the blood vessels in the lining of your rectum (butt). It takes about 3-5 minutes to feel the effects. Don’t share booty bumping syringes, which could put you at risk of hepatitis, parasites, or other diseases. If you bottom after booty bumping, have your partner wear a condom since booty bumping can damage the membranes that line your rectum–increasing the risk of giving or getting STIs.

Overdose prevention

While large doses of ketamine can lead to significant psychological distress, it does not present a major risk for overdose death, at least when used on its own.

Some people call the feeling of taking too much ketamine as a “K-hole.”

What does a K-hole feel like?

It can feel overwhelming. Your body may go completely numb, and it may be hard to see. You may feel disconnected from your body, and experience “floating” above your body. You may not be able to move. You may have hallucinations or psychosis.

On the other hand, some people experience K-holes as comfortable and euphoric experiences.

To prevent taking more than you want, start with a small amount and give it time before you decide whether you want to do more.

If you’re with someone who falls into a K-hole, make sure they are breathing and that their airways aren’t blocked. If it looks like they’re having trouble breathing, get them medical help.

If you’re with other people taking ketamine, help prevent injuries like falling onto the floor or into furniture.

Help create calm spaces for people who are coming out of K-holes and who are regaining consciousness.

Other facts about ketamine

Ketamine was developed in 1963 as an anesthetic for humans and other animals. The creator synthesized PCP first, but found it had too many side effects (including psychosis) to be used as an anesthetic.

Ketamine is a PCP derivative, and is roughly one-tenth as potent.

Recreational use of ketamine was first recorded in the mid-1960s, and became widespread during the 1990s club scene.

Ketamine is not used for anesthesia as frequently as it has in the past, but is now used as part of therapy for people experiencing treatment-resistant depression.