You may have seen news articles about ketamine treatments and changes in its legal status within the Drug Enforcement Administration. You may have even seen ads recently promoting companies that will ship doses of ketamine straight to consumers.
This drug, which has had recreational users for decades, is becoming increasingly accepted societally as a treatment for various mental health conditions. Pharmaceutical companies are making a public relations push for widespread legalization, similar to the way that medical marijuana was introduced and sold as a concept to the public.
But just as other technically legal substances (like alcohol, painkillers, and anti-anxiety medications) can have major health effects if misused, taking ketamine and other drugs with dissociative effects can have serious negative impacts. The misuse of these substances presents grave consequences for public health.
Misuse of ketamine can cause irregular heart rate, seizures, and delusional thinking. One widely misunderstood element of ketamine use is the risk of falling into a k-hole.
Read on to learn more about the origins of this controlled substance, its effects, and the risks of too much ketamine, both short- and long-term.
Introduction to Ketamine
Ketamine was first synthesized in 1962 by Calvin Stevens, a researcher seeking to develop new drugs called dissociative anesthetics. Phencyclidine (PCP), which was in wide use in a clinical setting at the time, caused vivid hallucinations.
Notably, PCP has now become a recreational drug and has many of the same effects as ketamine.
Medical Use
Ketamine was found to induce rapid anesthesia with fewer respiratory issues and fewer hallucinogenic effects than those caused by PCP. By 1970, the FDA approved ketamine for human use, and it quickly became a widely used general anesthetic, especially in cases where reducing pain awareness while maintaining respiratory function was crucial.
Unlike neuromuscular blockers, like rocuronium, which induces paralysis in patients, ketamine allows patients to mostly maintain motor control, reducing physical risks.
Over time, ketamine’s distinctive properties made it an important tool outside of the surgical setting it was originally used for. Beyond its role as an anesthetic, it has been used for its psychological effects as a sedative in emergency situations.
In recent years, ketamine has attracted significant interest in psychiatry due to the substance’s ability to reduce intense feelings of depression. This has led to the development of new treatment protocols and the FDA approval of a ketamine-derived nasal spray, esketamine, in 2019 for depression treatment.
The Effects of Ketamine
Ketamine’s effects are widely documented due to its use under medical supervision. The following are some of the more commonly reported effects of ketamine on the physical, cognitive, and emotional functioning of humans.
Physical Effects:
Anesthesia: Ketamine is a powerful anesthetic, inducing a dissociative state where patients feel detached from their body and surroundings.
Sedation: Ketamine often causes drowsiness and a sense of calm, making it useful for sedation procedures, where uncomfortable physical sensations can cause patients to react negatively.
Irregular Heart Rate and Blood Pressure: Ketamine can increase blood pressure, and at high doses can cause irregular heart rate, making it a dangerous substance for people with underlying heart conditions.
Seizures: At high doses, ketamine can increase seizure risk, particularly in individuals with epilepsy or other seizure disorders.
Muscle Relaxation: It often induces muscle relaxation and reduced motor control, which is useful during surgical procedures.
Nausea and Vomiting: These can occur, especially when ketamine is administered at higher doses.
Cognitive Effects:
Dissociation: Ketamine is known for causing a dissociative state where users feel disconnected from their thoughts, body, and environment. A k-hole is an extreme version of this state, where brain to body communication is seriously impaired
Hallucination: At higher doses, ketamine can cause vivid hallucinations. Users will often describe an out-of body or near-death experience.
Confusion: Cognitive functioning may be impaired, resulting in confusion or difficulty concentrating. The aforementioned out of body experience can make it difficult for users to recognize what they are doing, potentially leading to reckless behavior.
Emotional Effects:
Anxiety and Fear: In some cases, ketamine can induce anxiety or fear, especially if the user is unprepared for the dissociative effects.
Emotional Blunting: It may cause a rapid reduction in emotional intensity, making users feel emotionally numb or detached. This is one reason it is used in clinical settings to treat dysphoria when other substances may take too long to take effect.
Euphoria: Some users report feelings of euphoria or a sense of well-being.
Calmness and Relaxation: Ketamine can induce feelings of calmness and emotional detachment, reducing anxiety and stress.
The K-Hole
The term “k-hole” refers to a strong dissociative experience that occurs on high doses of ketamine, typically during recreational use. While some people who use ketamine recreationally seek to induce this intense out of body experience, others may be frightened by it. Notably, it puts users at risk of physical harm due to their decreased ability to react to danger.
Users who experience a k-hole are often temporarily unable to control their physical movements. Falling into a k hole can feel like descending from one’s typical level of awareness of bodily sensations and surroundings into a state of total dissociation.
Near Death Experience
Some compare a k-hole experience to being on the verge of death, due to the loss of control and distorted sense of time. Users of other common dissociative drugs like PCD and DXM report similar feelings. Some who do not enjoy this level of ketamine use compare it to a bad LSD trip.
How Long Does a K-Hole Last?
At the level of a k hole, ketamine effects are significantly stronger than those experienced during medically supervised ketamine use, which involves low doses. Consequently, the effects also last longer.
A k-hole can last from 30 minutes to an hour. Due to the out-of-body or near-death experience feeling that users experience, it may seem to last much longer.
Is It A Ketamine Overdose?
Although a k-hole can be very uncomfortable for some users, it is not considered a ketamine overdose because it is technically not life-threatening.
An overdose requires serious physical harm, such as respiratory depression or loss of consciousness. A user who has a ketamine overdose may fall, begin vomiting, or stop breathing, which are not typical elements of a k-hole.
The Risks of Ketamine Abuse
Ketamine misuse can have many severe negative consequences.
Physical Risks
Because users are less able to respond to external stimuli, they are at increased risk of physical harm. For people at risk of assault, sexual or otherwise, ketamine use is not advisable. Sexual assault risk increases with the use of illicit substances of any kind.
While the drug is injected intravenously in surgical setting, recreational users snort it in powder form, which can injure their nasal passages.
Long-Term Effects of Ketamine Abuse
People can develop physical dependence and psychological dependence on ketamine, leading to a substance use disorder.
Ketamine abuse and ketamine addiction can cause users to have withdrawal symptoms when they stop using.
Long-term use also causes urinary complications, including urine retention and decreased bladder size.
Impact on Mental Health Disorders
Long term ketamine use can also lead to schizophrenia like symptoms, as users adjust to constant dissociation and lose touch with reality. Although ketamine is being used to treat depression, its impact on people with other mental health disorders is unclear, and mixing ketamine with prescribed medication is not advisable.
Treatment Options for Ketamine Use Disorder
There is a lack of specific support groups for users of this substance. But treatment is available. Turning Point of Tampa offers evidence-based substance abuse treatment for users of ketamine and other drugs of abuse. Their licensed clinicians can help you form a plan to overcome your substance use issues and achieve a healthy mind and body.
