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Sunday, December 17, 2017

Ketamine

Overview
Ketamine is a dissociative anesthetic that has traditional been used in both human and veterinarian
medicine as an anesthetic, although it has been discontinued from use in humans due to its intense
psychedelic episodes. Ketamine use is common in the U.S and abroad, particularly with younger people,
with the Drug Abuse Warning Network reporting 74% of ketamine users between the ages of 12 to 25.
Ketamine’s primary danger comes from its potent dissociative effect which can lead to a wide range of
dangerous neurological effects, a loss of physiological control, and various psychological issues. Because
high doses of ketamine can act as a hallucinogen, ketamine also carries dangers commonly associated
with regular hallucinogenic drug usage. Ketamine is perhaps most famous for what is known as the “KHole”,
a state of severe dissociation that can occur at a high enough dose, which results in severe visual
and tactile sensory distortions. Ketamine works on a certain class of neurotransmitter receptors known
as NMDA receptors by temporarily slowing and severing neurological connections between these
receptors in the brain and spinal column. Although ketamine addiction is relatively infrequent when
compared to other drugs, ketamine is one of the few drugs classified as a psychedelic drug that has the
potential for both physical and psychological dependency, which may develop into an addiction.
Ketamine exhibits short-term effects similar to other dissociative drugs including dissociation, calmness,
numbness, sensory distortion, and disorientation. Long term abuse of Ketamine can lead to a variety of
physiological and mental ailments including depression, anxiety, memory impairment, and insomnia.
There are currently no effective pharmaceutical treatments for Ketamine abuse, but there are many
therapeutic options available to help manage dangerous and addictive behaviors, and rehabilitation
facilities offer extensive resources for recovering from drug abuse in a safe, stable, and comfortable
manner.

What is Ketamine?
Ketamine, a member of the arylcyclohexylamine class of medicinal compounds that includes the
extraordinarily dangerous drug PCP, is a dissociative anesthetic. Ketamine holds a reputation for its
usage in veterinary medicine as an anesthetic, as well as its intense feelings of dissociation and
psychedelic distortion of reality when abused as a drug. Although first used in medicine during the 1960
exclusively for veterinary procedures, but slowly gained popularity on the street as a recreational drug.
Although deaths from ketamine abuse are uncommon, there have been reported cases of overdose, and
it can often be fatal when mixed with other similar drugs such as GHB, alcohol, and barbiturates.
Ketamine’s primary danger comes in its potency as a depressant, which can dangerously slow down
heart rate and breathing, and can cease functioning altogether. Ketamine is known as one of the few
psychedelic substances with a potential for physical dependency, and can develop into an addiction in
some people. Ketamine is classified as a Schedule III drug by the Controlled Substances Act (CSA),
meaning that ketamine does have an accepted medical use in the United States but has some potential
for abuse, including both physical and psychological dependence.

How Does Ketamine Work?
Ketamine’s primary effect on the brain is its use as an NMDA receptor antagonist, a group of
neurotransmitter receptors that are responsible for carrying signals from the brain to the spinal column.
When these important receptors are blocked by ketamine’s antagonistic property, they are unable to
function properly. This leads to a disconnect between partial regions of the spinal column and brain that
can lead to a loss of feeling and sensation, loss of muscle control, and in relatively high doses, complete
dissociation of mind and body. When this dissociation reaches the point of accompanying visual
distortions, external sensory input becomes halted in a phenomenon colloquially called the “K-Hole”.
Ketamine’s psychedelic property, which may be due to its blockage of serotonin depletion in the brain,
becomes evident in a K-Hole, in which sensory distortions including visual, auditory, and tactile senses
may manifest in various manners.

Short and Long Term Effects
Ketamine is most often taken snorted in a powdered form, but is frequently used as an intramuscular
injection as well. Onset of effects varies from around 2-4 minutes when injected, and
5-15 minutes when snorted. Ketamine is shorter lasting than many other drugs of its kind, and
generally lasts for up to an hour at most.

Users report short-term mental effects such as feelings of:
 Out-of-body experiences
 Sensory and visual distortion
 Euphoria
 Dissociation
 Calmness
 Frightening shifts in perception of reality
 Paranoia

And physical effects such as:
 Pleasant body high
 Numbness
 Ataxia
 Increased energy
 Decreased pain sensation
 Slurred speech
 Disorientation
 Decreased breathing

Repeated long-term use of Ketamine leads to physical side effects such as:

 Diminished cardiovascular health – Ketamine has been shown to lead to dangerously
slow heart rates, and can be responsible for heart arrhythmias and dangerously high or
low blood pressure
 Gastrointestinal problems – Because of ketamine’s effect on appetite, frequent use of
ketamine may result in a variety of gastrointestinal problems including morning sickness,
anorexia, and vomiting.
 Memory Impairment – Ketamine has been found to induce irreversible neurological
damage. While infrequent usage of ketamine is generally safe in terms of neurological
damage, frequent use has been shown to induce varying levels of memory impairment
in individuals, as well as impair other essential neurological functions such as neuron
development and upkeep.
 Bladder problems – Ketamine has led to bladder problems to such a frequency that a
variety of names have been developed for particular cases that have been induced by
ketamine, such as “ketamine-induced vesicopathy”. These bladder problems can include
ordinary urinary tract infections, as well as a general loss of bladder control resulting in
lowered bladder volume and incontinence. These problems are generally curable by
removing all ketamine uptake and beginning treatment with antibiotics or steroids.
 Insomnia – Due to Ketamine’s effect on neurological functioning, a general decay in
personal health, as well as frequent interruptions in ordinary circadian activity,
Ketamine users often experience worsening sleeping problems that can develop into
insomnia.
Long-term use of Ketamine also carries several mental side effects including:
 Depression – One of the most common symptoms of extended ketamine usage is
depression. This can come from either hormonal or chemical imbalances that develop
through extended use of ketamine, or through the psychological effects of a ketamine
high.
 Depersonalization and Derealization – These psychological impairments which are
often accompanied by depression and anxiety can develop from the usage of any
dissociative drugs. Symptoms include a feeling of permanent dissociation of mind from
body, being unable to recognize and identify with the body, a general feeling of the
world not seeming “real” as well as various symptoms of paranoia and anxiety that are
further developed from experience of these impairments.
 Anxiety – Anxiety is a frequent symptom of drug abuse in general, and is common in
ketamine abuse due to internal factors from the psychological and physical effect of the
drug itself, as well as external factors such as pressure family, friends, and work that
may all be affected by addiction. This can compound and develop into chronic paranoia.
Other risks posed by Ketamine abuse include:
 Extended hallucinations – At doses used for medicinal anesthetic, some patients have
reported sensory distortion, hallucinations, and delirium that can extend up to a full day
after the dose has been administered.
 Interactions with preexisting mental illness – Like all hallucinogenic and dissociative
drugs, users with preexisting mental illness or a disposition toward mental illness may
have negative interactions with ketamine that may trigger symptoms, or even the onset
of the condition itself.
Although not life-threatening, ketamine withdrawal can be a difficult process to go through, and
includes withdrawal symptoms such as:
 Loss of motor skills
 Fatigue
 Mood swings
 Restlessness
 Depression
 Loss of concentration
 Tremors, muscle aches and cramps
 Memory problems

Methods of Treatment
Pharmacological:
Because chemical dependency on ketamine is relatively infrequent, there are no pharmaceutical
treatments currently available for Ketamine abuse.

Therapeutic:
Other forms of treatment for beer addiction come in the form of psychological and behavioral therapies.
These treatments focus on the behaviors and habits that led to addiction in the first place in an attempt
to remove the root of addiction. Amongst these forms of treatment, Cognitive Behavioral Therapy (CBT)
is one of the most common, and is growing in support from the scientific and clinical communities all the
time. Cognitive Behavioral Therapy sees substance abuse such as beer addict as a symptom of a greater
psychological issue, and not a cause in and of itself. By utilizing reflective and analytic techniques, an
addict is better able to understand what led them to addiction in the first place, change bad habits, and
avoid behaviors that may trigger cravings. The twelve-step program is also available as a longestablished
method of treating drug and alcohol addiction. The twelve-step program works as a gradual
method of guiding principles and pragmatic steps that can be taken to go from the depths of addiction
and unhealthy habits to sobriety. These twelve steps are aimed at effectively recovering from
compulsive and addictive behaviors, and addressing mental and behavioral problems that led to
addiction in the first place. These twelve steps include both internal and external actions aimed at
making amends for past mistakes, accepting responsibility for the actions that led to addiction, and
moving forward to establish healthy habits and a positive mindset.

Rehabilitation
Rehabilitation for Ketamine alone is generally uncommon, but may be beneficial for those who abuse
Ketamine frequently and have difficulty stopping dangerous behaviors that lead to its usage.
There are two main types of rehabilitation: inpatient and outpatient. Inpatient rehabilitation refers to
programs that require patients to check themselves into a facility where they will undergo all
rehabilitation treatment. Although inpatient rehabilitation requires a greater level of commitment, the
facilities, environment, and support offered by these facilities are conducive to a stable and effective
recovery. Inpatient facilities generally offer services such as psychiatrists, counselors, group therapy, and
all of the living facilities necessary for a comfortable stay. The extensive support offered by these
facilities, combined with an environment that is focused on self-improvement and wellness is a great
combination for providing the motivation to push through the difficulties of withdrawal and to establish
good healthy habits to prevent relapsing once you leave. This form of rehabilitation is effective for those
who would benefit from a stricter more scheduled recovery in which the outside distractions and
temptations of life won’t get in the way of focusing on recovery.
Outpatient rehabilitation is based on the principle of spending only part of your time in recovery
programs while offering you the freedom to continue daily living on your own. Generally these programs
will require ten to twelve hours of commitment per week spent in a treatment facility participating in
similar activities to those done in an inpatient facility such as group therapy, counseling, and even detox.
While this does offer easier access to drugs, some may find being able to maintain their normal daily
schedule more beneficial. This form of rehabilitation is effective for those who require more freedom
and contact with friends and family.
Both forms of rehabilitation may be effective solutions at combatting Ketamine abuse, and there is a
variety of different types of both inpatient and outpatient rehabilitation to suit the personal needs of
each individual