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Ketamine the Special K with a License to Kill

Special K or Ketamine as it is known in the drug world is not your friendly morning breakfast. This substance a deadly opioid plaguing addicts across the nation. Ketamine is officially used as a veterinary and medical anesthetic, but it’s also abused as a recreational drug. In 2018, twelve teenage boys were rescued from a cave in Thailand. To prevent them from panicking during the underwater rescue mission, they were given a mixture of ketamine, Xanax, and a saliva suppressant. The ketamine was a safer option for sedating the boys as it doesn’t create as many implications as other sedative drugs like morphine, which slows the heart rate down. While ketamine is an anesthetic and sedative, it is also hallucinogenic and can cause paralysis.

The Discovery of Ketamine

Ketamine was first synthesized in the 1960s as a sedative and anesthetic, which is why it was useful for rescuing the boys from the cave. Ketamine was first synthesized in 1962 by Professor Calvin L. Stevens at Wayne State University in Detroit, Michigan. At the time, Stevens was a chemical consultant to Parke Davis, a pharmaceutical company that was acquired by Pfizer in 2000. It is a derivative of phencyclidine (PCP or Angel Dust) and has less drastic psychoactive effects than PCP.  Experiments on animals revealed that ketamine had the potential for medical benefits. In 1964, Drs Edward Domino and Guenter Corssen controversially tested the new drug on 20 prisoners from Jackson Prison, Michigan. According to the classic paper “Taming the Ketamine Tiger,” there were patent issues and a settlement was made with Professor Stevens. The subjects reported feeling as though they were floating through space and felt “limbless.” The doctors had to be careful how they phrased their findings as if they chose the wrong wording any further research would be banned.  So they used the term, “dissociative anesthetic” to convey the “disconnected” feeling. Ketamine is considered by scientists a “dirty drug.” This means that it targets many different systems in the brain, rather than just one. Interestingly, ketamine has a mild effect on opioid receptors, which heroin and cocaine target. Unlike heroin and cocaine, though, ketamine mainly targets a transmitter called glutamate. Glutamate helps neurotransmitters to communicate with each other. It’s essential for the brain and central nervous system to function. Glutamate keeps the whole central nervous system from going into shutdown. In high doses, ketamine blocks glutamate, which makes it an excellent anesthetic. But, at low doses such as with a dose of a nasal antidepressant or street ketamine, it ramps up glutamate production. Low doses produce a variety of side-effects such as:
  • Hallucinations
  • Feeling out of touch with reality
  • Helps to reconnect some pathways in the brain

Ketamine as an Anesthetic

After ketamine was approved by the FDA in 1970, it was used on the battlegrounds as an anesthetic in the Vietnam War. It is considered a better anesthetic for the battlefield because it won’t slow down breathing or cause a drop in blood pressure so unlike morphine a patient doesn’t need to be constantly monitored. Ketamine was also effective in calming soldiers down during traumatic times in battle.

Ketamine for Depression

In 2019, the FDA approved ketamine as an antidepressant. There are two types of ketamine prescribed for this purpose, racemic ketamine, and esketamine (a nasal spray). This new form of antidepressant is a great treatment for many people who do not respond to typical depression treatments such as cognitive behavioral therapy and antidepressants that take several weeks to take effect.  Clinically, it’s not completely understood why ketamine works as an antidepressant. It stimulates the glutamate receptors, which stimulate different kinds of receptors that communicate along neural pathways. Ketamine is thought that the increase in connectedness in the brain helps to alleviate depression.  Doctors are considering using ketamine as an emergency medication for suicidal people as it can rapidly lift a person out of depression. When the person’s mental condition has improved, they can go on with cognitive behavior therapy and antidepressants. The medical profession is also considering infusions that last for a few days to lift a person from a depressive or suicidal episode, but there are concerns about the potential for addiction But, while ketamine has its uses it can also be abused and be addictive.

Ketamine Assisted Psychotherapy (KAP)

A new kind of treatment is starting up which combines doses of ketamine during two-hour psychotherapy sessions. It is believed that the combination can supercharge the effects of psychotherapy.   Ketamine-assisted psychotherapy works because ketamine induces an altered state of consciousness. The dissociative effects of the drug free a person from their anxieties so that they can see their problems more objectively.   KAP can be an effective treatment for conditions such as:  
  • Anxiety
  • Depression
  • PTSD
  • Grief
  • End of life distress
 

Ketamine Abuse

The 1960s and 1970s saw a wide rebellion take place in reaction to the Vietnam war. Recreational drugs took off as part of the “make love not war” movement. Phencyclidine and ketamine were added to the list of drugs of abuse, which subsequently led to the formation of the Drugs Enforcement Agency and the war on drugs.   The Controlled Substances Act classifies drugs according to their harm and medical potential. Phencyclidine was given Schedule I (the same as heroin and cocaine), and ketamine was given Schedule III classification.   As ketamine became widely abused, the DEA considered upgrading it to a Schedule II drug.   Ketamine first found its way on the underground as a rave drug in the 1980s. Many took ketamine to enhance the effects of ecstasy. Today, ketamine is still used as a party drug.   The National Survey on Drug Use and Health most users are aged between 18 and 25.   When taken recreationally, ketamine is known to provide an outer-body-experience and a disorienting effect known as a K hole. Higher doses can have someone feel like they are having a near-death experience, although for many this is pleasurable.   K is a fast-acting drug that lasts for around an hour.  Ketamine is a Schedule III drug according to the Controlled Substances Act. It can be taken in various ways from snorting and ingesting to injecting.  Typically ketamine is sold as a liquid and then converted into a powder by heating in a frying pan or a microwave. Ketamine can make it difficult for a person to move and has been used as a date rape drug. Ketamine has been likened to a tiger that must be tamed as it is so fast-acting and intense in its effects.  

Ketamine as a Law Enforcement Tool

In some states, the police are allowed to administer ketamine to suspects who display symptoms of “excited delirium,” which is not recognized as a mental health condition by the World Health Organization, the American Psychiatric Association, or the American Medical Association. It is however recognized by the American College of Emergency Physicians.  Symptoms of excited delirium include:
  • Severe distress or panic
  • Paranoia
  • Disorientation
  • Overheating
  • Unexpected strength
  • Incoherent shouting/speech
  • Aggressiveness
  This condition is typically a result of substance-use impairment but is not medically recognized and police are given the power to ‘diagnose’ a suspect that is resisting arrest. In December 2020, Colorado banned prehospital use of ketamine after an investigation into the death of Elijah McClain.  Elijah matched the description of the suspect police were searching for as he was wearing a ski mask.  When he first regained consciousness after being restrained, the police requested the paramedics administer ketamine. He died of a heart attack on the way to the hospital. The autopsy said that he was given twice the dose he should have as the paramedic misjudged his weight. He may also have had an adverse reaction to the ketamine.   This man was not suspected of any crime nor was he armed. The police used excessive force on an innocent man and then killed him by injecting ketamine because they weren’t capable of managing the situation appropriately.   Police can ask paramedics to administer ketamine if they feel that a person has excited delirium. There is no federal legislation on the use of ketamine on suspects, each state has its policies.

Ketamine Addiction

It is possible to build up a tolerance and develop an addiction to ketamine. You can tell if someone is addicted to ketamine if:
  • They often seem distracted or drowsy
  • If they lose coordination
  • Insomnia
  • Skin redness
  • Bladder pain
  • Incontinence
  • Their speech is slurred
  It is typical for people who are addicted to ketamine to go on binges and take large doses in short lengths of time. Users commonly disappear for days and retreat from their relationships and responsibilities.   Binges are a sign that a person has developed a high tolerance for ketamine. They need higher doses to get an effect. Unfortunately, this exacerbates the likelihood of severe health problems.  

Dangers of Ketamine Addiction

Prolonged use of ketamine can have serious health consequences.   Ketamine addiction typically causes depression and impaired motor skills. Some may need speech and language therapy due to the damage caused to the brain.   Ketamine particularly affects the bladder. Over time the bladder lining thickens with continued ketamine use. Eventually, the bladder lining swells to the point that it blocks the urinary tract.   Urinating becomes impossible and painful. This damage is irreversible and requires reconstructive surgery.   Even occasional ketamine users experience cystitis symptoms from time to time.   It is possible to overdose on ketamine. People who die from taking ketamine typically do so because they mix it with other drugs. There are also deaths from people who die from accidents after falling unconscious from ketamine.  

Where Is Ketamine Produced?

According to the World Health Organization , ketamine is not typically manufactured illicitly because it’s too difficult. It is hard to access the chemicals required to produce ketamine.   So most street ketamine is diverted from legal sources. For example, a vet pharmaceutical lab in Mexico that was decommissioned sold their surplus ketamine over the internet. ketamine injection  Much of the world’s ketamine is produced in India and China, a portion of which is channeled into the street drug market.  

Ketamine’s Molecular Structure

Ketamine comes from the arylcyclohexylamine class of chemicals. These chemicals antagonize the glutamate NMDA receptor, which is important for memory and synaptic function.   It’s this action that is responsible for ketamine’s anesthetic and hallucinogenic effects. Ketamine’s molecular structure is very similar to phencyclidine (PCP).  

Treatment for Ketamine Addiction

Unlike withdrawal from alcohol, ketamine is not life-threatening. But, the symptoms of withdrawing from ketamine can be unpleasant.   Withdrawals occur when a person stops using ketamine due to altered opioid receptors in the brain. The biggest danger of ketamine withdrawal is extreme depression, which could prompt someone to consider suicide.   Ketamine withdrawals are mainly psychological and include symptoms such as:  
  • Fatigue
  • Psychosis
  • Hallucination
  • Delusion
  • Nausea
  • Anger
  • Insomnia
  • Shakes
  • Cognitive impairment
  For safe withdrawal, it makes sense to be supported by professional support staff. Some people who withdraw from ketamine may be isolated from others for their safety.   Withdrawal from ketamine can take between a couple of days to several weeks. The symptoms of withdrawal tend to kick in around 24 to 72 hours after a person’s last dose.   The length of time it takes to withdraw from ketamine depends on several factors such as whether other drugs are implicated, the severity of the addiction, and tolerance level.   Treatment for ketamine dependence typically involves counseling and cognitive behavioral therapy.   The process of withdrawing from ketamine takes a few days.   Within 24 hours of the last dose, withdrawal symptoms will start. Symptoms can include nausea, shaking, double vision, rapid breathing, and loss of hearing.   The withdrawal symptoms taper off eventually. By the end of the second week, a person should be clear of symptoms.   Overcoming a ketamine addiction is a difficult one to overcome. Addiction is often accompanied by other co-occurring mental health disorders as well as multiple substance-use disorders. For treatment to be effective it must first start with an accurate mental health diagnosis.   A high-quality treatment center will have skilled psychiatric doctors who have the knowledge and perception to identify mental health disorders that underpin addiction. An accurate diagnosis means that the right treatment program can be tailored for your specific needs. While ketamine is thought to be a street drug, it also has various therapeutic uses. Ketamine is becoming more accepted and considered to be useful in treating psychological ailments such as depression, anxiety, and PTSD.   Now that it is approved for use with psychotherapy ketamine-assisted treatment programs are springing up. If it’s administered properly and used under proper guidance, ketamine can have profoundly positive benefits. It can even be life-changing.   Ketamine clinics around the country now offer ketamine assisted therapy. People who suffer from depression, obsessive-compulsive disorder and bipolar can benefit from ketamine if they don’t benefit from antidepressants.   The wonderful thing about ketamine treatment is that it works in an instant, whereas antidepressants can take weeks to take effect. Research has shown that ketamine therapy can work wonders where traditional therapy has failed.   Sometimes, mental illness sufferers experience a 70% reduction in their symptoms. As ketamine targets opioid receptors it can be used to treat pain. Ketamine infusions can provide long-lasting relief for pain.   There is also research that ketamine can help to treat Crohn’s disease and ulcerative colitis. With just six infusions, ketamine can be wonderfully transformative.   Ketamine is a kind of a wonder drug, but when it’s abused it can have devastating health effects, particularly urinary problems.   As long as ketamine is administered properly in the correct dosage, the negative health consequences of ketamine should be kept to a minimum.   So whether you’re suffering from mental health problems, pain, or chronic conditions, ketamine could be a promising treatment method.

What To Do Next

If you find yourself struggling with ketamine use and you want to investigate your options for detoxing and recovering, get in touch with the friendly team at Renaissance Recovery. We specialize in helping people just like you reclaim their old lives. Call us today at 866.330.9449.  

 

 
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Renaissance Recovery Coronavirus Policy Update

As the national pandemic continues to make it increasingly difficult for individuals to receive quality aftercare, The District Recovery Community & Renaissance Recovery has provided a solution to all those seeking long term care. We are proud to announce that we will be offering all aspects of our treatment including intimate groups, one on one therapy, and case management to individuals in all states from the comfort and safety of your home. This is a great option for clients that are in need of continued treatment, but are returning home to be with their families during this time.

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