A Review of the non-medical use of Ketamine: Part 1: Use, Users and Consequences

1. Abstract and introduction

2. Ketamine and the dance culture

3. The doors of dissociation

4. Near-death and near-birth experiences

5. Toxic effects

6. Physical effects

7. Conclusions and references

Jansen, K. L. R. (2001) A review of the non-medical use of ketamine: part 1: use, users and consequences. Journal of Psychoactive Drugs (in press)
(contact: K@BTInternet.com)

3. THE DOORS OF DISSOCIATION

Ketamine is a psychedelic ('mind revealing') drug because it can sometimes reveal aspects of how the mind constructs reality, personality, and a sense of meaning and sacredness, without necessarily inducing a toxic delirium. The term 'hallucinogen' is inadequate for describing increased empathy, insights, reliving old memories, religious ecstasy and many other effects (Grinspoon & Bakalar 1979), while the term 'entheogen' refers only to spiritual aspects. Timothy Leary observed that ketamine and Salvinorin A were the most profound psychedelic drugs in terms of the perceived depths of the experience (Leary & Sirius 1997) and The Essential Guide to Psychedelics described ketamine as the 'ultimate psychedelic journey' (Turner 1994). The experience is affected by the dose, route, 'set' (personality, history, mood, motivations, intelligence, imagination, attitudes, life events and expectations of the user) and 'setting' (the physical, social and emotional environment; e.g. Kumar et al. 1992). Sklar et al. (1981) concluded that a warm, understanding doctor who stressed positive aspects and told patients to think of a pleasant image produced the best reports post-anesthesia. Effects begin about 30 seconds after an intravenous (i.v.) injection, 2-4 minutes after an intramuscular (i.m.) injection, 5-10 minutes after intranasal use, and 10-30 minutes after an oral dose on an empty stomach or by rectal injection (using a lubricated syringe with the needle removed. Ketamine has an unpleasant taste and irritates the nose). The duration of the psychedelic effects varies from 10 minutes (i.v.) to an hour (i.m.) to 4 hours (oral). Psychedelic doses are about 10 to 25% of anaesthetic doses, by the same route. 100mg taken i.m. will produce an hour-long experience with full normality returning within 3 hours. The effects can have a much shorter duration in persons with a tolerance. A club 'bump' for intranasal use is 200mg, psychedelic doses for i.m. use are 50-150 mg, while oral doses are usually 350-500mg. Intranasal use can produce anaesthetic blood levels (Malinovsky et al. 1996), and some users take up to a gram by this route:

I used pure K in the NY Club scene (nasally)..."beyond words" experiences, deep thoughts of family, in touch with GOD, another dimension of "reality" - experimenting with K has changed my whole outlook on life, "death?", and GOD. I miss the deepness and extreme spirituality of the experience. At times during the trip, I reflected on my entire life, remarkably lucid visions of my birth - (interview in: Jansen 2000)

The effects may include a sense of merging with another person or group, and a sense of becoming an animal, plant, or inanimate matter. Awareness may seem to expand to include the entire universe. There may be apparent: out-of-body experiences; transcendence of time including foetal, ancestral, racial and 'past life trips'; experiences of evolution and appearing to see events in the future or the past; apparent extension of awareness beyond consensus reality and space-time into other universes, symbols, the dead, energy fields, archetypes and a merging with the 'Ultimate Reality' from which the 'illusions' of time, space and matter appear to be derived; and a link between the mind and physical events in ordinary reality (e.g. synchronicity). The sense of time can vanish completely. Plants were used for magical purposes in pre-industrial societies. Ketamine is a 'modern' drug, and has been used in this way by 'modern magicians':

I settled on a form which involved banishing, consecrating and performing a full invocation. I would then take a dose of K and don a pair of headphones which would play me a pre-recorded hypnotic instruction beginning with basic trance induction... No longer was I in my New York apartment; I was in Egypt, inside a pyramid. I was lying inside an open sarcophagus. The inside of the chamber was brightly lit, a bluish-white light adhering to everything and also radiating very strongly from me. I felt that this light, which moved through me, and radiated from me, connected me with - everything else through space and time, especially a moment in space-time when a man in New York was lying within a magic circle in the 20th century - (Farber 1995)

Some ketamine experiences resemble lucid dreaming in which the person is aware that they are dreaming, and can influence and control the dream. At higher doses, the drug is sometimes perceived as having 'its own agenda'. Other experiences are like virtual reality games or a journey through 'information networks'. A 'brick of ketamine' was mentioned in William Gibson's 1984 book Neuromancer, which is about launching awareness itself into a form of the World Wide Web. Some parts of films such as Tron and The Matrix (in which the central character is given a choice of two pills, representing 'dream' and 'reality' in an echo of Alice in Wonderland) give an impression of some of these features. Some other reasons why ketamine is taken in a non-medical context include recovery of forgotten memories (A), problem solving (B), bonding and love (C) and for spiritual experiences (D). All quotes are abridged from accounts discussed in Jansen 2000:

A: I was able to discover the hidden meanings behind every door that was normally closed... I also remembered events as a child - things I would never normally remember. I never felt as if I was not myself, my memory and intelligence seemed dramatically enhanced - There was no feeling of depression afterwards, only calmness and inner peace...

B:I would take doses in a plastic minibag with me to parties and a straw which I inserted into the bag to dose myself...I would pace doses at least an hour apart by affixing an hour-burning incense stick to the back of my wheelchair - it certainly helped to be sitting down, surrounded by mad dancers and throbbing music. I would have many great revelations on the dance floor that would often relate to either a graphic design project, or a book I was writing, and I took to carrying a micro-cassette recorder to record these ideas for later development - with great success -

C: Low dose K was pure emotion, no thinking. Just a warm, golden sun of love for my partner into which I could dive like a pool. If you take K in the dark by yourself, it'll be cold. If you take 50mg i.m. in a warm sunny bedroom with a friend you'll have a very different experience. Where you are and who you are with do count for K...People who think they're made of plastic and have turned into computers are telling us something about themselves as well as something about the drug - .

D. I was actually God. I distinctly felt the universe watching for my signal to see if it should cycle through itself once again, as it had an infinite number of times, or should it simply conclude. It felt so beyond unquestionably real, it was just as plain and crisp as it could be, not some hallucination...