Ketamine, known as K, Special K, Vitamin K, Ket, Kit-Kat, Catvalium, Super K, Cornflakes, Cereal Level.

Classified under table 1 by Italian Misuse of Drugs Act (DPR 309/90)

Ketamine is generally sold either in white or transparent powder form or fine crystals, crashed before sniffing.

It is sold by the gram and the sniffed dose is called “bump”, varying from 125 mg to 1 g. It is rarely taken orally because, before reaching the central nervous system, it is metabolized by the liver to norketamine, which has mainly a sedative activity. It is rarely dissolved to inject into muscle or to introduce the solution into the rectum and to be absorbed through the intestinal mucosa. It can be smoked mixed with cannabis and tobacco.

Never take ketamine with alcohol and GHB/GBL because of the potentiating sum of toxicity.

The effect appears after 5/10 minutes after sniffing and after 15 to 20 minutes when taken orally. Oral intake mainly gives sedation.

The action lasts from 30 minutes to 3 hours, depending on the dose assumed. If taken orally the effect is more prolonged.

Substances having a similar action: Methoxyethamine, 3-MeO-PCE, phenylcyclidine (PCP or “dust of the angels”), N-ethylnorketamine, N-ethylketamine, dextromethorphan, diphenidine.
Feeling highly energetic, separated from the world and from their own body, in a state of buoyancy.

Low dose gives insensitivity to pain, disorders of movement coordination, a sensation of perceiving only part of what surrounds you or only part of your body. You experience variation of time length.

At high dosage ketamine produces the sensation of body dissolving into or merging with the surrounding environment, together with the inability to communicate or to move. Sensation of intense detachment from reality and returning from death known as “K hole”.
Increased sexual desire but difficult erection.

When used during fisting, because of relaxing action, its anesthetic action, reducing pain, can mask rectum lesions due to penetration.

Sexual disinhibition and lack of control increase behavior facilitating sexually transmitted infections (as HIV, Syphilis and hepatitis C).
You may experience dizziness, nausea and vomiting. Vision and speech are confused. The sense of disorientation and detachment from reality can go up to a condition called “K hole”, which can last even 90 minutes, while you cannot speak or move. Your heartbeat can get very fast, and your breathing can become difficult.

There are no studies documenting addiction, but abstinence has been described. Who uses ketamine for a long time and falls in abstinence shows anxiety, tremors, abundant sweating and accelerated heart rate. Frequent use of ketamine damages ureters, bladder and urethra. Symptoms are: bladder pain, urination disorders and pain, nocturnal incontinence and urinary urgency. The damage may lead to surgically remove the bladder. Since ketamine is an anesthetic, the consumer can be led to take it repeatedly, trying to avoid pain in the urinary tract.

Abdominal pain is frequent and tends to disappear when ketamine use is stopped. Prolonged use provokes anxiety, depression, suicidal ideation and memory loss.
Ketamine in itself has a reduced toxicity. Toxic effects appear when it is associated with alcohol or other psychoactive substances, anxiolytic drugs, and particularly with GHB/GBL. These substances mixed with ketamine can increase their effect, slowing heart rate and giving deep sedation.

Ecstasy and ketamine do not go well together: the rhythm of the heart increases excessively.

The risk smoking tobacco and cannabis it is mainly due to the fact that, while smoking, ketamine can slow movement and increasing the risk of burns or causing fires.

The elimination of ketamine is slowed down by some antifungal drugs (ketoconazole, itraconazole, fluconazole), some antibiotics (erythromycin, clarithromycin, troleandomycin) and grapefruit juice.

Ketamine frequent users do not take regularly antiretroviral therapy. In antiretroviral therapy, ketamine can interfere with protease inhibitors, slowing down their elimination.

EDA (Agents of erectile dysfunction) sildenafil, tadalafil and vardenafil – generally called Viagra – are eliminated similarly to ketamine, resulting in a longer effect. Who takes an antiretroviral therapy that includes cobicistat, ritonavir or protease inhibitors will have a longer duration of action of both ketamine and EDA, with increased cardiovascular toxicity.