Ketamine cannot be safely snorted or smoked. Any use of the drug in this manner is highly dangerous and comes with many negative effects.
The dissociative anesthetic medication ketamine was developed in the 1960s when it was hoped that it could be used in place of phencyclidine (PCP), an anesthetic drug that produced psychosis and had a potential for abuse.
These drugs affect many neurotransmitters, including the excitatory neurotransmitters in the brain, and this is how they produce their medicinal effects. However, their overall mechanism of action accounts for their associated feelings of sedation, euphoria, hallucinations, and feelings of derealization (as if things are not real) or depersonalization (as if one is being separated from their body).
Because of these potentially serious effects, the drug is classified as a controlled substance (Schedule III) and is more commonly used by veterinarians for anesthesia during surgery than it is for humans. It still may be occasionally used for anesthesia or pain control, and it has demonstrated promise in the treatment of depression.
Ketamine abuse initially began in the 1970s and became very popular with younger individuals at parties or clubs. The drug began to lose some of its popularity in the late 1990s and early 2000s, but it has recently made a slight comeback, particularly with older individuals. Most of the ketamine available on the street likely has been stolen.
The drug can be taken orally in pill form, or the pills can be ground up and snorted, smoked, or mixed with water and injected. Ketamine is often smoked with tobacco or cannabis products.
According to the book Pharmacology and Abuse of Cocaine, Amphetamines, Ecstasy and Related Designer Drugs, when a person grinds up pills that are meant to be taken orally and smokes or snorts them, they are engaging in abuse, as pills are not designed to be taken in this manner.
Smoking or snorting ketamine allows the drug to quickly enter the bloodstream and rapidly bypass the blood-brain barrier. More of the drug is delivered to the brain than what would normally occur when the drug is taken orally and goes through the standard digestive process.
Because ketamine has significant suppressant effects on the functions of the central nervous system, taking the drug in this manner can result in many potential problems.
Because more of the drug reaches the brain, the potential for an overdose is increased, even when one smokes an amount that would not produce an overdose if it had been taken orally. Overdose of an anesthetic drug like ketamine can be potentially fatal.
Smoking the drug delivers it to the central nervous system more quickly than snorting it.
Smoking any drug that is not meant to be smoked, but was designed to be taken orally, can increase the risk for respiratory diseases, such as pneumonia or bronchitis, and produce lung damage.
Abuse of ketamine has been associated with damage to various organ systems. The more efficient delivery of the drug to the brain from smoking the drug can lead to more rapid development of liver, kidney, heart, bladder, and brain damage.
Snorting ketamine sends the powder into the bloodstream through the nasal and sinus tissues. The risk for an overdose increases as compared to taking the drug orally, but it is not as high as smoking or injecting the drug.
When individuals snort ketamine, they often use straws, rolled-up dollar bills, or glass tubes. These instruments are often not clean or sterile, and they are shared by other individuals. Shared drug paraphernalia can lead to many different types of infections, including bacterial infections.
Chronically snorting drugs significantly damages the nasal passages. This can lead to obstructed breathing, infections, and an increased risk for nasal cancer.
Nodding is a behavior that is most often associated with individuals who inject, snort, or smoke heroin, but it can occur in individuals who snort or smoke other drugs that suppress the central nervous system, including ketamine. Nodding occurs when the drug abuser alternates rapidly between periods of lethargy and sleeping to states of wakefulness.
The individual can become nauseated and vomit when unconscious. This can result in choking and death.
When ketamine is smoked, the effects are usually apparent almost immediately after inhaling the drug. Snorting the drug results in the effects occurring within 3 to 15 minutes. Oral ingestion usually results in the effects occurring between 5 and 30 minutes after taking the drug.
If individuals experience hallucinations, this will typically occur for about an hour after using ketamine. Some of the other detrimental side effects of ketamine abuse, such as amnesia, confusion, and other cognitive deficits, will last significantly longer, potentially up to 24 hours after using the drug.
Other adverse effects occur with ketamine abuse, and these are exacerbated by smoking or snorting the drug. Among them are:
Tolerance develops rapidly with ketamine. Those who achieve a more efficient delivery of the drug to their brains by smoking or snorting it will develop tolerance for the drug much more rapidly than those who use the drug orally.
There is a question as to whether ketamine abuse produces an identifiable withdrawal syndrome; however, individuals who have abused the drug for a significant length of time can expect to experience issues with depression, apathy, mood swings, insomnia, and cravings for the drug if they abruptly discontinue use.
The development of a substance use disorder as a result of ketamine abuse will occur more rapidly in individuals who snort or smoke the drug on a regularly.
Ketamine is a controlled substance and, therefore, should be taken only while under the supervision of a physician and according to the physician’s instructions. No physician is going to instruct any patient to snort or smoke ketamine.
Using the drug in this manner can lead to numerous adverse effects, including more rapid acceleration of tissue or organ damage, an increased potential for overdose (which can be potentially fatal), and more rapid progression to the development of a substance use disorder.
Snorting or smoking ketamine cannot be considered safe under any circumstances.
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(March 2014). Ketamine: An Update on its Abuse. Journal of Pharmacy Practice. Retrieved January 2019 from https://journals.sagepub.com/doi/abs/10.1177/0897190014525754