Ketamine is a dissociative anesthetic that has some hallucinogenic effects. It distorts perceptions of sight and sound and makes the user feel disconnected and not in control. It is an injectable, short-acting anesthetic for use in humans and animals. It is referred to as a “dissociative anesthetic” because it makes patients feel detached from their pain and environment.
Ketamine can induce a state of sedation (feeling calm and relaxed), immobility, relief from pain, and amnesia (no memory of events while under the influence of the drug).
It is abused for its ability to produce dissociative sensations and hallucinations. Ketamine has also been used to facilitate sexual assault.
Ketamine is produced commercially in a number of countries, including the United States. Most of the ketamine illegally distributed in the United States is diverted or stolen from legitimate sources, particularly veterinary clinics, or smuggled into the United States from Mexico.
Ketamine is found by itself or often in combination with MDMA, amphetamine, methamphetamine, or cocaine.
Since the 1970s, ketamine has been marketed in the United States as an injectable, short-acting anesthetic for use in humans and animals. In 1999, ketamine, including its salts, isomers and salts of isomers, became a Schedule III non-narcotic substance under the Controlled Substances Act.
It currently has accepted medical uses for short-term sedation and anesthesia. In addition, in 2019, FDA approved the S(+) enantiomer of ketamine (esketamine) nasal spray version (Spravato®) for treatment-resistant depression that is only available at a certified doctor’s office or clinic. Ketamine has the potential for abuse, which may lead to moderate or low physical dependence or high psychological dependence.
The drug product “tucibi,” also known as “tuci,” “tussi,” and “pink cocaine,” has experienced long-term growth in online discussions, with a large uptick in mentions since late 2022. The drug, which is alleged to be a mix of ketamine, MDMA, and pink food coloring, has been increasingly seized by authorities in Europe and Spain.
The rapidly shifting ketamine landscape in the US – JAMA Report (Jan 3, 2024)
A viewpoint paper published this week in JAMA Psychiatry, co-authored by NDEWS Deputy Director Dr. Joseph Palamar, discussed the rapidly changing landscape of ketamine both as a medical therapeutic and as a recreational substance. The authors highlighted several key points that healthcare practitioners, policymakers, and patients and their families should be aware of.