Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

8. Marijuana, Hallucinogens, and Club Drugs 169KETAMINESpecial K, Super K, Vitamin K, or just plain K, are all names for the nonanalgesicanesthetic ketamine. Ketamine was first manufactured in 1965. Veterinariansand pediatric surgeons still legally manufacture it, primarily for therapeutic use;recent crackdowns on the illegal distribution of ketamine from these sourceshave led to the increased smuggling of it from foreign sources. The recreationaluse of ketamine probably began in the 1960s and was first described in detail byLilly (1978). Since that time, its popularity has continued to rise (Cooper,1996; Dotson, Ackerman, & West, 1995; Graeme, 2000).Ketamine is classified as a dissociative anesthetic. As this classificationimplies, the drug causes a dose-dependent dissociative episode, with feelings offragmentation, detachment, and what one user has described as “psychic/physical/spiritualscatter.” Use of ketamine imparts a disconnection from awarenessof stimuli from the general environment. This includes but is not limited topain.HistoryKetamine was first manufactured in 1965 at the University of Michigan andmarketed under the name of Ketalar. It is most commonly available in 10-ml(100 mg/ml) liquid-containing vials (Fort Dodge Laboratories, 1997). It is aclose chemical cousin of phencyclidine, also known as PCP or angel dust. PCPhas physiological properties that made it advantageous as an anesthetic. PCPdoes not cause the kind of cardiac arrhythmias and respiratory depression inherentin classical anesthetics. PCP also had a number of severe limitations as ananesthetic, most significantly, that it causes a high degree of psychotic and violentreactions (National Institute on Drug Abuse, 1979). These effects occur atan alarmingly high rate (50%) and may persist for as long as 10 days (Crider,1986; Meyer, Greifenstein, & DeVault, 1959). Ketamine produces minimal cardiacand respiratory effects, and its anesthetic and behavioral effects remit soonafter administration (Moretti, Hassan, Goodman, & Meltzer, 1984; Pandit,Kothary, & Kumar, 1980). The medication continues to have therapeutic usefulness,principally with children and animals.Since the 1970s, ketamine has been a drug used for “recreational” purposes.Although the distinction is by no means complete, ketamine users clusterinto two distinct subtypes. The first type uses ketamine in a solitary fashion;the second type uses the drug in a social setting, although the effects of the drugdo not promote sociability. These are the young clubgoers and “ravers” (Weir,2000). Ketamine is especially popular at circuit parties and thus a favorite of gayurbanites (Lee & McDowell, 2003).Ketamine is commercially available as a liquid. About 90% of ketaminecomes from diverted veterinary sources (National Institute on Drug Abuse,