The Buzz
High dose Ketamine has been used by physicians for many years. It has primarily been used by anesthesiologists putting people to sleep for surgery. Low dose Ketamine has recently surged into the medical scene like a freight train, igniting discussions about psychedelics and micro dosing as treatments for various serious conditions, including depression, PTSD, chronic pain, postpartum issues, OCD, anxiety, and even alcohol abuse. While low dose ketamine clinics are becoming more prevalent, a lingering stigma surrounding the drug’s history of abuse persists. Ketamine is not a very popular street drug due to the difficulty for street drug users to avoid the “K Hole” that results when too much recreational ketamine is used. Even though ketamine is not a very popular street drug States like Louisiana have barred its use even by Medical Professionals due to the stigma of being associated with street drugs. After conducting extensive research and gathering firsthand accounts from those who received supervised medical treatment, it’s time to delve into the controversial world of the “Miracle Drug.”
The Father of Ketamine
Let’s take a trip back in time, Marty McFly-style, to explore the origins of ketamine. In 1962, Calvin Stevens, a distinguished chemist at Parke-Davis pharmaceutical Laboratories, synthesized ketamine from PCP (phencyclidine) —a molecule known for its psychedelic, hallucinogenic, and dissociative properties. PCP is also known as “Angel Dust”. Stephens developed ketamine while searching for a replacement for PCP because of its adverse effects. His new ketamine drug was shown to be safer and more precise than PCP for general anesthesia and pain relief. Ketamine has a wider therapeutic window, meaning the difference between an effective dose and a dangerous dose is larger than with PCP. This makes it less likely for individuals to accidentally overdose on ketamine. When high dose ketamine is as an induction agent for general anesthesia it can very predictably and safely induce the unconscious state that patients require when undergoing major surgeries. High dose Ketamine is still widely used by Anesthesiologists for surgery.
The Stigma
The Stigma
Low dose Ketamine entered the drug abuse scene in the 1970s when the FDA approved its high dose use as an anesthetic. Initially low dose ketamine was administered primarily to injured soldiers from the Vietnam War due to its safety profile, its popularity in clinical and veterinary settings led to its misuse on the streets. In some circles low dose ketamine became a party drug, leading to increased abuse. Abusers seek serious dissociative effects, known as a K-Hole high, achieved through extremely large doses. The “K Hole Experience” it is commonly described as an out of body experience typically associated with an overwhelming sense of dread or some even believe they died in the high. In general, the K Hole was not a fun place for addicts to be and as a result the abuse of low dose ketamine is for the most part self-limited. High dose ketamine often used at veterinarian practices is often used as a date rape drug do to its ability to tranquilize users or victims. As addicts find the K Hole they quickly move away from ketamine abuse for other street drugs that offer a more enjoyable high.
The DEA
In 1973, the Drug Enforcement Administration (DEA) was established by President Nixon to combat drug abuse and addiction. All hallucinogenic drugs such as Ketamine, along with many other types of drugs, were blacklisted due to their addictive potential. The DEA created a classification system for all drugs based upon their potential for addiction and abuse with schedules one through three. Schedule one drugs were thought to be the most highly addictive and posed the highest threat for addiction. Many street drugs like phencyclidine (aka PCP, Angel Dust) were classified as a Schedule I drugs. Many other drugs that had less addictive/abuse potential like ketamine were deemed Schedule III drugs. Over the years, numerous clinical studies have not only highlighted low dose ketamine’s anesthetic uses but also its psychological benefits, sparking a demand for further research and potential FDA approval for ketamine in treating mental illness. Numerous large clinical studies now support the use of ketamine for many psychiatrics conditions. For example, low dose ketamine has all but replaced electroshock treatment (ECT) for many conditions such as refractory depression.
Clinical Studies
Presently, ketamine remains classified as a Schedule III drug. Abusers seek serious dissociative effects, known as a K-Hole high, achieved through extremely large doses. However, in the control of clinical settings, low dose ketamine is administered at significantly lower and safer dosages. Doctors now recognize its benefits in treating severe conditions like depression, chronic pain, OCD, and PTSD. Administered via a 30–40-minute IV drip, patients often experience immediate improvements, as if ketamine hits a reset button on their brains, enhancing clarity while reducing anxious and depressive thoughts. It has even shown promise in combatting alcohol addiction. The popularity of ketamine has grown significantly, leading to dedicated clinics throughout the United States. As more clinical studies are released, the outlook for reevaluating low dose ketamine’s potential as a medical breakthrough continues to improve.
Pill, IV, Nasal or Topical?
With increasing interest and research on the positive effects of ketamine, doctors have administered it in four primary forms: pill, IV, nasal spray, and topical creams. While some medical companies now offer orally administered ketamine for home use, IV administration is deemed safer and more precise, with self-administered pills posing risks of overdosing without medical supervision. According to the FDA website in 2019 the ketamine nasal sprays know as label name “Spravato” (esketamine) is FDA approved for treating depression in a clinical setting. Nasal sprays with extremely low dosages are often prescribed to chronic pain, or depression patients alongside IV treatments or anti- depressants. The FDA has strict guidelines on clinically monitoring patients by administering nasal sprays. Additionally, topical ketamine creams have shown promise in various clinical studies, boasting an 80% success rate in treating patients. Regardless of the administration method, ketamine has significantly impacted patients’ lives.
Conclusion
Ketamine’s journey started as a revolutionary anesthetic for pain relief but faced setbacks due to its misuse and subsequent blacklisting. However, new findings are now revealing the drug’s potential, helping to dispel its stigma. Even though most forms of ketamine are not yet approved by the FDA to help treat many mental illnesses its striking success shows a bright future for mental health. The FDA release that the ketamine application has been accepted to be on the Fast Track and Break Through designations. To wrap it up, under clinical supervision, low dose ketamine is proving to be a safe, valuable and highly successful tool treating mental illness. .
Sources
1 [History of Ketamine: An ancient molecule that is still popular today] – PubMed (nih.gov)
2 Taming the Ketamine Tiger | Anesthesiology | American Society of Anesthesiologists (asahq.org)
3 What Drug Class Is Ketamine? Is It A Controlled Substance? – Addiction Resource
7 “Ketamine Podcast” Steven Radowitz
8 K-Hole and the Dissociative Effects of Ketamine (verywellmind.com)
9 PCP (Angel Dust): Effects, Hazards & Extent of Use – Drugs.com