An investigation by DrugScope’s Druglink magazine [1] has revealed concerning trends in the use of the Class C drug ketamine, with users taking higher doses of the drug and more people injecting the substance. Some drug services are also reporting an increase in the number of young people using ketamine.
Ketamine is a complex drug with an unusual combination of stimulant and hallucinogenic properties. The drug is used recreationally due to its ability to alter users’ perceptions, leaving them feeling detached from themselves and others around them. Ketamine, which can be snorted or swallowed in liquid form, is ‘dose specific’, meaning its harms are strongly linked to the amount used.
Despite ketamine’s reputation as a horse tranquiliser, low doses can be administered safely as a medical anaesthetic [2]. However, the high doses typical of illegal ketamine use risk serious injury, unconsciousness and potential respiratory collapse or heart failure [3]. Ketamine can be particularly dangerous when used alongside depressant drugs, including alcohol. An independent Lancet study in 2007 ranked ketamine as more harmful than both cannabis and ecstasy [4].
The government’s decision to make ketamine a class C drug in 2006 does not appear to have impacted on the drug’s availability, popularity or price on the illegal market. According to last year’s annual DrugScope Street Drug Trends Survey, which first revealed the extent of ketamine’s emerging recreational use in 2005, the average price of a gram in the UK has fallen from £30 to £20 in the last three years [5]. Nine of the 20 cities surveyed in 2008 reported an increase in ketamine use in the past 12 months. Official figures suggest overall levels of ketamine use remain low compared to cannabis, ecstasy and cocaine [6].
Side effects of ketamine use can include damage to the urinary tract, bladder and kidneys. Users can become psychologically dependent on the drug and tolerance can increase with use. Ketamine has also been implicated in some deaths, although these are mainly thought to have been due to accidents that have occurred while users have been disorientated by the drug’s effects.
DrugScope Chief Executive Martin Barnes, said:
“These trends are concerning. Ketamine has been increasingly common on the club scene but there is worrying evidence that people are experimenting with larger amounts or are even injecting the drug. Ketamine’s harms increase considerably at high doses and injecting users risk exposure to blood-borne viruses such as Hepatitis C or HIV.
“Evidence of young people using ketamine is a particular concern, especially as many users may underestimate the risks involved. It is essential that we provide young people with clear and accurate information on the dangers of ketamine so that they can fully appreciate the drug’s considerable harms.”
ENDS
To obtain a PDF of the Druglink article on ketamine, more information, or interviews contact Andrew McNicoll at the DrugScope Press Office on 0207 520 7563 or email andrewm@drugscope.org.uk
NOTES TO EDITORS
[1] About DrugScope and Druglink
DrugScope is the national membership organisation for the drugs field. Our aim is to inform policy and reduce drug-related harms - to individuals, families and communities. Druglink is our bi-monthly magazine which focuses on news, current affairs and policy and practice developments in the drugs field. For more on our work, see www.drugscope.org.uk
[2] Recommended medical dose of ketamine
Ketamine can be administered at low doses as a medical anaesthetic. According to the British National Formulary the recommended medical dose of ketamine by intravenous infusion is a total of 0.5-2mg per kg of patient’s weight.
Source: British National Formulary (September 2008)
www.bnf.org
[3] Illegal dose of ketamine
The ‘normal’ dose for snorting ketamine is reported to be around 60-100mg.
Source: DrugScope (2007) ‘The Essential Guide to Drugs and Alcohol’
[4] Lancet Study
In 2007 a team of independent researchers produced a paper assessing the potential for dependence, physical and social harms of 20 drugs, including alcohol and tobacco.
Based on this assessment ketamine was ranked as the 6th most harmful substance behind heroin, cocaine, barbiturates, street methadone and alcohol. Cannabis and ecstasy were ranked as the 11th and 18th most harmful substances respectively.
The higher scores indicate higher assessed levels of harm.
| Substance | Overall ranking | Physical harm | Potential for dependence | Social harm |
| Cocaine | 2nd | 2.33 | 2.39 | 2.17 |
| Ketamine | 6th | 2.00 | 1.93 | 1.69 |
| Cannabis | 11th | 0.99 | 1.51 | 1.50 |
| Ecstasy | 18th | 1.05 | 1.13 | 1.09 |
Source: Nutt et. al (2007) ‘Development of a rational scale to assess the harms of drugs of potential misuse’ The Lancet Vol 369. Mar 24 Issue.
http://www.thelancet.com/journals/lancet/article/PIIS0140673607604644/abstract
[5] Average UK national street drug prices
| Average UK National Street Drug Prices | 2006 | 2007 | 2008 |
| Ketamine (per gram) | £28.00 | £25.00 | £20.00 |
| Cocaine (per gram) | £43.00 | £43.00 | £42.00 |
| Ecstasy pill | £3.00 | £2.40 | £2.30 |
| MDMA powder (per gram) | £40.00 | £38.00 | £39.00 |
| Standard quality herbal cannabis (per oz) | £70.00 | £87.00 | £89.00 |
Source: DrugScope Street Drug Trends Survey (2008)
[6] Prevalence of ketamine use in the UK
The 2005 DrugScope Street Drug Trends Survey first highlighted the emergence of ketamine’s use as a recreational drug and found the drug had become a major street drug in eight of the 15 UK towns and cities surveyed. Nine of the 20 areas surveyed in the 2008 research reported an increase in ketamine use.
Government statistics on the prevalence of ketamine use have only been recorded in the British Crime Survey since the drug was classified in 2006:
| Number of 16 to 59 year olds reporting using a substance in the last year | 2006/07 | 2007/08 | Best estimate of number of 'last year' users in 2007/08 |
| Cannabis | 8.20% | 7.40% | 2,382,000 |
| Cocaine powder | 2.60% | 2.30% | 734,000 |
| Ecstasy | 1.80% | 1.50% | 470,000 |
| Ketamine | 0.30% | 0.40% | 113,000 |
Source: Home Office (2008) 'Drug misuse declared: Findings from the British Crime Survey 07/08'
http://www.homeoffice.gov.uk/rds/pdfs08/hosb1308.pdf
