Ketamine

Consumption and Standard Dose

• Ketamine is typically sold as a white powder or liquid, in small vials.
• Ketamine is typically snorted in small lines or bumps.
• In liquid form, it is dried to make the powder to be snorted.
• It can also be injected into a muscle (never a vein), smoked if mixed with tobacco or cannabis, or swallowed in a capsule.
  

The Buzz

• Numbs and alleviates physical pain
• In small doses it can initially give you a small boost of energy
• In moderate doses, it induces feelings of relaxation, relief from pain, numbing, and a state disconnected and disassociated from your body, which feels like you are floating outside or above your body
• In higher amounts it induces psychedelic journeys, called “trips” during which some people hallucinate meeting spiritual beings, aliens or travel inter-dimensionally or through a tunnel of light
• Effects last 40-90 minutes after snorting, and up to 3 hours if injected or swallowed
  

Overdose and other negative effects

• Dizziness, disorientation, confusion
• K-Hole: a state of paralysis in which it can be hard to breathe and feel claustrophobic, and can last up to 90-minutes. Get people in K-Holes away from crowded areas with bright lights and loud noises, and reassure them that they will soon be okay. K-Holes wear off in time. Do not leave people in K-Holes alone.
• Vomiting while in a K-Hole can cause choking. Make sure people are in recovery position if they have gone to the floor or are laying down.
• Falling over, and being unable to stand, which can cause physical injury
• Blurry vision, slurred speech
• Nausea, especially when mixed with alcohol, or if food is eaten before using.
• K-Pains: urinary tract pain, and bladder problems, kidney and liver problems. These symptoms usually stop or lessen if use is stopped. Continuing to use after the onset of urinary problems can lead to much more serious and permanent bladder problems.
• Physical addiction and tolerance can build up with K
• Injecting brings the risk of infection, abscess, vein damage, blood clots, all of which can lead to serious health complications. Click here to learn how to inject more safely. K needs to be injected intramuscularly not intravenously.
• Use new, unused syringes. Prepare for injection on a clean surface. Use ascorbic acid to dissolve your drug for injection. You can get unused injection drug gear through any site associated with The Works through Toronto Public Health.
  

Dangerous Drug Combinations

• Mixing with other downers like GHB can dangerously suppress your breathing
• Mixing with alcohol will make you vomit
• MDMA mixed with K can increase blood pressure to dangerous levels
• Tobacco/Cannabis, although useful for rolling with K into a cigarette creates a fire hazard if you cannot respond to something that is burning, due to going to into a sedated state while smoking.
  

Sex on Ketamine

• Can increase horniness, but makes it hard to get or keep an erection
• K can help relax your ass, and make it easier to have rough sex or get fisted, but this can make it harder to register if you’ve injured your rectum. Learn how to engage in butt play such as fisting, or using larger toys prior to dosing on K. 
• K can make it less likely that you remember to practice safer sex
• Ongoing consent is an important consideration as it can be difficult to communicate with sex partners once high
• Psychedelic drugs effect sex drive and sexuality activity very differently for different people
  

HIV Medications & Ketamine

• Protease Inhibitors (PIs) can increase the intensity and duration of K’s effects, with increased duration of sedation and higher blood pressure.
• Elvitegravir/Cobicistat/TDF/FTC (Stribild) also has this effect.
• If you use K and are on PIs you can go into a K-hole more easily.
• Ritonavir/Norvir can increase risk of drug-induced hepatitis.
• If ketamine makes you throw up within an hour of taking HIV medication, it is recommended to that you take a dosage of your HIV meds again.