Ketamine (ketamine hydrochloride) is often used as general anesthesia. It can be used alone or in combination with other medications. Ketamine has many applications in the medical community, treating everything from severe pain to depression.
Outside of its medical uses, it is used recreationally as a drug of abuse. Commonly referred to as “Special K” or “K,” the NIH refers to it as a club drug. However, ketamine is also often used outside of this environment, as users seek its unique effects, including hallucinations, dreamlike states, and feelings of detachment from oneself and the surrounding environment.
Structurally similar to PCP, ketamine causes amnesia and pain relief without the respiratory and cardiovascular depression associated with other anesthetics. Although ketamine is one-tenth the potency of PCP, it is still a dangerous drug.
Unfortunately, when taken in high doses, potentially serious side effects may develop, including impaired motor function, high blood pressure, and fatal respiratory issues.
Compared to other drugs, ketamine’s effects are generally short-lived. However, just because the effects of ketamine wear off doesn’t mean your system has eliminated the drug. Ketamine itself will be eliminated in 1-3 days, but research shows that ketamine’s metabolites can be detected for up to two weeks in urine.
How Long Does It Take for the Effects of Ketamine to Wear Off?
Ketamine comes in several forms. When used illegally, it generally comes in powder form and may also be made into pills or a liquid. It is also available in an injectable liquid. First synthesized in 1962, the ketamine found in a medical setting may differ from the ketamine found on the street. However, a significant amount of ketamine is illegally sold from veterinary offices.
Users will swallow pills, inject or swallow a liquid form of ketamine, or snort powdered ketamine.
A couple of minutes after taking ketamine, users will experience an increase in blood pressure and heart rate. This effect decreases 10-20 minutes after the initial dose is taken.
Ketamine distorts reality, producing hallucinations. Distortions in sound and sight can make users feel disconnected, but these effects are relatively short-term compared to drugs like PCP or LSD. The hallucinatory effects last only around 30 to 60 minutes, compared to several hours. However, the overall effects of ketamine can last anywhere between 15 minutes and several hours, depending on the dose and the route of administration.
Since it is water- and fat-soluble, ketamine can be administered via almost any route. Oral, inhaled, intramuscular, intravenous, and snorted are all common methods. Bioavailability depends on the route of administration. For example, 20% oral, 90% intramuscular, 50% intranasal, and 77% epidural.
The onset of these effects is rapid, occurring within minutes of taking the drug. When taken orally, the onset is slightly slower.
- When taken intravenously, the onset of action is around 1-2 minutes, with anesthesia lasting approximately 20-30 minutes.
- When taken orally, the action onset occurs within 20-30 minutes, with the effects lasting between 60 and 90 minutes.
- When administered intramuscularly, sedation hits in around 10-15 minutes, with the effects lasting for 30-120 minutes.
There is emerging evidence that regular, repeated use can impair aspects of cognition and memory. Those who use ketamine regularly can experience flashbacks, which can occur days, weeks, or months after a person has used the drug.
How ketamine affects a user, what effects they experience, and the risk of toxicity are all dose dependent. Other factors include:
- Whether ketamine is combined with other substances.
- The strength of the dose.
- Whether the user has a history of ketamine use.
- The size, weight, and overall health of the user.
The effects of ketamine are caused by the drug’s interaction with the glutamate receptor, NMDA, and other receptors. This influences brain chemical levels, ranging from GABA (which produces a calming effect) to serotonin (which is a mood booster).
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How Is Ketamine Detected on Drug Tests?
As ketamine continued to gain popularity as an illegal party drug, it caught the attention of the Department of Defense (DOD). When requests for ketamine analysis rose from 1 in 1997 to 116 in 2000, the DOD considered adding ketamine to its random urinalysis program. To date, it is not a part of the standard screen. However, individuals can still be tested specifically for ketamine if there is a suspicion of use.
When testing for ketamine, the most common test is a urine test. This test will aim to identify metabolites of ketamine. The detection time in urine is approximately one day for ketamine. However, ketamine’s metabolites can be detected for much longer periods.
Ketamine and metabolites are both excreted in the urine, with 2% being unchanged when excreted. The metabolism process is extensive and occurs mainly in the liver.
Research shows that when ketamine is taken intravenously, 91% of the radioactivity can be recovered in urine over five days. Most of this drug is converted to other metabolites. In one study, one of ketamine’s metabolites, norketamine, could be detected in urine up to 14 days after a single IV dose.
There are no roadside testing devices that can detect ketamine. Lab analysis of urine samples and/or oral fluid is required to confirm the presence of this drug. However, a study showed great success in being able to determine whether a driver was drug-impaired using field impairment tests (FIT). These tests include measurements of three vital signs, three eye examinations, and four divided attention tests.
Of those who only used ketamine, compared to those who used ketamine and other substances, 71% were successfully identified by the FIT. However, when salivary ketamine concentrations were greater than 300 ng/mL, the detection rate using the FIT was over 90%.
How Is Ketamine Metabolized in the Body?
The metabolic process of ketamine is complex and extensive. Ketamine’s major metabolites are norketamine (NKET), dehydronorketamine (DHNK), and hydroxynorketamines (HNKs).
First, nitrogen removes a methyl group to convert ketamine into norketamine. This is completed via two key liver enzymes, CYP2B6 and CYP3A4. How each individual metabolizes ketamine is determined by the expression of P450 enzymes. Following this step, norketamine is then broken down into dehydronorketamine and hydroxynorketamines. Although other pathways have been studied, the above processes are the major metabolic pathways.
Several studies have focused on these pathways, many of which were conducted in mice and rats. For example, one study looked at brain concentrations of ketamine metabolites following vein administration. Within one minute, peak concentrations of ketamine and norketamine rapidly accumulated in the brain. Another study injected ketamine into the abdomen of mice. Within 10 minutes, norketamine, DHNK, and HNK metabolites were detected in blood plasma.
Research shows that ketamine rapidly distributes in tissues with high blood flow, including the brain. With a plasma protein binding rate between 10% and 50%, ketamine spreads quickly. However, the method of administration does matter when aiming to determine how quickly the effects of ketamine are experienced.
In terms of elimination, the available data shows that plasma levels of ketamine are generally below detectable limits within one day following an intravenous antidepressant dose of ketamine. In this case, the dose was highly controlled. Although ketamine could not be detected a day after administration, levels of circulating DHNK and HNK metabolites were observed for up to three days.
Again, the dose matters. Compared to the antidepressant study above, when children were given anesthetic doses of ketamine, norketamine and ketamine were detectable for up to 14 and 11 days, respectively. However, the actual rate of clearance is high, with a half-life of just 2-4 hours. This means that, within that timeframe, approximately half of ketamine’s active substances will be eliminated from the body.
While ketamine is mainly metabolized in the liver, elimination is primarily performed in the kidneys, with only 2% being excreted as ketamine, 2% as norketamine, 16% as DHNK, and approximately 80% as conjugates of HK and HNK.
In adult humans, the rate of elimination is not affected by the route of administration. For example, ketamine will be eliminated at the same rate whether taken intravenously or intramuscularly. However, repeated administration can prolong elimination time.
The effects of ketamine can be unpredictable and dangerous when combined with other drugs. Certain combinations are incredibly hard on the body and may result in death. For example, ketamine combined with alcohol or opiates can impair heart or lung function. In contrast, ketamine combined with amphetamines, MDMA, or cocaine can significantly increase your heart rate. Both are potentially life-threatening situations.
Data shows that of the ketamine-related emergency department visits, 71.5% involved alcohol. This is because alcohol is a depressant, resulting in the effects described above. When used in a party setting, this combination is common. This places immense strain on the liver, increasing the risk of toxicity.
How Zinnia Healing Provides Support for Ketamine Addiction
In many cases, ketamine addiction paints a larger picture. Users often abuse several substances and may also exhibit symptoms of poor mental health. This is known as co-occurring disorders. This can complicate recovery, making professional support even more critical. Mental health disorders paired with addiction can create a vicious cycle of abuse and diminished health.
That is why it’s so important to seek a treatment center that offers comprehensive, individualized treatment plans. Whether you will benefit most from individual counseling, family therapy, drug and alcohol detoxification, residential inpatient treatment, or all the above, Zinnia Health offers full recovery.
For those struggling with a ketamine addiction, overcoming your cravings to use will be an ongoing process. Although ketamine abuse does not typically lead to the traditional physical addiction symptoms seen with heroin or alcohol, a strong desire to continue long-term use is not uncommon and is something that needs to be addressed based on your unique history. These psychological cravings often require the help of a professional, especially if you’re using substances to mask symptoms of a mental health disorder. For example, if you suffer from severe depression and take ketamine to help ease symptoms, this is a temporary and dangerous solution.
At Zinnia Healing, we treat a wide range of conditions, helping you begin healing. The goal is for you to achieve a healthier, happier, and more fulfilling life. With a wide spectrum of evidence-based treatment options, Zinnia Health will provide you with your path to recovery. Help is just one phone call away.
If you or your loved one are ready to seek the help you need and deserve, Zinnia Healing is here for you. Please contact us via our confidential online form or call us at (855) 430-9439.