KETAMINE 
(Street Names: Special K, "K", Kit Kat, Cat Valium)

October 2009 DEA/OD/ODE

Ketamine is a dissociative anesthetic that has gained popularity as a drug of abuse. On the street, it is commonly known as "K" or "Special K." Other street names include Cat Valium, Super Acid, Special La Coke, Purple, Jet (Texas), and Vitamin K. Slang for experiences related to ketamine or effects of ketamine include: "k-land" (refers to a mellow & colorful experience), "K-hole" (refers to the out-of-body, near death experience), "baby food" (users sink in to blissful, infantile inertia), and "God" (users are convinced that they have met their maker).

Since the 1970s, ketamine has been marketed in the United States as an injectable short-acting anesthetic for use in humans and animals. It is imported into the United States and formulated into dosage forms for distribution under the trade names Ketalar, Ketaset, Ketajet, Ketavet, Vetamine, Vetaket, and Ketamine Hydrochloride Injection.

Ketamine hydrochloride, 2-(2-chlorophenyl)-2-(methylamino)-cyclohexanone hydrochloride, is a white crystalline powder, which is soluble in water. It is a rapid-acting non-barbiturate dissociative anesthetic, structurally and pharmacologically similar to phencyclidine (PCP). Like PCP, ketamine has activity at N-methyl-d-aspartate (NMDA) receptors. It also binds to mu opioid and sigma/phencyclidine receptors. Ketamine produces sedation, immobility, amnesia, and marked analgesia. At low doses and upon emergence from anesthesia, it produces changes in mood, body image, and hallucination. Relative to PCP, ketamine is less potent as an anesthetic, has a faster onset and shorter duration of action.

Ketamine distorts perceptions of sight and sound and makes the user feel disconnected and not in control. A "Special K" trip is touted as better than that of LSD or PCP because its hallucinatory effects are relatively short in duration, lasting approximately 30 to 60 minutes as opposed to several hours.

Ketamine powder is usually snorted , mixed in drinks or smoked. Liquid ketamine is injected, applied on a smokeable material or consumed in drinks. Most abusers of ketamine take small lines or "bumps" for a mild, dreamy effect. A dose of 100 mg is usually enough to enter a "k-hole" experience. A dose is referred to as a "bump."

Ketamine is abused by many teenagers and young adults. The 2008 Monitoring the Future Report states the annual prevalence of ketamine among 8^th, 10^th, and 12^th graders is 1.2%, 1.0%, and 1.5%, respectively. These numbers did not change significantly compared to 2007, which reported an annual prevalence of 1.0% use among 8^th graders, 0.8% of 10^th graders, and 1.3% of 12^th graders. According to IMS Health, the number of prescriptions of ketamine increased from 12,000 in 2006 to 16,000 in 2007 and remained at 16,000 in 2008.

DEA reports indicate that Mexico is a major supplier of illicit ketamine in the United States. Despite DEA and Mexican law enforcement dismantling the major drug ring of illicit ketamine in the United States in September 2002, Mexico continues to supply large amounts of ketamine into the United States. In November 2005, DEA successfully dismantled a large ketamine distribution organization operating throughout Los Angeles, Riverside and Orange counties in California. At that time, approximately 35,000 dosage units of ketamine smuggled from Mexico were seized.

Law enforcement information indicated that another source was an international pharmaceutical drug organization. This organization was smuggling ketamine from India into the United States. In April 2005, that organization was dismantled and 108 kilograms of Indian ketamine was seized with an estimated street value of approximately $1.62 million.

Ketamine is distributed as a dried powder or as a liquid in small vials or bottles. It is snorted, smoked, ingested orally or injected. Powdered ketamine is formed from pharmaceutical ketamine by evaporating the liquid off.

Ketamine is mainly found in isolation; however, it has also been found in combination with MDMA, amphetamine, methamphetamine, cocaine, or carisoprodol. Occasionally, ketamine is found in polydrug "MDMA" (Ecstasy) tablets.

DEA laboratories reported 377 ketamine items/exhibits in 2007 and 181 items/exhibits in 2008. According to the National Forensic Laboratory Information System (NFLIS), law enforcement officials submitted 2,319 ketamine items/exhibits to state and local laboratories in 2007 and 1,538 items/exhibits in 2008. The American Association of Poison Control Centers (AAPCC) Annual Reports indicate that there were 122 case mentions of ketamine (64 single poison exposures) in 2006, 134 case mentions (72 single poison exposures) in 2007 and 134 case mentions (72 single exposures) in 2008. There were no deaths associated with the ketamine poisonings for 2006 through 2008.

On August 12, 1999, ketamine became a schedule III non-narcotic substance under the Controlled Substances Act.

Comments and additional information are welcomed by the Drug and Chemical Evaluation Section, Fax 202-353-1263, telephone 202-307-7183, or Email ODE@usdoj.gov.