Ketamine: The Many Faces of the Chameleon Drug

By Maxim W. Furek, MA, CADC, ICADC

Ketamine: The Many Faces of the Chameleon Drug

Because of its many faces, Ketamine has been called the “chameleon drug.” Now, this popular club drug has reappeared on the streets, as a tool for law enforcement.

Elijah McClain was a 23-year-old Black man apprehended by Colorado police for “suspicious behavior.” After being placed in a chokehold, paramedics injected him with ketamine, a powerful sedative. McClain was 5 feet, 6 inches tall and weighed 140 pounds. The standard dose of ketamine is 5 milligrams per each kilogram of a person’s weight. With those parameters, the correct dose given to McCain should have been 320 milligrams, but instead, he received 180 milligrams over the recommended limit.

A fire rescue medic injected 500 milligrams of ketamine into McClain’s right shoulder, enough to sedate a man twice his size. After seven minutes, McClain went into cardiac arrest. Although medics were able to revive him, he was later declared brain dead and taken off life support less than a week later.

Dissociative Anesthetic

Ketamine is a dissociative anesthetic. It is a short acting and less powerful derivative of PCP (phencyclidine). Ketamine was created in 1961 because PCP caused people to become violent and hallucinate. In Vietnam, ketamine was known as the “battlefield buddy drug.” Fellow soldiers were able to administer the anesthetic to each other on the battle field.

Ketamine currently is used for short-term surgical procedures in veterinary hospitals primarily on dogs and cats. It is marketed for human application as Ketalar, often used in conjunction with Valium or other sedatives that relax muscles during medical procedures.

Depending on the dosage, Ketamine has many faces. Ketamine is unique among anesthetics because it does not depress critical body vitals often used in procedures with burn victims. It is used for acute pain and depression in low doses and in higher doses as a medical sedative.

Ketamine’s sedating effects were highlighted during a 2018 rescue attempt in Thailand. The drug was instrumental in the survival of 12 boys and their soccer coach, trapped in a flooded underwater cave. Thailand’s Navy SEALS conducted the grueling 18-day ordeal that riveted people around the world. During the mission, the boys were injected with Ketamine to knock them unconscious for their protection and the protection of the divers. British divers said if they were to attempt this rescue, the sedation was non-negotiable.

The Ketamine injections assured that the boys would remain sedated and not harm
themselves or the rescue divers. Guardian writer Susan Chenery believed that the drug was an important part of the successful rescue:

The boys and their young coach were to be given Xanax and then ketamine
shots to keep them unconscious as they travelled through the 2.6km of the
caves, much of which were underwater. Too small a dose and the boy might
wake up, panic and endanger everyone; too big a dose and he might not
wake up at all.

The many faces of ketamine, a Schedule III drug, includes treatments for specific mental illnesses and neurological conditions including epilepsy and depression. Variations of ketamine have been approved by the Food and Drug Administration (FDA) to treat depression. The treatment appears to work immediately, while current antidepressants can take weeks to take effect. The Food and Drug Administration put the experimental drug esketamine on the fast track to official approval for use in treating major depression. This designated “breakthrough therapy”; would offer psychiatrists a new method for treating patients with suicidal tendencies and would qualify as the first new treatment for major depressive disorder in about half a century.

Recreational Club Drug

Ketamine is still a popular recreational club drug. Because it only lasts 20-60 minutes and doesn’t induce hangovers, many young professionals feel it is a better option than LSD or ecstasy (MDMA).

Ketamine at higher doses, becomes a dissociative anesthetic, where the user feels a trancelike disconnection to their environment. The drug may produce pleasant dream-like states, vivid imagery, hallucinations and possibly extreme delirium.

The substance often leaves the user lost in a “K hole,” a state of massive sensory deprivation akin to a “bad trip.” Users are detached from their body and mind and unable to speak, move or experience pain.

Ketamine is less potent than PCP. The ketamine drug experience lasts only 30 to 60 minutes, while LSD and PCP trips typically last for several hours. 25 mg of PCP will produce a full psychedelic experience while it would require at least 100 mg of ketamine for a similar effect.

Possible Misuse

Ketamine is being successfully used to treat depression, acute pain, and PTSD. From the early 1990’s until 1998, ketamine was used in a controversial study conducted by the National Institute of Mental Health, Yale University and several other facilities. The study of some 100 volunteers attempted to unlock the mysteries of mental illness, including Alzheimer’s disease and schizophrenia by triggering symptoms of psychosis in healthy individuals. The volunteers participated in a one -time exposure that came under scrutiny from medical ethicists over its possible misuse.

In 2018, Minneapolis police allegedly directed EMTs to inject ketamine into dozens of suspects leading to an investigation that revealed suspects had been enrolled in a ketamine study by Hennepin Healthcare without their consent. Some medical and legal experts worry that ketamine, and other anesthetics, raises too many unknowns and that it should not be used to subdue someone in a police action.

While researchers develop additional faces for ketamine, authorities need to balance the legitimate applications of this drug against its abuse and not violate an individual’s rights. The coroner for the death of Elijah McClain did not rule out that the police chokehold, in addition to the ketamine, might have contributed to his unfortunate and unnecessary death.

Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis. Contact him at jungle@epix.net