I believe it's different from person-to-person, you know, with each person having a different enzyme profile and personal metabolism. There isn't a set amount, per se; however, Ketamine is a prescription drug used both as an anesthetic and to treat acute spells of depression otherwise immune to traditional antidepressant drug therapy, so that alone indicates it is not ordinarily a problem until people start abusing the drug.
We know that ketamine is the actual substance that causes damage to the bladder upon contact, not a metabolite of ketamine. The ketone – a double-bonded oxygen that gives the compound its "2-Oxo" nomenclature – probably lends the molecule some pharmacokinetic shielding, preserving the molecule unchanged until it gets to the bladder. MXE, FXE, HXE, DMXE and O-PCE would all suffer from this same dilemma (among others), in theory, but bc they are more potent, less drug is taken in a single dose and so less damage is inflicted on the user. Of course, there's 3-MeO-PCE, which is the same drug minus the ketone group, and I wonder how it stacks up in terms of relative toxicity. There's controversial evidence that excessive NMDA-receptor antagonism can lead to brain lesions, at least it does so in rats given large doses of arylcyclohexylamines, but that might be bc the rat brain has a higher metabolism.
There are papers published on supposed Olney's lesions found in the brains of "Ketamine addicts" but I'm fairly dubious of Chinese science literature, and the authors' attitude toward "drug addicts" smack of heavy bias and a lack of quality peer-review.
Regarding insufflation: I agree that IM, IV and other RoAs not involving first-pass metabolism may do a lot to avoid this bladder issue since it doesn't send Ketamine into first-pass and the body has more time and chance to metabolize it into something less toxic to the body's organs before excretion occurs. When most ppl snort a drug they tend to sniff too vigorously, shooting a large portion of the drug into the back of the throat and the sinuses where it further drips and is swallowed and introduced more quickly to the bladder.
A wiser way to insufflate K, or any drug, is:
- Cut smaller lines to give your nasal mucosa more time to absorb the drug. (If you have to do gangster rails of K to feel it, it's time for a tolerance break after tapering down as needed.)
- Sniff gently – just enough to pull the powder into the cavity of your nose where the nasal mucosa is, not past it in the sinuses.
- Pinch your nose shut right at the end of the snort before you've finished inhaling.
- Keep your nose pinched for maybe 20 - 30 seconds to aide in absorption
- Tilt your head back slightly so when you let go of your nose, crumbs don't go spilling out if any are present.
Generally make sure the powder is chopped up very finely, as this will aide in absorption. And do more, smaller lines rather than fewer, gigantic lines. Spit out any drip. Keep that K out of your gut as much as you can to avoid unnecessary exposure to the bladder.
I'm not sure anyone here can answer
for real for reals until there's more clinical data available. Staying dissociated for long periods of time most likely is not good for your brain or body. My best conjecture is that doing some K (or FXE, et al.) here and there on the weekends and holiday is probably fine. Using dissos every single day for a number of years might fuck with your health, some people more than others, but just try to use responsibly, like you have good sense, and don't wantonly chase a buzz. It's a bad look and bad P.R. for the harm reduction cause/movement/philosophy. Thanks for hearing me out! Much love and good luck.
