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    Beginners Guide To Ketamine 
     

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    What is Ketamine?

    Ketamine is a dissociative anesthetic, chemically 2-(2-Chlorophenyl)-2-(methylamino)-cyclohexanone. Legitimately used by veterinarians, ketamine is sometimes stolen from animal hospitals and veterinary clinics. DEA reporting also indicates that some of the ketamine available in the U.S. has been diverted from pharmacies in Mexico. Being a dissociative anesthetic places it in the same class as PCP and nitrous oxide. It is used mainly in veterinary sciences, available as 100mg/ml injectable under the trade name Vetalar (Parke-Davis) and Ketaset (Bristol). In the seventies it began to be used as an illicit drug. The separation from consciousness is the more attractive aspect of this drug. Its popularity has grown tenfold since the rise of the rave scene.
     

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    Why do people use Ketamine recreationally?

    Snorting the powdered form of ketamine increases the effects of the drug a significant amount (compared with smoking). To increase the effects even more you may inject it in its liquid form. The injection is almost always in the muscle tissue; directly through the vein produces an instant "K-Hole". A "k-hole" is when your hold on consciousness begins to deteriorate. You may begin to experience a near death feeling. In many
    cases, this separation results in profound hallucinations and
    the sensation of entering another reality. Continuing with more large dosages may begin to permanently perforate the fabric of one's consciousness. In human use, a benzodiazapine like Versed is generally used along with ketamine to induce amnesia concerning the "emergence
    reactions".
     

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    What are Ketamine’s effects?

    Dose, how the drug is taken, set and setting have an influence on the experience. 'Set' refers to the personality, past experiences, mood, motivations, intelligence, imagination, attitudes, what is going on in his or her life and the expectations of the person. Expectations are affected by what people hear and read about the drug. 'Setting' refers to the conditions of use, including the physical, social and emotional environment and the other people present. Empathy with the person giving the drug is a very important factor, even with an anaesthetic.

    Ketamine effects take two different forms: physical and mental. Ketamine effects may feel devastating but at the same time they are also seductive. Some enjoy the drug for the same reasons that it is affecting them negatively. Of all the ketamine effects the most sought after is this feeling of disassociation.

    The more mild ketamine effects are the heart rate increases along with a slight euphoric feeling. The physical ketamine effects are mild compared to the mental ketamine effects. PCP, ketamine, and alcohol all belong to a class of drugs that prevent brain cells from picking up glutamate, a chemical messenger that cells use to communicate with each other.

    Perhaps the most important property of ketamine is that, despite the induction of both anesthesia and dissociation, the cough and gag reflexes *USUALLY* are not affected. This means that, contrary to most other agents which will produce anesthesia and/or unconsciousness, it is very unlikely that a person using ketamine will aspirate their own saliva and other excretions.

    Before reaching the first line of the trip, fragmentation will occur- the world will begin to spin, but it won't be dizzying. Music will become fragmented. Chaos will ensue. At some point, you will find yourself complete removed from your surroundings and your body. Descriptions of the post-line experience vary substantially, but most include talk of alternate planes of existence, oneness, past and future revelations, and strange fabrics of all sorts. It will be very difficult to communicate at this point, and you probably will not be able to see or hear others in the room. Some revelations will be extremely heavy and some scary, but that fear does not seem to come back with you and is therefore difficult to describe as scary. You will probably find yourself coming back across the line again visibly, attempting to put an object in focus or define it. It is at this point that you will likely want to get in touch with your co-trippers. This is the "Wow" period. It is very important here that you do not try to move for awhile. The trip will continue mildly for an
    hour or so after this, with more conventional focuses

    You'll start to notice the ketamine kicking in when you start to feel floaty; in a "dream-like" state. Sounds and apperance begin to distort. Eventually you will notice that you'd much rather lay down when things start to spiral and objects begin to expand their length and width. At this point the experience gets exciting (or scary). When you begin to feel yourself lift away from your body and rise up above everything the K-Hole is about to begin. From this point on it is very difficult to describe the experience, but you will be full of fear but at the same time simply amazed. I have experienced "death" a few times on ketamine...I remember once playing chess with God (the pieces were homes) as he explained what my soul will experience now that I was dead. I have also been through some very frightening experiences, realizing that there is no heaven or hell, no after life, that in fact we are all just numbered vessels that float aimlessly in space...and since I thoght that I was really dead, that scares the shit outta me!

    There is a place known as "Lego-land" that many people on ketamine experience when you reach a certain dose. This is insanity at its finest, as the world looks like the original Super Mario Bros. Nintendo game and objects are built of colorful Lego pieces. If there is somebody with you they simply become a cartoon. This is what I look for when I use ketamine because I no longer notice the sickness when I stand up (because you can't feel yourself...you're completly numb) and I can do some hardcore dancing as my legs are moved to where the Lego pieces light up.

    There is such a wide range of experiences while in a K-Hole, somebody else's experience may be WAY off from mine which is the cool thing about ketamine. But you must beware of ketamine addiction, it is horrible. You get seduced by the negative aspects of ketamine and start to think backwards. You will notice that K addicts are very ego-centric and "lost in another world", your mind is cloudy and begin to think very cynical. I think the near death experience and what you learn from it plays a part in that. I haven't used in months just cause it starts to control you in an evil way. As I type this I think of all the destructive effects of ketamine and the more I think of them, the more I want to use, and that is just how it is....
     

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    What are the dosages for Ketamine?

    Doses:

    Threshold .1mg/lb nasal; .1mg/lb IM
    Light .15mg/lb nasal; .15mg/lb IM
    Common .3mg/lb nasal; .2mg/lb IM
    Strong .75mg/lb nasal; .5mg/lb IM
    K-Hole 1mg/lb nasal; .75mg/lb IM
    Anaesthetic 1.5mg/lb nasal; 1mg/lb IM

    Doses may need to be increased over time due to tolerance. Insufflated the onset takes place within 5-15 mins; duration of 4-60 mins; after effects may last 1-3 hours. IM the onset is within 1-5 mins; duration 30-60 mins; after effects may last 2-4 hours.

    IV and IM require fully sterile Ket bottle and needle.
     

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    How do I dry out Ketamine that is in solution?

    Powder for nasal use can be gotten from gentle boiling off of solution (editors note: people disagree on whether or not boiling of Ketamine destroys some of the drug. It is recommended that one either pour the Ketamine solution into a large flat dish and leaving it in a warm place until the liquid evaporates or placing the solution on a plate and placing that over a pot of gently boiling water until the liquid is evaporated.)
     

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    How do I prepare an oral dose of Ketamine?

    To prepare an oral dose from a powder, place powder in a cup and pour about 1 cm of hot water (tap should be ok) in it and stir to solution. Fill remainder of cup with an acid such as orange juice.
     

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    What are Ketamine’s effects with other drugs and side effects?

    Ketamine should not be used with respiratory depressants, primarily alcohol, barbituates, and Valium. Ketamine has been used with no ill interactive effects with marijuana, acid, nitrous, dextromethorphan, and MDMA, although no combinations are recommended and are highly unnecessary given the totality of ketamine. It does not have a build-on effect with halucinagins and will generally overpower other drugs. Nitrous in the up and down periods can be effective. Food should not be consumed within an hour and one-half before the trip, and should be avoided for longer periods of time if possible. As with all anaesthetics, Ketamine may make you nauseaous to varying degrees, directly related to dosage. Therefore, you should find a place where you can stay for several hours, with most ammenities close at hand (any movement will compound nauseau).

    This information was obtained from the following links and further info can be found at:

    http://members.tripod.com/ketotal/ket.html
    http://www.erowid.org/chemicals/ketamine/ketamine.shtml
    http://www.ketamine-effects.com/ (deals with addiction to ketamine)
    http://peyote.com/jonstef/ketamine.htm
     

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    Is the Ketamine experience enjoyable?

    The experience can be very enjoyable in the right enviornment and state of mind. I would never recommend using ketamine in public; walking around can make you very sick and more than likely you'll be falling all over the place creating all kinds of bruises. I made that mistake with a friend once, first time using it, just picked it up downtown (from a dealer who was later arrested for child porn ) and bumped up a few hundred milligrams each, naive and unaware of the doses. And thus started our journey driving around k'd out of our mind trying to find our way back. What should have been a 25 minute drive home turned out to be a three and half hour drive, our lives deffinitly at risk considering we were down in the ghetto and my friend was so blown that driving was nearly impossible. I don't remember much of that night and don't really know how we made it back home without killing ourselves, the entire drive I was coming in and out of a K-Hole so don't remember all the stops my friend talks about. I guess he had to pull over near Mexico cuz he couldn't drive anymore. I was paralyzed the entire drive and vomited all over the place at a few stops along the way in front of people (I think?). But anyway, in conclusion, don't use ketamine in public, it can also be a very frightening experience as you are very vulnerable.


    Ketamine is relatively safe when used in hospitals. There is a wide margin between the top end of the medical range and a lethal dose. Psychedelic doses are usually only 10-25% of surgical doses, given by the same route for the same person. At these levels, it behaves more like a stimulant than a sedative and does not usually suppress the breathing or heart rate, although exceptions do occur. The higher brain is switched on rather than shut down. This state is different from being unconscious, where the light-bulb is turned off and if the person goes too far they may stop breathing. There are cases of accidental injections with 10 times the amount required for surgery, with no obvious, lasting ill-effects. When ketamine is taken outside a medical setting, the main dangers arise from the physical incapacity it produces.
     

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    I’ve heard about ‘Near Death Experiences on Ketamine? What’s up with that?

    Near-Death and Near-Birth Experiences

    A 'near-death experience' (NDE) is a report of leaving the physical body, and sometimes going through a tunnel towards 'the light'. Ketamine can reproduce all aspects of the NDE, including the conviction of being dead, having a telepathic communion with God, seeing visions, out-of-body trips, mystical states, entering other realities, re-experiencing old memories, and a life review which may have therapeutic value Most NDE's occur in people who are not physically near death.

    The Quantum Mind

    Some people believe that ketamine is a mental modem which can potentially connect the mind to 'everything else', allowing a peek behind the curtain at the inner workings of this and other realities. In the old Newtonian universe, the mechanical view declared that all possible forms of energy and fields had already been discovered; that the ordinary, everyday perception of space, time and matter and energy was the only scientifically correct reality; that all people were separate from each other and the rest of the universe; and that consciousness could not exist without a living brain.
     

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    Ketamine and Therapy

    Ketamine Psychedelic Therapy (KPT)

    Over the past 15 years, ketamine has been given to over 1,000 patients in St. Petersburg as an aid to psychotherapy, mainly to assist in the treatment of alcoholism in well-planned trials with proper clinical control groups. The scientific rigour of these studies is impressive. Long-term follow-up of patients has been very encouraging, and the treatment has been extended to heroin addicts and some forms of neurosis. Not a single patient has had complications such as prolonged psychosis, flashbacks or non-prescribed use of ketamine. This work has been carried out by psychiatrist Dr. Evgeny Krupitsky and his team. Evgeny is Chief of the Laboratory, and was recently awarded an honorary Doctor of Science. He spent a year with the ketamine research team at Yale, sponsored by the conservative National Institute of Drug Abuse.

    Sessions are supervised by two physicians, a psychotherapist and an anesthetist. A return to normal usually began after 45 minutes to an hour, with a recovery period of 1- 2 hours.

    Death-Rebirth Psychotherapy

    An NDE can be a pivotal turning point, encouraging significant and positive life changes. People who attempt suicide have a subsequent risk of making further attempts which is at least 50 -100 times greater than the normal population. In contrast, suicide attempts which result in NDE's are followed by a reduced risk of further attempts, despite an increased belief in an after-life. Of those who survived a jump from the Golden Gate bridge and had an NDE, none went on to completed suicide, and all were united in their support for a barrier to prevent further attempts. These findings suggested that the artificial induction of NDE's by relatively safe means, within a therapeutic alliance in an appropriate set and setting, might have positive benefits in some people.
     

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    Trip Suggestions

    Setting: As with all anaesthetics, Ketamine will make you nauseous to varying degrees, directly related to dosage. Therefore, you should find a place where you can stay for several hours, with most amenities close at hand (any movement will compound nausea). A non-Ketting person is a great help, and will be fun to talk to, and convenient for changing music, etc. Darkness will eliminate some very strange visual experiences. Music is very powerful. Warmth can also be important, as although your respiratory system will not be depressed, you may become cold from inactivity. A blanket is a good idea. Marijuana should be handy for nausea, and a bucket should be available as a precaution. Vomiting should be rare, but in the case, it is not a good idea to have to travel to the bathroom. You should try to make sure that your co-trippers start when you do, as it is a rapid starting drug. Nasal doses can usually accommodate real scenes, i.e. clubs or company, but expect things to be very strange.

    Timing: Taken intramuscularly, Ketamine will bring you up quickly in less than two minutes. Orally, with a medium-full stomach, expect 15-20 minutes, and as little as five minutes on an empty stomach. Nasal doses allow 5-10 minutes. The acceleration is great but not alarming. Expect to be semi-unconscious on a Line-Dose for about an hour intramuscularly, and slightly longer when taken orally. You will come down quickly as well past the first line, and will begin to assimilate senses over about an half-hour. When taken orally, a soft trip will linger for approximately 2-3 hours after that and can be lots of fun. You will feel light, lanky, and queasy for several hours, and may be somewhat light-headed, though not incapable the following day. Nitrous has had success in bringing Ketamine down quickly, despite its anaesthetic nature.

    Credits:
    http://www.a1b2c3.com/drugs/ket03.htm

    http://www.biopsychiatry.com/ketaminedep.htm

    You might want to also check out:

    http://www.biopsychiatry.com/ketamine.htm
     

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    Does Ketamine make Opiates stronger?

    Oral Ketamine and Transdermal Nitroglycerin as Analgesic Adjuvants to Oral Morphine Therapy for Cancer Pain Management

    Kalle Varav, M.D.
    GR Lauretti, ICPR Lima, M Reis, WA Prado, NL Pereira, Anesthesiology, 90: June 1999


    ----Background----
    The development of tolerance and the high incidence of side effects with escalating doses of opioids in the management of chronic and cancer pain, is an all too common phenomenon.

    ----Purpose of the Study----
    This pilot study attempts to determine clinically whether the effect of oral opioids can be potentiated, and whether the development of tolerance can be suppressed with the use of co-analgesics. Theoretically at least, activation of the NMDA receptor and production of Nitric Oxide are known to be involved in the development of opioid tolerance. Nitric Oxide has also been shown to interact synergistically with morphine in producing analgesia. Additionally, Ketamine Hydrochloride (KG), an NMDA antagonist, has been shown to have activity at opiate, cholinergic, adrenergic, and 5-HT systems, as well as local anesthetic properties of action potential blockade.


    ----Methods----
    In this prospective, non-blinded study, 60 patients with cancer-related pain were randomly divided into 4 groups of 15. All patients were initially taking between 80-90mg of oral morphine and 50mg of oral amitryptiline daily. Pain was assessed using a Visual Analog Scale (VAS) (0-10). There were no differences among groups regarding age, gender, weight, height, primary cancer site or VAS scores before initiation of oral morphine treatment. Patients were treated with the study protocol when their pain levels were rated as 4/10 or worse. The first group of 15 served as the control group (CG), and subjects received an additional 20mg of oral morphine (10mg at 12hr intervals). The second group (DG) received 500mg of dipyrone (a NSAID) at 6-hour intervals. The third group (KG) received ketamine 0.5mg/kg orally at 12hr intervals, and the 4th group (NG) received a 5mg transdermal Nitroglycerin patch daily. After the test protocol, patients were allowed to manipulate their daily morphine consumption by requesting additional oral morphine to their 80-90 mg pre-study dose in order to maintain a VAS less than 4/10. Daily morphine requirement and VAS scores were recorded on days 1,5,10,15, 20, and 30.


    ----Results----
    Results of this pilot study revealed a significantly lower consumption of morphine in the ketamine and Nitroglycerin treated groups compared to the control and Dipyrone group on Days 15, 20, and 30. Additionally, patients in the control and Dipyrone group reported more somnolence, constipation, nausea and other side effects compared to the other study groups. There was, however, one incidence of intense headache in the NG group, and one incidence of hallucination in the KG group.


    ----Discussion----
    The authors conclude that ketamine and nitroglycerin may be effective coadjuvants to opioid therapy and include a theoretical discussion to explain their findings. Although this is intended to be a pilot study and lacks in its sample size, the outcome is promising because both objective and subjective measures are evaluated. Ketamine is itself a potent analgesic with multiple mechanisms for its effects as mentioned above, and one would anticipate an additive effect when co-administered with opioids. However, nitroglycerin has no analgesic properties alone, and these findings encourage the continued search for adjuvant medications. A decrease in pain, side effects, and opioid requirement may encourage clinicians to consider the use of these adjuvants in their own clinical practice. In addition, further investigation is warranted to evaluate the joint administration of these adjuvants with opioids as well as a comparative efficacy with other NMDA antagonists, such as dextromethorphan and amantadine, as well as other nitric oxide donors.

    The entire story...
    http://www.ucdmc.ucdavis.edu/pain/re..._ketamine.html

    ----------------------------

    A 57-year old man was admitted to the Palliative Care Unit with an adenocarcinoma of unknown primary. He gave a 4-month history of a painful shoulder which had initially been diagnosed as a rotator cuff injury. Unfortunately, on CT scan, this was shown to be a soft tissue metastases involving his left scapula, ribs and muscle. His predominant pain features were pain on movement with allodynia and hyperalgesia. His morphine was gradually titrated to a dose of 300mg per day. This provided him with incomplete pain relief and he became morphine toxic with hallucinations and narcosis. Due to the clinical situation he was deemed too unwell for chemotherapy.

    He was admitted to the palliative care ward and given a ketamine infusion subcutaneously for 5 days. This not only bought about improved pain control, but his opioid requirements were greatly reduced, hence his narcosis and hallucinations ceased. He was sufficiently well to actually commence chemotherapy.

    More information that NMDA antagonists have a role in the prevention or treatment of opioid tolerance.
    http://www.medicineau.net.au/clinica...tivec1263.html

    --------------------

    "Ketamine as a co-analgesic for breakthrough pain"

    We report the case of a 39-year-old man with severe pain due to unresectable squamous-cell carcinoma of the maxillary sinus that had invaded cranial bone and had metastasized to the cervical spine. Tolerance to opioids had developed, and high doses of transdermal, continuous intravenous, and epidural opioids did not control his pain. An acute episode of extremely severe head pain was immediately controlled with a subanesthetic dose of ketamine after failure of a stress dose of corticosteroid and intravenous lidocaine. Because the patient was terminally ill and invasive procedures were not options, we controlled his pain using a low-dose ketamine infusion until his death 13 days later. Ketamine may be a good co-analgesic for breakthrough pain and for severe pain caused by terminal cancer when invasive techniques are inappropriate. Its mechanism of action may include reversal of opioid tolerance in addition to an inherent analgesic effect.

    http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract
     

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    Much thanks to K'dOUTinAZ for creating this guide.
     

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