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Through the K hole: the dangers of Special K

By Terrapinzflyer, Nov 17, 2011 | |
  1. Terrapinzflyer
    "So many of my friends have videos of people K-holing. There are literally loads of them on YouTube"

    Rosie, a bright, attractive 19-year-old student from an affluent London home, is talking about ketamine. She first took the drug two years ago at a music festival - which is where most young people first try it, she says. Since then, she has taken it at squat parties and club nights, at student houses and halls of residence. For her generation, snorting a line of the pinkish-white powder, popularly known as a horse tranquilliser, is as familiar a feature of a night out as taking an ecstasy pill was to my own generation.

    It is cheap, around £20 for a gram in London, as little as £6 a gram elsewhere, making an evening on K significantly cheaper than going to the pub. Users say that taking it transports them to a profoundly different mental place, far away from earthly concerns. They laugh, hallucinate, fall about. Ketamine gets you high almost immediately, they say, lasts a relatively short amount of time (around two hours) and doesn't give you much of a comedown.

    Even among regular drug users, however, ketamine is considered an acquired taste. When you underestimate its effects, or "disrespect the drug", as they say, the results can be harrowing.

    "One of my friends recently had drunk about half a bottle of vodka and another friend gave her three big bumps of K," Rosie recalls. "As we were in the queue for this club she like collapsed on the floor and was like, 'I'm going to die, I'm going to die'." Rosie had a frightening experience herself this summer when she inhaled a laughing gas balloon on top of a cocktail of LSD, 2CI, MDMA and ketamine. Then there was the time she fell into the "K-hole" on a recent night out at university. Her friends captured her distress on a mobile phone.

    "Inside, I could hear everything they were saying but I couldn't move. I was just mumbling. When I watched the video later it really reminded me of one of my grandpa's friends who had a stroke and now he can't talk. His brain is completely working but he can't verbalise his thoughts." She pauses. "Obviously you don't want to K-hole."

    That may be so, but it's a risk many consider worth taking. As for the other dangers - damage to the urinary tract, agonising pain when you pee, the potential removal of your bladder, depression, drowning, death by misadventure? Many of the K-addled hipsters you might see tumbling out of clubs in Hoxton and Dalston remain blissfully unaware of them. As ketamine becomes the zeitgeist drug, that is a source of growing dismay to drugs counsellors, doctors, educators and parents.

    Ketamine was first synthesised in 1962 as a safer alternative to PCP, and is widely used medicinally - but it is only recently that its recreational use has become widespread. I didn't come across it once at university in the early 2000s, where there was no shortage of other stimulants. According to a survey carried out by the dance magazine Mixmag in 2001, 25 per cent of clubbers had tried it. When the survey was repeated in 2009, the figure had gone up to 68 per cent.

    It was classified as a Class C drug in 2006, meaning you can get a two-year prison sentence for possession and up to 14 years for dealing it. However, criminalisation has had little effect. The 2010/11 British Crime Survey reported that 2.1 per cent of 16- to 24-year-olds had used it in the past year, more than double the estimate from the 2006/07 figure. Its popularity, particularly at east London techno nights and on the free party scene, has led to its status as "the new ecstasy".

    That may be a misnomer, however. While ecstasy produces effects of euphoria and extroversion, ketamine tends to focus users inwards. In clinical terms, it is a disassociative anaesthetic, producing analgesia (immunity to pain) without affecting breathing or heart-rate. Its popularity among vets has given it a sort of dirty glamour (popular street names include "donkey dust"). However, it is also used widely in paediatric medicine.

    As you'd expect from something they give to kids, the drug itself has quite a high "safety ratio" - it's hard to overdose on it. However, that does not mean it is safe. Ketamine was mentioned in just two coroners' reports in 1999 (meaning it was present in the body of the deceased but didn't necessarily cause the death). In 2008, the figure was 22.

    "It detaches you from your body - that's why it's used as an anaesthetic," says David, 31, who says he has taken the drug hundreds of times and was troubled enough by his use to go to Narcotic Anonymous and renounce it. He still exhibits a certain fondness for the drug, however.

    "The first time I took it, I remember having the sensation of my arms being made of balsa wood and being intent on trying to snap my fingers off just to prove it." It also distorts space and time and produces out-of-body experiences. David recalls one evening in which he attempted to document the drug's effects. He returned to what he thought was a detailed written account of his experience on the following morning - and found a blank page.

    As that account suggests, the principal danger of disassociating with your surroundings is that you will damage yourself without realising it - say, by snapping off your fingers for fun. David reckons the drug incapacitates you so much you're unlikely to do that. However, a UCL study recently published in the journal Addiction gives some horrible cautionary tales - such as a hospital worker who took ketamine and collapsed into an electric fire and suffered third-degree facial burns. A 2010 study of 30 frequent ketamine users found that two had died between the initial test and the end of the trial 12 months later: one had drowned in a bath, the other died of hypothermia. A study of vehicle fatalities in Hong Kong, where the drug is popular, found that nearly two per cent involved ketamine. Professor Valerie Curran, one of the authors of the UCL report, advises that if users insist on taking the drug they do so in a safe environment with sober people present.

    The long-term dangers of the drug are only just coming to light. Ketamine can exacerbate depression and cause significant psychological trauma (it has been used to mimic the effects of schizophrenia in clinical trials). It is thought to impair cognitive ability and cause amnesia, which makes its prevalence at universities a source of concern.

    It is its effects on bladder function that are most alarming. One long-term user described the irreparable damage to his bladder like this: "I'll go for a piss and it will literally be one tablespoon's worth of urine. I'll piss out slugs of blood, like congealed jelly, and the pain is horrific. It feels like a ball with loads of spikes in it bouncing around your bladder.

    During a bad week, I'll have to go to the toilet every five minutes." As the Addiction report stresses: "Ulcerative cystitis and loss of bladder control do not mesh well with desirable images of being young and attractive, so a strong harm reduction message could be constructed." Curran would like GPs to become more aware of the link and routinely ask males reporting symptoms of cystitis whether they have taken the drug. She also warns of the new legal high, "M-Ket", which is marketed on the internet as ketamine minus the bladder problems - a claim that has been subject to no clinical trails whatsoever.

    Can we expect to see more ketamine use? Martin Barnes, chief executive of DrugScope, the national membership organisation for the drug sector, suggests that ketamine's esoteric effects may put a natural barrier on its popularity. (There is significant anti-ketamine feeling on the clubbing scene, with users referred to as "zombies" for their knack of ruining the party atmosphere.) However, he does agree that it is currently more fashionable than it has ever been.

    "Drugs can go through cycles of use and are as susceptible to trends as other aspects of society," he tells me. "Substances may be 'in vogue' for a time, then slip back into relative obscurity. There is evidence that ketamine use has been on the rise in the past few years - this is clearly concerning due to the significant short- and long-term health risks associated with the drug."

    I ask Rosie if she is aware of these risks.

    "Erm … no," she says. "Someone told me the other day that snorting MDMA [the pure form of ecstasy] could give you a brain haemorrhage. But K … is it really bad for your liver?"

    It can completely destroy your bladder, I explain. "Oh yeah, I do know that, because you need to pee the whole time when you're on K."

    Even when I describe to her what it would be like to have to urinate from a plastic bag, she says she would still take it again, if her friends were, but that she is beginning to go off drugs overall. "If I was going to pick up and someone didn't have MDMA on them, I'd happily pick up K."

    And that's a common stance. Most of the young people I speak to say they prefer ecstasy or MDMA as a party drug but restrictions to active chemicals and doctoring agents as well as criminal busts have made it harder to come by in recent years. This is a significant factor in the rise of mephedrone (meow meow) and an assortment of untested legal highs as well as ketamine.

    Authorities should be aware that by dramatically limiting supply of a drug that is relatively safe, they are pushing young people towards more dangerous alternatives.

    There are also intriguing societal aspects in the growth of ketamine use. Drugs have always had a symbiotic relationship with youth culture - it is impossible to imagine the 1967 Summer of Love without the psychedelic effects of LSD, or the punk movement without the aggressive energy of amphetamines. Throughout the 1990s, the rise of ecstasy, with its euphoric high and despondent comedown, seemed to mirror Britain's ascent from recession into the shallow prosperity of the credit boom.

    Today, one million 16- to 24-year-olds are unable to find a job. They are routinely demonised in the media. They face an uncertain future. Is it any wonder the zeitgeist drug should be an anaesthetic? There is plenty to disassociate from.

    "People aren't really doing that much with their lives," says Rosie. "If you've got no, like, real great prospects, if you're not in a job or whatever, then why not take it? Cos you've got nothing that great to look forward to. I don't know what it was like in your day, but drugs are really easy to get. So many people do them."

    She sees a growing detachment in her peer group that is reflected in the drugs they choose to take as well as their responses when they take them.

    "People aren't scared," she offers. "So many young people take anti-depressants. If people have no hope in their lives, ketamine makes life … not better, it probably makes it worse. But it makes it more fun."

    Some names have been changed

    Richard Godwin
    17 Nov 2011



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