Ketamine

Ketamine is usually a powder. But you can also encounter it as crystals (sticks and little balls) and even in bottles as a fluid.

The effects of alcohol and other drugs can be different every time.
This depends on how you feel physically and mentally (set), and where you are and who you’re with at the time (setting). The amount you take and what exactly is in the drug also influence the effect. This is called 'drug, set, setting'.

What does ketamine do to you?

How you feel after taking ketamine depends partly on how much you take (the dose).

With small doses, you mostly feel relaxed and 'high'. With larger amounts, the trip effects and dissociation become stronger.

With a small dose:

• You feel relaxed and carefree
• You feel less pain, and your body may feel looser or more flexible

With a larger dose:

Dissociation:

• You experience the world around you differently
• Time may feel distorted, usually slower. This can be pleasant if you're feeling good, but scary if you're not
• Your thoughts may change. You might see things from a new perspective, but you could also think more chaotically or illogically
• It becomes harder to stand or walk, increasing the risk of falling
• You might not feel pain, which makes it easier to injure yourself without noticing

That’s why it’s important to sit down if you take a large dose of ketamine.

If you take a very large amount, you may end up in a k-hole

A k-hole is a very intense experience. It can feel like you can’t move or speak. It becomes hard to connect with the world around you, and difficult to tell what’s real and what’s just in your mind.

Some people find this interesting or even insightful, but others find it frightening. If you take a high dose of ketamine, make sure you have a place to lie down safely.

Where is ketamine used?

Ketamine is used at home, but also at parties and festivals.

Duration of effects

If you snort it, the effects begin after 3 to 10 minutes. The experience usually wears off after about 1 to 1.5 hours.

Ketamine is usually snorted, but it's also possible to directly inject fluid ketamine.

What you feel exactly strongly depends on how much you take. To know how much you're taking, it's important to know how pure your ketamine is. You can get this tested at our test service.

• A low dose (10-30 milligram) feels lightly numbing and relaxing
• With a moderate dose (30-70 milligram) you start to feel the tripping effects and it can get more difficult to move the way you want to

• At a large dose (70–150 mg), the trip effects become strong, and you may enter a k-hole.

Using ketamine does carry risks. Some risks you'll notice right away and are called 'short term risks'. An overwhelming trip or feeling scared, for example. Other risks you'll notice only later when you use a lot of ketamine, often. Those are called long term risks.

Short-term risks:

• Problems with balance and movement: You could have a hard time walking straight or standing. You could fall and hurt yourself. Because you feel less or no pain on ketamine, you might not always notice this. So make sure to sit down if you're having a hard time standing or walking and stay away from traffic or other dangers.
• Nausea: Ketamine can make you feel nauseous. Sometimes people throw up. If you pass out, you could choke on your own vomit.
• You could feel anxious or scared (bad trip): the effect of ketamine can be hard to predict sometimes. You could feel scared.
• Taking too much: The amount of ketamine makes a huge difference in what you feel. If you take a lot, you might feel like you can't move or talk. This is called a k-hole. This can be very scary.
• Combinations: It's extra dangerous to take ketamine together with alcohol/weed or other drugs, like GHB or anxiety medication (sedatives). Because your brain doesn't get enough oxygen when you combine these drugs, it can be deadly.

Long-term risks:

• Addiction: If you use ketamine often, it might be difficult to quit. It can be mentally addictive. You can read more under 'Ketamine and addiction' on this page.
• Bladder, kidney and stomach problems: Using a lot of ketamine often can badly damage your bladder. It could be painful to pee. You can also get pain in your kidneys or stomach. These are sometimes called 'k-cramps'. Do you suffer from these pains for an extended period of time? Then make sure to contact your doctor (huisarts).
• Mental problems: If you use ketamine often, you could start feeling anxious, sad or confused. If you're sensitive to it or if it runs in your family, it can also cause psychosis or feelings of paranoia
• Memory problems: Using a lot of ketamine often, you can start facing memory-loss, like having trouble with remembering new things and concentrating. Some of these problems can disappear when you stop using ketamine, but some problems can stay.

Are you planning to use ketamine? Then that's never without risk. But there are things that you could look out for to make the risks smaller. Read these tips:

• Make sure to get your drugs tested before use. Then you'll know how strong they are and whether there's other dangerous substances in there.
• Don't use if you don't feel good mentally or physically.
• Are you using ketamine for the first time? Then do it at home (and not somewhere crowded). Start with a low dose and make sure someone who has experience with ketamine is nearby.
• You can get nauseous from ketamine. For this reason it's best not to have eaten for 3 hours before using ketamine.
• If you feel scared or overwhelmed by the experience, don't fight it but let it happen. Remind yourself that the feeling is temporary and goes away, usually within 1 hour.
• Never use ketamine together with alcohol/weed, GHB or other calming substances (like benzodiazepines). These combinations are especially dangerous.
• If you've been snorting ketamine, clean your nose before you go to sleep.
• Voel je een pijnlijk of brandend gevoel bij het plassen of kramp in je buik? Stop dan met ketamine gebruiken. Als je hier last van blijft houden, ga dan naar je huisarts. Vertel artsen altijd te waarheid over je gebruik - ze kunnen je dan beter helpen.
• Do you feel pain or burning when you pee, or a cramp in your stomach? Then stop using ketamine. If you continue to have problems, contact your doctor (huisarts). Always tell doctors the truth about your usage - then they can help better.

Ketamine, because it's a kind of medicine, falls under Dutch medicine law (Geneesmiddelenwet). This means that you're only allowed to have ketamine if a doctor gave it to you. If you have ketamine without a prescription from a doctor, that's illegal.

If you carry a little bit of ketamine with you (1 gram or less) you usually aren't punished. Police could however take (confiscate) your ketamine. You can also be rejected or kicked out of a party if you are seen carrying ketamine. If you have more than 1 gram  with you, security or the police could think that you're selling drugs (dealing). You can get a fine or prison sentence for this.

There is a lot of research into drug usage in the Netherlands. Some research is about all people above 18 years old. Other research is about smaller groups. Like people who go out a lot, students, or citizens of a specific city. This research gives us a good overview of drug usage in the Netherlands.

0,8% of Dutch people aged 18 and over had in 2022 used ketamine in the last year (NDM). If we look only at 18-29 year olds the percentage is a bit higher at 3%. When we look at people who go out between the ages of 16-35, the percentage is a lot higher at 25%.

• A large amount of incidents reported to the Monitor DrugsIncidenten involved patients combining different drugs with ketamine.
• The LADIS keeps track of how many people need help with a certain substance in addiction care organizations. In 2023 ketamine users made up 0,7% of the total amount of people looking for addiction care.

If you want to use alcohol or other drugs it's important you feel good physically and mentally. If you're sick, sad or fearful for example, then alcohol and drugs can make it worse.

Some drugs in combination with certain medicine can make you very sick. Some combinations can even be deadly.

Are you using medicine and do you still want to use alcohol or other drugs? Then carefully research if you can beforehand. You can ask your doctor or pharmacy. Or check our overview. Do you still feel uncertain? Then make sure to message us at our Question & Answer service.

Do not use alcohol or other drugs if you are pregnant or breastfeeding. Drugs are harmful for the baby and can cause your baby to be born sick.

More info about the influence of cocaine on sex, pregnancy and breastfeeding can be found in this overview.

Ketamine as an anti-depressant

Ketamine is sometimes used as an anti-depressant. This is usually when other treatments haven't worked (therapy resistant depression). Since 2019, medical specialists in the Netherlands are allowed to prescribe ketamine against depression.

When using ketamine as an anti-depressant, it's important this is done under supervision of a doctor. Don't self-prescribe ketamine. A trained medical professional is familiar with the right amount (dosage) and will keep a good eye on risks for the patient.

Do you use ketamine often or in large amounts? Then it can be addictive. You might lose control of your use and using less or stopping is difficult.

Quickly you'll start needing more to feel the same effect. We call this tolerance.

People can get addicted to ketamine mentally. This means they think about it a lot and want to use it. Your body does not get addicted to ketamine. So if you stop using, you don't get sick or pain in your body (withdrawal symptoms).

Quitting ketamine is different for everyone. Usually it takes 4-6 days before you feel better. This could be longer or shorter, it's different per person.

You could;

• Feel like you don't want to eat
• Sweat a lot
• Feel anxious or sad
• Have bad dreams
• See things a bit blurry
• Get headaches
• Get a strong urge to use ketamine (craving)
• Have difficulty sleeping

Do you have questions about your use or someone else's? Or are you looking for help to quit or use less? Then you can reach out to Jellinek for a free and non-binding [consultation](link naar nieuwe advieslijn url, misschien een synoniem voor consultation vinden)