Let’s Talk About Ketamine

What is ketamine?

Special K. KitKat. Super K. Vitamin K. Cat Valium. Purple. These are all street names for the drug known as ketamine.

Ketamine is a drug that was first synthesized in the 1960s and is used worldwide as a painkiller and anesthetic. It is a dissociative anesthetic, meaning a type of drug that produces feelings of detachment from one’s self and distorted sensory perception. (For reference, PCP and nitrous oxide (laughing gas) are also dissociative anesthetics.) Ketamine is a class 3 scheduled drug and approved for use in hospital and other medical settings.

It is common to find ketamine in veterinary offices for use on animals as it is a powerful sedative. Ketamine is also used for anesthesia in many parts of the developing world where access to more traditional forms of anesthesia may be limited. In the 1980s, Ketamine became popular as a club drug because of the hallucinations and feelings of detachment it can produce at recreational doses.

Ketamine’s controversial uses

Ketamine is manufactured as an injectable liquid that is delivered either by injection to the muscle or given intravenously. It can be evaporated to form an odorless and tasteless powder for illicit use. Because ketamine is incapacitating and can induce memory loss, it is also considered a “date rape drug” that has been used to sedate unsuspecting victims.

In recent years there has been a growing trend among police officers to ask emergency medical technicians to administer ketamine as a fast sedative “to gain compliance.” The high-profile death of Elijah McClain in 2019 has brought national attention to the use of ketamine by police officers. McClain died after police officers in Aurora, Colorado placed him in a carotid hold and then injected him with a large dose of ketamine.

How ketamine works

Ketamine is a dirty drug, a term that is used informally in pharmacology to describe drugs that target different receptors which may all have different effects in the body. Because of its multifaceted application, there is still a lot that scientists don’t know about ketamine and how it works. One of the things they currently understand is that it affects the glutamate system in the brain. Glutamate is a neurotransmitter that is responsible for sending signals between nerve cells. What’s interesting about ketamine is how it functions differently at different doses. Low doses of ketamine, enhance glutamate production which can cause stimulant and hallucinogenic effects. High doses of ketamine block glutamate which is what makes it an effective anesthetic. As an anesthetic, ketamine does not reduce the blood pressure or breathing rate. Additionally, it does not need electricity or highly trained staff to be administered which makes it ideal for battlefield or disaster situations.

Ketamine’s use in depression treatment

Traditionally depression medications focused on the use of Selective Serotonin Reuptake Inhibitors (SSRIs) like Prozac. For a time, it was widely believed that people with depression had lower levels of the neurotransmitter, serotonin. Later, scientists realized that serotonin wasn’t the only game in town when it came to neurotransmitters affecting mood. GABA and glutamate accounted for 80% of the neurotransmitters in a person’s brain.

Together, the two neurotransmitters form a complex push-and-pull response, sparking and stopping electrical activity in the brain. Researchers believe they may be responsible for regulating the majority of brain activity, including mood.

What’s more, intense stress can alter glutamate signaling in the brain and have effects on the neurons that make them less adaptable and less able to communicate with other neurons. This means stress and depression themselves make it harder to deal with negative events, a cycle that can make matters even worse for people struggling with difficult life events.

Yale Medicine News

– Yale Medicine News

Researchers at Yale University knew that ketamine promoted glutamate production and also helped the brain form new neural connections. Over 20 years, these researchers led experiments delivering ketamine intravenously to patients with severe and treatment-resistant depression. The results were astounding. Multiple studies showed that over 24 hours, more than half of the patients had significant decreases in their depression symptoms.

In 2019, the FDA approved the use of a nasal spray called Esketamine, which uses a form of ketamine. Esketamine is the first major depression advancement in depression medication in over 60 years.

Support ketamine therapy

From club drug to battlefield anesthetic, ketamine is a complicated drug. But it’s also an effective medication for people with severe mental health disorders. Over 4 million people in the United States suffer from treatment-resistant depression. Many of them served in our military. Ketamine works faster and more effectively than SSRIs reducing suicidal ideation in hours instead of weeks. This drug can save lives.

“Ketamine is the agent that works when most others have failed. It is something that really allows us to give patients a new hope. They’re in this situation where nothing’s really working and they’re suffering, they’re miserable.”

— Andre Atoian, Ketamine Specialists

We think access to ketamine therapy is an important and essential step to healing the trauma and mental health that so many vets have experienced. Our mission is to provide hope and healing to military veterans and end the excessive dependence on powerful medications to treat mental traumas. We think ketamine is an important part of this mission.

For more information about how Heroic Hearts Project is supporting veteran access to psychedelic treatment for mental health please visit our Veteran Programs page

Sources:

klarisana
Harvard Health Blog
Partnership to End Addiction
Drug Science
Alcohol and Drug Foundation
Psychology Wiki
Huntington’s Outreach Project for Education, at Stanford
New Frontiers Psychiatric and TMS
Medical News Today
The Intercept
Yale Medicine
Johns Hopkins Medicine