IRELAND’S KETAMINE EPIDEMIC Powerful drug is growing threat to health as more revellers abuse it without understanding the risks
KETAMINE is known as a powerful anaesthetic, a horse tranquiliser and more recently a miracle cure for depression – but it has been implicated in five recent deaths in Ireland and rising admissions to treatment facilities.
An overlooked but sharp rise in popularity in Irish drug youth culture since the return of post-pandemic nightlife is causing concern in the HSE.
In December, when a County of Los Angeles Department of Medical Examiner announced Friends superstar Matthew Perry died from the “acute effects of ketamine”, there was an outpouring of concern.
Contributing factors included “drowning, coronary artery disease and the effects of buprenorphine” – used to treat opioid use disorder – but it was also reported that he was receiving ketamine infusion for depression and anxiety in the days before his death.
While there is renewed debate about its efficacy for treatmentresistant depression – mainly in the US – there is concern in the HSE that it has become a leading recreational drug among 18- to 24-year-olds.
The latest figures recorded by the National Drug-related Deaths Index in Ireland show eight poisoning deaths where ketamine was implicated between 2011 and 2020. Five of these were recorded between 2018 and 2020.
Meanwhile, ketamine-linked admissions to Irish drug treatment facilities have also been rising year on year with 500 cases over the past five years.
The figures show seven cases where ketamine was the main problem drug in 2018 compared to 17 in 2022 while treatment cases where ketamine was an additional problem numbered 67 in 2018, but shot up by 65 per cent to 122 cases in 2022.
The street drug can result in horrific side effects from hallucinations and seizures in the short term to bladder issues, memory loss and neuropsychiatric disorders with long-term use.
Nicki Killeen, coordinator of the HSE Safer Nightlife Programme – which operates a back-of-house drugchecking service aiming to identify drug market trends at festivals – said there is concern about the sudden increase in ketamine use.
Similar to drugs like MDMA, it’s moving from what would have been considered the cultural margins to more popular use, particularly in nightlife settings with younger people.
“We’re basing this on our work in festivals. In advance of Covid, we did see ketamine beginning to become a trend.
“But the past few years what we have noticed more concern and more young people talking to us about their use of ketamine,” she said.
Findings from the programme show that across four events in 2022 and 2023, 266 substances were surrendered to the HSE as part of the backof-house drug-checking programme – 117 were MDMA, 40 were ketamine and 34 were cocaine.
There were medical concerns observed across events related to ketamine last summer, in particular ketamine-related seizure activity.
“What is concerning is the pattern of use, they’re using it with other substances and they’re using large volumes of it,” Ms Killeen said.
“The young people we’re speaking to are often unaware of what ketamine is. They think of it as a club drug. They would compare it to something like MDMA or cocaine that will give a stimulating effect.
“What we’re seeing with them is
They’re using it with other substances and using large volumes
that they don’t realise that it has a dissociative effect.”
While at lower doses it can be a stimulant with euphoric or trippy effects, higher doses can result in hallucinations or delusions or dissociative out-of-body experiences where people can’t move their arms or legs.
In the European Web Survey for Drugs 2021, 23 per cent of respondents from Ireland reported use, considerably higher than the overall
proportion of ketamine use from the other 30 participating countries which was 13 per cent.
Ms Killeen, Project Manager with the HSE National Social Inclusion Office, also highlighted the trend observed in Ireland of the intentional mixing of cocaine and ketamine known as CK or Calvin Klein. This can have the effect of impacting the heart and causing palpitations.
Unlike ketamine used in clinical settings, the drug used in nightlife settings is often illicitly produced in clandestine laboratories. The HSE expert also warned of the trend of mixing alcohol with ketamine. “Ketamine used with any type of depressant drug is extra risky. It can lead to increases in accidents, drowsiness, passing out.”
The HSE have listed the long-term health effects of ketamine use as stomach cramps known as K cramps, psychological dependence, urological disorders, and impairment of memory.
Other chronic effects include neuropsychiatric disorders typically a schizophrenia-like syndrome associated with long-term and frequent use.
“This is the most sustained trend or peak that we’ve seen of ketamine compared to the past so long-term effects can impact on memory, cognition, mental health, dependency. But one of the lesser-known long-term effects is emerging evidence has shown that long-term and frequent ketamine use can lead to bladder damage,” she said.
“We’re trying to raise awareness, particularly with young people, and particularly amongst health professionals, who may need to look at people’s substance use if they’re presenting with symptoms like this.”