Is my friend in the k-hole?

“It’s difficult to comprehensively know about all the ingredients of the drugs someone has taken. We don’t know about how the drugs were prepared. It’s also difficult to be sure about the strength or purity of a drug,” says ACON’s Jack Freestone.

“Several factors might affect how someone responds after using a drug. These include things like the other drugs someone has taken (inclusive of alcohol or prescription medications), whether the person has slept or eaten previously, how hot or cold the environment is, how crowded a space is, and whether someone is in a positive or negative state of mind.

“Given that drugs and our reactions to them can be unpredictable, ACON always reminds people that if they’re going to use drugs, they should always start low and go slow. Remember you can always take more but you can’t take less.”

This is particularly true of ketamine, according to High Alert, an Australasian nonprofit. A ketamine overdose is sometimes described as a k-hole, “a feeling of dissociation – the sense of being detached from reality and yourself. This gets more intense at higher doses, to the point where someone may feel numb and unable to control their own bodies, including being able to talk or move.”

The impact of a k-hole is “a very disturbing experience, especially if it wasn’t the intended effect, as the feeling of helplessness can be overwhelming”.

Because high doses of ketamine may cause “numbness and the inability to move or speak, there’s a risk someone can fall and injure themselves or others. It may also not be possible for someone to ask for help if they’re in distress”.

If someone falls into a k-hole they may have difficulty coming out of the state of dissociation – meaning they continue to feel disconnected from the world and their life. There have been reports of people developing ongoing symptoms of psychosis.

In addition to starting low and going slow, users should be particularly mindful not to take k with other depressants like G, alcohol, benzos and opiates, as the combined sedative effect increases the risk of choking, overdose or losing consciousness.

And by low, the experts mean really low; this is why people tend to take ketamine in tiny “bumps” definitely not in lines like they do with cocaine.