Ketamine, also known as K or ket, is a sedative drug sometimes used in chemsex contexts as it can enhance sexual feelings and desire. Emojis like 🐴 on hookup apps can indicate an interest in using ketamine in sexual contexts.

Ketamine is a dissociative anesthetic, meaning it can cause a feeling of separation from reality or one’s body.

🔴 Ketamine does not have a particularly high risk profile when used in moderate doses with intervals between each use. Higher doses of ketamine can lead to what is known as a ‘k-hole’. Ketamine can be psychologically addictive for some, but it does not cause severe physical withdrawal symptoms.

Ketamine is fundamentally an anesthetic and has been used for both humans and animals. It is also known as “horse tranquilizers,” hence the 🐴 emoji. Ketamine is also used in low doses to treat depression and other mental illnesses, although this is a relatively new development where the ketamine form esketamine is used in low doses.

Ketamine is most commonly snorted as a white or whitish powder or swallowed in tablet form. Users also sometimes ‘bump’ ketamine, meaning they roll the powder in a piece of paper and swallow it.

It can be difficult to distinguish between ketamine and other powder drugs like cocaine or amphetamine.

Ketamine can also appear as a clear, colorless liquid medication or as a nasal spray, both from medical production. Injecting ketamine is less common; the effect is immediate with injection, and both effect and after-effects last shorter compared to snorting or swallowing ketamine.

🕐 It takes 5-15 minutes to feel the effects after snorting ketamine, and the high lasts for about an hour. After-effects can last longer, and it is common to feel weak for 1-3 hours after use.

🕐 When swallowing tablets, the effect is felt after about 20 minutes, depending on how much you have eaten before (stomach contents), the high lasts for about 1.5 hours, and the after-effects can last 4-8 hours after use.

Many take ketamine and cocaine in similar doses, but ketamine should be taken in much smaller doses. This confusion often leads to many overdosing on ketamine and falling into what is called a ‘k-hole’.

Ketamine has psychoactive effects, including sedation, dissociation, and euphoria. The sensation is often intense. It can feel like the body and mind are separated; it is also common to experience a dreamlike state, affecting the perception of time and space. Hallucinations can occur, which can sometimes feel unpleasant and frightening.

People with mental health issues are at greater risk of experiencing hallucinations, impaired memory, and cognitive functions. Hallucinations in those with mental health issues can also feel more intense.

In chemsex, ketamine is often used to complement the effects of other substances. The effect of ketamine is individual and varies depending on body weight, tolerance, which other substances it is combined with, how much is taken, the strength of the ketamine, and other drugs.

Ketamine provides a floating sensation, relaxation, and disconnection. It blocks receptors that cause pain, leading to reduced pain sensation. This can facilitate harder sex or fisting, which can lead to injuries such as small tears or fissures in the anus, increasing the risk of hepatitis C and HIV.

The sexual feeling and desire are enhanced by ketamine, and one may feel more uninhibited. The sense of euphoria, happiness, and peacefulness can lead to greater relaxation and openness in sexual contexts.

Ketamine can make it harder to maintain an erection or reach orgasm. This leads many to use other substances, such as Viagra, in combination with ketamine to achieve the desired effect.

Safer sex with ketamine

• If someone has taken too much ketamine, they may find it harder to consent or defend themselves due to the strong dissociative and numbing effects. Be vigilant if someone needs help, and always use ketamine with people you trust
• If you or someone else has experienced assault, there is help available. If you have experienced something you do not feel comfortable with you can find out where to turn for support in the article support and connections
• If a condom is used during sex, change it after 30 minutes to avoid it tearing or breaking
• Make sure to have what you need, e.g., condoms, lubricant, gloves, cleaning products for dildos and plugs

Common side effects of ketamine:

• Impaired balance and fine motor skills, leading to easier falls and injuries
• Difficulty moving, paralysis
• Slower breathing
• Severe drowsiness
• Increased heart rate
• Reduced emotional experience
• Anxiety, panic (e.g., in a k-hole experience)
• Nausea, vomiting
• Unconsciousness

When coming down from ketamine, one can feel down, anxious, and weak. Memory issues, flashbacks, or visual hallucinations may occur.

Long-term ketamine use can lead to difficulty concentrating, memory problems, depression, and other mental issues. Problems with the stomach, intestines, and urinary tract can also arise.

High doses of ketamine over a long period can cause permanent organ damage.

A well-known effect of ketamine is the k-hole. It is a coma-like state characterized by dissociative and sedative effects. Some enjoy the effect of a k-hole, while others find it unpleasant. Several factors influence how you experience a k-hole, and it can vary from time to time depending on how much you take, if you mix it with alcohol or other substances, but also your environment and mental health.

Although it may feel unpleasant, it is good to know that a k-hole usually does not lead to further problems beyond some disorientation. However, it is also important to know that the effects of a k-hole can lead to increased vulnerability to sexual assault or accidents such as falling.

Signs of an impending k-hole include:

• Blurred vision
• Intense hallucinations
• Feeling disconnected from your body (e.g., feeling like you are just a floating head)
• Strong feeling that you are going to die

How can I help a friend in a k-hole?

Ensure the person is in a calm place without bright lights; it can help to speak calmly to them if they are experiencing anxiety and panic. Pay attention to the person’s breathing, and always call an ambulance if you suspect an overdose.

Signs of overdose include:

• Extreme confusion and disorientation
• Severe hallucinations and paranoia
• Involuntary muscle movements and spasms
• Respiratory depression
• Unconsciousness

If you suspect an overdose:

• Call an ambulance (112 in Sweden, the number works in all EU countries)
• Ensure the person is breathing and keep their airways clear
• Keep the person calm, try to ensure they do not harm themselves or others during hallucinations or confusion
• Try to get information about what and how much the person has taken to provide the right information to medical personnel. This is important so the person can get the correct treatment.

It is possible to develop a psychological dependence; the likelihood of developing addiction increases if ketamine is used daily. Currently, there is no research indicating that ketamine causes physical dependence.

In cases of psychological dependence, withdrawal symptoms such as anxiety, tremors, sweating, loss of appetite, nightmares, and depression can occur.

Ketamine should not be combined with sedative drugs like alcohol or GHB/GBL. The combination of ketamine, GHB/GBL, and alcohol can be dangerous as depressants enhance the sedative effects when used together. This can cause increased drowsiness, impaired motor functions, respiratory depression, and increased risk of memory lapses.

Be cautious when combining ketamine with methamphetamine, cocaine, and MDMA/ecstasy. The combination can cause harmful increases in heart rate, confusion, and risk of injury.

Booster medications such as Norvir and Tybost slow down the breakdown of ketamine. This can make ketamine more intense or longer-lasting and can also increase side effects.

🕐 Always have your HIV medications with you. If you often forget to take your medication, set an alarm or reminder on your phone. Take substances and HIV medications at different times to reduce the risk of side effects. Always take low doses of substances when taking medications simultaneously.

🗣️ Talk to your doctor or an expert about interactions between HIV medication and ketamine.

• Ensure you have a safe place to take ketamine, avoiding places where you risk injury from falls.
• Always start with smaller doses to wait for the effects. If you swallow ketamine, the effect will come later!
• Avoid using ketamine if you feel depressed, anxious, or have other mental issues, as ketamine can enhance these feelings.
• Be careful when smoking while using ketamine, as motor skills are impaired, and there is a risk of starting a fire.
• Use ketamine with people you feel safe with.