People who use ketamine recreationally often enjoy the tranquilizing and hallucinogenic effects of the powerful dissociative drug. At lower doses, ketamine can make a person feel relaxed, numb and trippy. Floating sensations are common, and some people become giggly.
But at high doses, ketamine can cause people to completely lose awareness of the world around them and fall into a psychedelic abyss known as a k-hole.
Ketamine can be smoked, snorted or mixed in drinks, but many people experience a k-hole after injecting the drug.
Falling into a k-hole is often described as an intense out-of-body or near-death experience.
People in a k-hole will feel completely detached from their body and surroundings. They are unable to move or speak. Drooling is common, and they appear to be in a catatonic or zombie-like state.
But the mind is far from quiet. During a k-hole, an individual typically experiences vivid, dream-like hallucinations and distortions of time and space.
While some people find the psychedelic experience enjoyable, others find it terrifying. In fact, going into a k-hole is often compared to a bad LSD trip.
Ketamine’s k-hole effect stems from the drug’s unique ability to completely shut off communication between the brain and body, blocking awareness of pain and other physical sensations.
But the same properties that have made ketamine a useful drug in the operating room make it dangerous for the people who use the drug recreationally.
Because ketamine causes paralysis, a k-hole can leave a person more prone to injury.
As a k-hole takes hold, a person may stumble and fall. Ketamine can cause nausea and vomiting, and immobilized people could potentially choke on their vomit. People have also been slipped the drug unwittingly in drinks and assaulted or raped.
While rare, fatal ketamine overdoses have occurred.
High doses of the drug, particularly when injected directly into veins, can suppress breathing. Mixing ketamine with other central nervous system depressants, such as alcohol, heroin, valium or GHB, is extremely dangerous and can increase the risk of overdose.
Frequent use of the ketamine can lead to long-term mental problems.
A 2014 article in the British Journal of Clinical Pharmacology describes the k-hole effect, noting its schizophrenia-like symptoms.
The article also states that chronic ketamine abuse can cause memory problems and persistent schizotypal symptoms, including delusional thinking, depression, dissociation and superstitious beliefs.
When these effects recur regularly, even when people are not high on the drug, it is known as a k-hole flashback.
The effects of ketamine usually develop within 10 to 20 minutes of use and end after about 45 to 90 minutes. The k-hole may last from 10 minutes to an hour.
Chronic use of ketamine increases the likelihood of a person experiencing a k-hole. A 2013 report by the British government’s Advisory Council on the Misuse of Drugs notes that the effect is particularly common among people who have used ketamine more than 20 times.
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