Ketamine Injection among High Risk Youth: Preliminary Findings from New York City

Abstract

Ketamine, a synthetic drug commonly consumed by high risk youth, produces a range of experiences, including sedation, dissociation, and hallucinations. While ketamine is more typically sniffed, we describe a small sample of young ketamine injectors (n=25) in New York City and highlight risks associated with this emerging type of injection drug use. Our findings indicate that the injection practices, injection groups, and use norms surrounding ketamine often differ from other injection drug use: intramuscular injections were more common than intravenous injections; injection groups were often large; multiple injections within a single episode were common; bottles rather than cookers were shared; and the drug was often obtained for free. Our findings suggest that the drug injection practices exercised by ketamine injectors place them at risk for bloodborne pathogens, such as HIV, HBV, and HCV. We conclude that ketamine injectors represent an emerging, though often hidden, population of injection drug users, particularly among high risk, street-involved youth.

HIV Sexual Risk Behaviors among Ketamine and Non-Ketamine Using Criminal Offenders Prior to Prison Entry

“…Consistent with previous studies of non-criminal offenders (Lankenau and Clatts 2002;), inmates in this study who had used ketamine before entering prison were more likely to be young, white males. In addition, and as expected, ketamine users had more extensive substance use histories and were overrepresented among the injection drug users; however, there was no statistically significant difference between ketamine and non-ketamine users in the number of substance abuse treatment admissions.…”

“…This is the first known study of criminal offenders to examine differences between ketamine users and non-ketamine users across demographic characteristics, substance use history, criminal history, and HIV sexual risk behaviors in the U.S. Due to inmates' high levels of both risky drug use and sexual practices, additional research is needed to examine ketamine use because studies suggest that it can no longer be called just a club drug (Halkitis and Palamer 2006;Lankenau and Clatts 2002). In fact, the substantial finding from this study was that ketamine use can be a marker for engaging in high risk sexual behaviors among criminal offenders.…”

“…Ketamine has been used as a surgical anesthetic for children, elderly, and wounded military personnel on the battlefield (Dotson et al 1995). Currently, the clinical use of ketamine is not commonplace because its side effects can produce vivid dreaming, hallucinations, and confused states; however, ketamine is still regularly used as a veterinary anesthetic (Curran and Morgan 2000; Fine et al 1974;Lankenau and Clatts 2002;Perel and Davison 1976). Ketamine also has analgesic actions and has been used in radiation therapy as well as in the treatment of severe burn victims or individuals with chronic pain (Dotson et al 1995;Fine 1999).…”

“…Users included medical professionals, educated individuals, and recreational drug users who were seeking altered states of consciousness (Jansen 2001;Lankenau and Clatts 2002). Recreational drug users obtained ketamine through underground 'medicinal chemists' (Jansen 2001) and most illegal ketamine on the streets was diverted from veterinary offices.…”

Towards an Explanation of Subjective Ketamine Experiences among Young Injection Drug Users

“…The user group may also impact a person's "set" by creating positive or negative expectations for the drug experience (Zinberg 1984). Ketamine user groups include "ravers" or young people involved in the club/dance settings (Curran and Monaghan 2001;Degenhardt and Topp 2003;Dillon et al 2003); gay men and men who have sex with men (MSM) (Degenhardt and Topp 2003;Dillon et al 2003;Rusch et al 2004); young injection drug users (IDUs) (Lankenau and Clatts 2002;); homeless youth (Lankenau and Clatts 2004;; and workers in the medical field (Ahmed and Petchkovsky 1980;Moore and Bostwick 1999;Jansen 2001). Ketamine using practices, e.g., mode of administration, polydrug use, will be influenced by the expectations, norms, and membership within these groups, which may result in varying subjective experiences across user groups.…”