Ketamine is recognized in the Russian Federation as a narcotic substance, belongs to the list of A. The list includes drugs, the sale of which is controlled by the state. The medicine is dispensed only with the prescription written out on a special form intended for recording the movement of narcotic drugs.
Ketamine narcotic
Ketamine is a synthetic narcotic psychoactive drug, a hallucinogen. It shows an analgesic, hypnotic effect, does not have the ability to accumulate in the body.
Is a white crystalline powder, soluble in alcohol, water, fats. Refers to a group of means of general anesthesia.
Scope
It is used in surgery for introductory and basic anesthesia, especially in emergency surgery due to the preservation of the ability to self-ventilate the lungs.
Due to the ability to dissolve in fats, it easily penetrates the blood brain barrier of the brain.
Forms of use
Used by drug addicts mainly in the form of a snuff. This form of drug is considered less dangerous, to achieve the effect requires a small dose of psychedelic.
The effect is more pronounced and the use of a drug in tablets is a great danger. Tablets are sold under the guise of Ecstasy with a distinctive logo. The introduction of intramuscular ketamine is accompanied by a brighter appearance and severe pain at the injection site.
Even more dangerous is the introduction of ketamine into the vein. The change in consciousness sometimes happens faster than a person has time to take the needle out of the vein. With intravenous administration, the risk of a lethal dose increases.
Composition
In ampoules, bottles for non-anional anesthesia contains ketamine hydrochloride as an active substance, as well as auxiliary components.
Available in ampoules with a capacity of 2, 5, 10 ml, 5 ml vials. In 1 ml of the solution contains 57.6 mg of ketamine hydrochloride, which is equivalent to 50 mg of ketamine.
Ketamine is an antagonist of excitatory amino acids, an NMDA receptor blocker. The structure and properties are close to phencyclidine.
The elimination half-life is 2-3 hours. But the drug is found in the blood when tested for another week after ingestion, and in case of chronic addiction and after 20 days.
Mechanism of action
Ketamine disorganizes the brain by the type of dissociative anesthesia, acting on the associative zone of the cortex and the thalamus.
The brain under the action of ketamine for a short time loses the ability to analyze incoming sensory information, keeping in full the respiratory reflexes, in part - the muscular activity. In particular, the cough, pharyngeal, laryngeal reflex is preserved.
Indications
The drug is used for intravenous anesthesia, it is shown:
- when performing medical manipulations that do not require muscle fixation;
- transportation of patients with burns;
- pain, traumatic shock;
- significant blood loss.
This use of Ketamine is possible due to the fact that the properties of the drug include the ability to maintain the ability to self-ventilate the lungs in the absence of oppression of cardiac activity.
Ketamine is used by dentists, otolaryngologists, gynecologists with small surgical interventions that require fast anesthesia for a short time( up to 3 hours).
Ketamine is contraindicated in the violation of cerebral circulation, epilepsy, alcoholism, high blood pressure. It is not used for heart failure, angina, operations on the pharynx.
The effect of
The psychedelic effect of "separation from the body", "expansion of consciousness" is explained by the disruption of communication between the centers of the brain, analyzing signals from the senses, and by the sensory analyzers themselves.
The action of the drug when administered intramuscularly begins almost immediately. When taken in the form of tablets "Nastya", "ket", "vitamin K", as it is called ketamine on slang, it penetrates into the brain and starts to act 15 minutes after use.
Stages of intoxication
First the legs, hands, the person lose their desire to actively move, there is a desire to lie down. His head is spinning, consciousness is distorted. A person does not know what his name is, who he is, what size.
The lack of euphoria in the use of the drug, fortunately, did not make it popular, but nevertheless, it is quite common. Excitation is absent, there is no desire to run, sing or dance with delight. No desire to communicate.
Consciousness is moving into a parallel world, a person can observe from the outside without feeling his body. A person can feel himself an object that moves through electrical wires or lines of communication, travel in the future or in the past.
A good and bad trip
In most of the descriptions of the ketamine trip, it slips that the scenario of these fantastic visions is related to the occupations, the sensations that preceded the drug intoxication.
If before taking a drug a person was engaged in painting, then somehow the imagination will outplay this theme. And what is perceived by the "expansion" of consciousness is just walking around in circles, repeating in different variations of what the brain recently received and stored in memory.
Ketamine trip is similar to the action of cannabis, opium, alcohol, nitric oxide, and lasts up to 1.5 hours. At the same time, as an answer to the question "how much the drug works," you can safely answer - a day, because so many are observed the consequences of taking psychedelic.
After about a month of drug consumption, both good and bad trips disappear. By this time, the addict is constantly experiencing anxiety, panic.
A source of anxiety, perhaps, is the metabolite of ketamine, norketamine, which has a sedative effect. And with the use of ketamine, the usual calm state simply returns.
Exit from intoxication
Exit from ketamine intoxication begins with self-awareness within the body. The return is accompanied by unpleasant discomfort in the muscles, tingling, strange mechanical sensations with the slightest movement.
Gradually, the ability to focus vision on objects is returning, and it is even possible to recall their names. Coordination does not immediately return. Movement for a long time remain "rubber", which is noticeable to others and is not felt at all by drug addicts.
Repeated desire to take ketamine after the first time does not usually arise, physical dependence is not formed. But the psychological dependence is formed quickly and makes you take the drug again.
And after a few months of dependence all these vivid and interesting impressions, which the patient experiences during intoxication, he is no longer able to remember and describe the next day due to the weakening of memory and the growing degradation of the person.
Dependence development
It is believed that ketamine does not cause a strong dependence, and get rid of it is not difficult. Nevertheless, physical dependence exists, if only because the addict has to increase the dosage of the drug. Formation of physical dependence lasts 4-7 months.
An indication of physical dependence can be the rapid relief from discomfort, lethargy when taking even a small dose of the drug.
The addict does not experience physical pain when the drug is withdrawn, but the withdrawal syndrome exists, manifests itself with the symptoms:
- with muscle pain;
- depression;
- is a violation of sleep, digestion.
The discomfort continues for a short time, and after 7-10 days completely passes.
Mental dependence on the drug is formed quickly and manifests itself vividly. The addict develops a condition when the drug is required so that the patient throws all his affairs and searches for this source of bliss.
Signs and symptoms of use
Ketamine is predominantly injected intramuscularly( into the buttocks), it is impossible to determine the ketamine addict by veins. In a vein because of the short action of the drug, the need for a partner to stitch a shot, a high risk of overdose, ketamine is rarely administered.
Ketamine addicts with experience in clothing can have traces of blood from injecting drugs directly through it.
Common to the Ketaminers are the symptoms:
- the diameter of the pupil is not changed, but the sight is detached, unblinking.
- movement is constrained, poorly coordinated.
- no pain;
- hindered speech;
- inability to focus the view;
- sudden mood changes, flashes of irritability.
Side effects of
In a large dose, ketamine disrupts the work of the respiratory center, causing shortness of breath, acts on the respiratory musculature, the muscles of the tongue, causing spasm, tongue lancing in the throat, preventing breathing.
When taking a drug in the form of a powder, the effect seems insignificant, and the person under the influence of the drug leaves the house to seek adventure. The absence of a connection between signals coming from the body and brain analyzers leads to an inadequate assessment of the situation.
A person under ketamine can freeze without feeling cold, get burned, without feeling heat from a match, get a serious injury without experiencing pain. Intranasal use of ketamine has a delayed side effect.
Do not remain without effects of irritation of the mucous membrane analgesic. Chronic inflammation of the mucosa can end very badly - malignant tissue degeneration, the development of cancer.
Effect on heart
Ketamine is dose dependent. Large doses of the drug depress the work of the heart, causes nausea, vomiting, difficulty breathing.
Admission of small doses of ketamine leads to an increase in the work of the heart muscle( myocardium), which increases the pressure in the pulmonary artery.
Acting on the nervous centers of the sympathetic nervous system, the drug:
- raises blood pressure;
- causes heart palpitations;
- increases cardiac output, the amount of blood that can be ejected when the ventricles contract.
Action on the brain
Ketamine increases blood flow in the brain, increases oxygen concentration, increases intracranial pressure, increases subcortical activity of neurons, manifested by myoclonic movements. On awakening, hallucinations, intimidating dreams, prolonged disorientation in space can occur. Excitation, psychosis are possible.
About strong psychic dependence on psychedelia says personality change, which is expressed in violation of sleep, memory, weakening of intellect, frustration of attention. Quite soon a person completely changes the circle of communication, loses his job, his family.
Effects on the digestive system
Large doses of ketamine cause vomiting, nausea, salivation. The admirers of this drug go to the world of dreams, building a basin nearby, so that they do not have to interrupt the flight of fantasy by going to the toilet.
The drug addict loses, as a rule, the appetite. He develops exhaustion, is emaciated, weight loss.
Consequences of
- Ketamine causes mental and physical dependence.
- The person during ketamine intoxication does not feel pain.
- The use of ketamine can provoke panic, aggression, personality change right up to schizophrenia.
- In combination with alcohol, ketamine causes changes in the heart that are life-threatening.
Overdose and poisoning
The intensity of the psychedelic effect depends on the dose, especially when using the drug in tablets or injections. At some point, another increase in the dose will not cause the separation of consciousness from the body, but completely disconnect both the body and consciousness, which threatens a fatal outcome.
Pharmaceutical preparation of ketamine in ampoules has a low concentration and is not capable of causing a narcotic effect in a single dose. Increasing the dose, mixing ketamine with alcohol, a person risks to cause an overdose, provoke vomiting, stop breathing.
Lethal dose:
- when taken orally - from 50 to 400 mg per 1 kg of body weight;
- for intravenous / intramuscular injection - 77 mg per 1 kg of body weight.
Treatment of addiction
Ketamine addiction causes a strong mental dependence, so the question arises, like "how to get off" from the drug. The treatment is aimed at overcoming the attraction to the drug at the level of consciousness. From panic attacks, fear can not be eliminated by simply replacing ketamine with a medicine."Get off ketamine" will not work without psychotherapy and psycho-rehabilitation.
The standard treatment is carried out in three stages:
- detoxification - 3-7 days;
- rehabilitation - 6 months;
- social adaptation - 6-7 months.
The detoxification phase is not required for all drug addicts, as the physical dependence is poorly expressed. Longer treatment is required to overcome mental dependence.
The patient has to learn to live without a drug, change the way he responds to changing life circumstances, solve problems, and not hide from them in a fairy tale, disabling the connection of the brain with the world through the drug.