The Reagan-Udall Foundation for the FDA, in collaboration with the FDA, is hosting a hybrid public workshop on "Understanding Current Use of Ketamine for Emerging Areas of Therapeutic Interest."
Identifying Safety Concerns and Potential Risks
Associated with the Use of Ketamine Products
Joseph Palamar, PhD, MPH
New York University Langone Health
History of abuse possibly as far back as 1967, law enforcement seizures of medicine, 99% of which is in powder form, produced by clandestine labs in southeast asia and smuggling through Mexico— this is not medicine-grade ketamine being diverted.
In US — Ketamine use over time as decreased since 2000, hovering around 1% use in adolescents. In adult use, some increase, but well below 1% of the full US population of adults.
In UK - 3-4% use in 16-24 year olds in the UK.
In Nightclub scene, close to a third of night-club goers in NYC have used ketamine in the last year. Ketamine is coming back. Past month use, close to 15%, with 8% having used in the last 24 hours going into clubs.
Effects - why in a nightclub? quotes murderer, James St. James
Numbness, passiveness, that world is not real, changed perception of body consistence, arms feel like wood, weightlessness, floating, absence/distortion of time. Even small doses lead to hallucination/disccoiation. Larger doses lead to a “k hole” out of body / near death experience.
Ketamine artwork — Almost creepy, not beautiful like psychedelic artwork
Effects can be pleasurable but “a lot of people find effects are horrific”
So uise increasing, but peopole find it creepy and horrific?
59% asked for help, 7 % went to ER.
Majority of ketamine hospializations involved alcohol use. Do not mix ketamine with alcohol.
second mention of Matthew Perry - what if bad things happoen to you while on the medicines? Mugged? Beat up? Raped? You wouldn’t remember what happened. Use disorder.
K cramps, bladder issues seem pretty common
Ketamine posionings - 1 in a million report to poison conrtrol - 5% of cases were child exposures.
2019-2023- number of poisions have doubled to 400 in the last year.
Most cases of poisonings are moderate - 20% major events, couple of deaths (least likley) 41% reports co-drug use, mostly alcohol. Do not mix ketamine with alcohol.
Ingestion - liquid, powder, lozenges, injecting has decreaswed
Most using liquid, then powder, — solid 15% and lozenge use least misused.
At home psychiatric treatment - big concern -
reference to Smith Family MD prescribed to over 3000 patients - clinic shut down
What ifs -
anxiety, panic, dysphoria
self harm, harm to others
left stove on? Kids?
Operate a car/heavy machinery?
You don’t know what’s going to happen
Diversion - a month’s supply of ketamine - who’;s to say they’re not selling it, diverting, anything could happen if you give someone a large supply
Stockpiling large doses
routes of administration - lozenges at home - people are trying to break them up and sniff them - I’ve googled it, and looked on reddit
Swallowing it instead of spitting it out
Ketamine use disorder — it is not classically addicting
What stops people from buying it on the street? Seeking illegal supply after introduced to medicine
More research needed, surveillance, is off-label ketamine making its way to black market? (not according to the info he presented)
Identifying Safety Concerns and Potential Risks Associated with the Use of Ketamine Products Joseph Palamar, PhD, MPH New York University Langone Health
History of abuse possibly as far back as 1967, law enforcement seizures of medicine, 99% of which is in powder form, produced by clandestine labs in southeast asia and smuggling through Mexico— this is not medicine-grade ketamine being diverted.
In US — Ketamine use over time as decreased since 2000, hovering around 1% use in adolescents. In adult use, some increase, but well below 1% of the full US population of adults.
In UK - 3-4% use in 16-24 year olds in the UK.
In Nightclub scene, close to a third of night-club goers in NYC have used ketamine in the last year. Ketamine is coming back. Past month use, close to 15%, with 8% having used in the last 24 hours going into clubs.
Effects - why in a nightclub? quotes murderer, James St. James
Numbness, passiveness, that world is not real, changed perception of body consistence, arms feel like wood, weightlessness, floating, absence/distortion of time. Even small doses lead to hallucination/disccoiation. Larger doses lead to a “k hole” out of body / near death experience.
Ketamine artwork — Almost creepy, not beautiful like psychedelic artwork
Effects can be pleasurable but “a lot of people find effects are horrific”
So uise increasing, but peopole find it creepy and horrific?
59% asked for help, 7 % went to ER.
Majority of ketamine hospializations involved alcohol use. Do not mix ketamine with alcohol.
Adverse effects - impaired consicousness 45 % hypertention 40% tachycardia 39%
second mention of Matthew Perry - what if bad things happoen to you while on the medicines? Mugged? Beat up? Raped? You wouldn’t remember what happened. Use disorder.
K cramps, bladder issues seem pretty common
Ketamine posionings - 1 in a million report to poison conrtrol - 5% of cases were child exposures.
2019-2023- number of poisions have doubled to 400 in the last year.
Most cases of poisonings are moderate - 20% major events, couple of deaths (least likley) 41% reports co-drug use, mostly alcohol. Do not mix ketamine with alcohol.
Ingestion - liquid, powder, lozenges, injecting has decreaswed
Most using liquid, then powder, — solid 15% and lozenge use least misused.
At home psychiatric treatment - big concern -
reference to Smith Family MD prescribed to over 3000 patients - clinic shut down
What ifs -
anxiety, panic, dysphoria self harm, harm to others left stove on? Kids? Operate a car/heavy machinery?
You don’t know what’s going to happen
Diversion - a month’s supply of ketamine - who’;s to say they’re not selling it, diverting, anything could happen if you give someone a large supply
Stockpiling large doses
routes of administration - lozenges at home - people are trying to break them up and sniff them - I’ve googled it, and looked on reddit
Swallowing it instead of spitting it out
Ketamine use disorder — it is not classically addicting
What stops people from buying it on the street? Seeking illegal supply after introduced to medicine
More research needed, surveillance, is off-label ketamine making its way to black market? (not according to the info he presented)