Recreational ketamine use has increased in recent years, but remains rare

Recreational ketamine use and availability of the drug have increased in recent years, but it remains an uncommon drug used by less than 1 percent of people in the U.S., according to a new study published in the American Journal of Public Health.

Ketamine has long been used as an anesthetic in veterinary and health care settings, but ketamine is also a party drug that produces hallucinations and feelings of dissociation. In 2019, the Food and Drug Administration (FDA) approved the use of a nasal spray version of the drug as a fast-acting option for treatment-resistant depression. 

“Since the approval of ketamine for psychiatric use, we’ve seen substantial attention and media coverage about the drug. As such, we wanted to determine whether there have been shifts in recreational ketamine use and availability,” said study author Joseph Palamar, PhD, MPH, an associate professor of population health at NYU Grossman School of Medicine and an affiliated researcher with the Center for Drug Use and HIV/HCV Research at NYU School of Global Public Health.

Palamar and his colleagues examined past-year recreational use of ketamine between 2006 and 2019 using the National Survey on Drug Use and Health, a nationally representative survey of U.S. teens and adults. They also looked at trends in ketamine-related poisonings between 1991 and 2019 as reported to poison control centers across the country. Finally, they examined trends in law enforcement seizures of ketamine, tracked by the Drug Enforcement Administration’s National Forensic Laboratory Information System from 2000 to 2019.

Their results suggest an increase in recreational use and availability of ketamine in recent years—particularly in 2019, coinciding with the drug’s FDA approval for depression. However, despite these increases, its use has remained relatively rare, with less than 1 percent of teens and adults using the drug. The highest prevalence of recreational ketamine use—0.9 percent—was reported in late 2019.

Poisonings were highest in 2000-2001, which was also the peak in use of other club drugs such as MDMA (also known as ecstasy or Molly). “As a ‘club drug,’ ketamine use has always been closely linked with ecstasy use, which is also most likely to take place in nightlife settings,” said Palamar. After a decline in poisonings, there was an increase again through 2014 to 1.1 poisonings per 1,000,000 people; this measure has remained relatively consistent since.

Rates of ketamine seizures by law enforcement have increased exponentially since 2012, although seizures are still uncommon relative to other drugs. The proliferation of seizures suggests an increase in the drug’s availability.  

“Increases in ketamine use in nightclub and non-hospital settings indicate the need for additional public health measures so that individuals who use non-medically are aware of risks and side effects,” said Katherine Keyes, PhD, associate professor of epidemiology at Columbia University Mailman School of Public Health, and co-author.

“While ketamine is used medically throughout the world, it is important for surveillance efforts to focus on recreational use in an effort to inform prevention and harm reduction programs,” added Palamar. 

In addition to Palamar and Keyes, Caroline Rutherford of Columbia University Mailman School of Public Health co-authored the study. The research was supported by the National Institute on Drug Abuse of the National Institutes of Health (R01DA044207 and U01DA051126).

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The mission of the Center for Drug Use and HIV/HCV Research (CDUHR) is to end the HIV and HCV epidemics in drug using populations and their communities by conducting transdisciplinary research and disseminating its findings to inform programmatic, policy, and grass roots initiatives at the local, state, national, and global levels. CDUHR is a Core Center of Excellence funded by the National Institute on Drug Abuse (Grant #P30 DA011041).  It is the first center for the socio-behavioral study of substance use and HIV in the United States and is located at the NYU School of Global Public Health. For more information, visit www.cduhr.org.

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