
The Ketamine Connection - herendin
http://www.bbc.co.uk/news/resources/idt-bc7d54e7-88f6-4026-9faa-2a36d3359bb0
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joergsauer
"Ketamine is still used in developing countries as an emergency anaesthetic."

Actually, it is on the _WHO Model List of Essential Medicines_
<[http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng....](http://apps.who.int/iris/bitstream/10665/93142/1/EML_18_eng.pdf?ua=1>)
and used frequently and routinely in emergency procedures around the world,
not just in "developing countries".

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BgSpnnrs
Still used in pediatrics in the UK. Just the BBC being the BBC.

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joshcrowder
I thought this, it's widely known in the UK to be used on paediatrics. It's
also something the BBC has publicised before... Weird

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jrapdx3
Certainly a fascinating slant on ketamine, more familiar to me from reports
documenting benefit in patients with severe, treatment-resistant depression.
In clinical applications the dose is very small vs. street use and not
associated with the destructive gut and brain side effects described in the
article. However it's not innocuous, hallucinations or psychosis, among other
side-effects, are known, non-trivial risks.

It has been a drug of abuse in the US, but nothing like the near-epidemic
proportions going on in China. If the article is accurately describing
conditions over there, it suggests it's probably only a matter of time before
we'll see it in N. America.

Kind of ironic in a way. Here in Oregon cannabis is now legal for recreational
use, and other states will probably join the handful that permit sale and
possession of the drug. Widespread abuse of ketamine with harmful outcomes
might inspire a new round of a "war on drugs" just as unnecessary controls on
cannabis are being reduced.

Perhaps it might lead us to think that not all "recreational" drugs should be
regarded as harmless or the same as others, and one set of rules does not fit
all.

Edit: fix grammar.

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civilian
The use is really small? Uh, no. In operating rooms the amount of ketamine
they use is to _knock out_ the patient. Recreational uses are only interesting
because they have less than a knockout dose. If you did twice the amount of a
clinical knockout dose, you'd just be more knocked out, you wouldn't be
tripping.

Here's the recreational dosage numbers:
[https://www.erowid.org/chemicals/ketamine/ketamine_dose.shtm...](https://www.erowid.org/chemicals/ketamine/ketamine_dose.shtml)

Upon some more research, it appears I'm wrong. K isn't being used to knock
people out anymore. (idk, my mom is a retired physician and she talked about
how heart surgeons used to knock people out with k.) On page six you can find
battlefield doses
[http://www.health.mil/~/media/MHS/Report%20Files/201203.ashx](http://www.health.mil/~/media/MHS/Report%20Files/201203.ashx)
After you convert erowid's mg/lb to mg/kg it's clear that they're just giving
light doses.

You can find some reference to high doses of ketamine in this review article:
[http://www.annals.in/article.asp?issn=0971-9784;year=2015;vo...](http://www.annals.in/article.asp?issn=0971-9784;year=2015;volume=18;issue=2;spage=202;epage=209;aulast=Mazzeffi)
"Similarly, Marlow et al. found that in coronary artery bypass patients,
ketamine (2 mg/kg) caused significant decreases in stroke volume when used as
an induction agent."

tl;dr it varies. Also repeated/daily usage of ketamine is definitely bad and
will make you piss blood.

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jawr
I think he was referring to it's use as an anti depressant:
[http://www.nhs.uk/news/2014/04April/Pages/Ketamine-tested-
as...](http://www.nhs.uk/news/2014/04April/Pages/Ketamine-tested-as-severe-
depression-treatment.aspx)

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alexandercrohde
The thing I dislike about this article, as somebody who as experiment with
ketamine (I took it twice two years ago, and then twice last month) is that
the article's presentation implicitly vilifies ketamine a tad.

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joeyo
It's not all fun and games: ketamine will eventually destroy your bladder.

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efng
Yes it will,if you do 5 grams a day - which is a ridiculous amount. If you are
doing that much, you might in fact be a horse.

[https://en.wikipedia.org/wiki/Ketamine#Urinary_tract_effects](https://en.wikipedia.org/wiki/Ketamine#Urinary_tract_effects)

~~~
jawr
I'm pretty sure the way in which you deliver the drug is the biggest variable
as to how much damage it causes. The article briefly touched upon it; most
illegal ketamine comes in a crystal form and needs rehydrating (cooking), most
people do not rehydrate the ketamine and instead just crush it. Taking this
instead of hydrated ketamine is much more detrimental to the bladder/ut.

~~~
shabble
I think you might have it backwards.

Legitimately manufactured ketamine is typically in sterile saline solution at
a fixed quantity per dose. This is because the usual medical route of
administration is intra-muscular or intravenous injection.

For recreational use, (afaik) the majority is insufflated, or snorted. For
this you need the dry, crystallised form.

You can either purchase it as crystal from your friendly neighbourhood drug
dealer, or they may be able to supply you with vials diverted from veterinary
or medical suppliers. To get this to a powder, you boil off the water
"Cooking" and are left with a mixture of ketamine and salt.

The 2 biggest problems are trying to either rehydrate crystal powder for
injection (because ensuring sterility and consistent dosage is hard), and that
crystals are much easier to cut with other ingredients (because the legit.
vials usually have tamperproof seals like other legitimate drugs).

The other point is that most people won't be injecting it right from the
beginning. Only once they become tolerant and require high doses does the
appeal of IM/IV's increased 'efficiency' (bioavailability) tend to override
the common wisdom of not sticking needles in oneself.

From what I recall, most of the research has shown that long-term
administration of high doses is where the damage is predominantly done, and
even very high doses (1000mg would be a plausible dose for 'short term
surgical anesthesia (15-25 mins) of an 80kg adult), if given very rarely, are
not likely to cause harm.

But injecting that sort of quantity, multiple times a day, for weeks or
months, is absolutely going to lead to problems, and even more of them if
you're getting impurities or bacteria/spores along due to contamination.

~~~
jawr
I'm only speaking from personal experience, unfortunately I have friends that
have been abusing this drugs for almost 2 decades (none that inject so I can
not speak about that).

I might have my terminology mixed up, but there is definitely a difference
between crystallised and that which has been cooked (possibly again). Some of
it might possibly be myth on there behalf, as in they don't get as bad a "k
belly" or irritated bladder after a binge on the latter.

As well as the bladder/ut issues, snorting (anything) also leads to the
corrosion of the septum and also the bone(s) that supports teeth.. Basically
excessive use leads to teeth falling out.

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mrottenkolber
The writing in this piece is horrible.

"Free parties were popping up all over the country, and there were many in
Bristol. That's when ketamine came flooding into the city."

Differentiation? Anybody? As far as I am concerned these so called "Free
parties", aka outdoor raves, exist in most places of the world, as they cater
for a basic human need to have a good time. Now when people enjoy themselves,
they tend to drink, smoke and use various consumerables. We know Ketamine is
big in the UK. Now how are non commercial social events connected to Ketamine?

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steve19
"Sometimes, they would use motorcycles to surround the police, threatening
them with AK47 rifles and grenades."

Very, very unlikely. China has an almost complete ban on civilian ownership of
firearms. The only exception is for rare hunting permits (there is very little
hunting in China) and wildlife conservation. Even then traditional hunting
tends to use blackpowder muzzle loaders (and they restrict ownership of
black/gun powder)

They don't even allow regular cops to use useful firearms (they are issued a
revolver that fires rounds with as much energy as a .22 LR ... enough to wound
but not kill or even stop someone attacking police). They don't want the cops
ever rebelling against the PLA.

The BBC wants us to believe that Chinese authorities allowed an armed militia
to directly challenge law enforcement and did nothing about it for over a
decade?

More likely that was just a story made up by bribed cops, cops who were shit
scared of going into that village or cops/politicians who wanted extra credit
for going into that village.

So I wonder how much else of this story is exaggerated by the journalist.

Fully automatic AK ownership, and even grenade ownership is fully legal in
many or most US states, if you pay the required BATFE taxes and have the right
permits (explosive storage permits for grenades) but so much wave one at a cop
and you will be surrounded by armored cars and black helicopters sooner that
you can blink.

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bcraven
I'm not sure the legalities of gun ownership would bother the members of an
illegal drugs operation.

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vidarh
He's not suggesting the legalities is the primary reason it sounds strange,
but that the Chinese government appears to be less than likely to tolerate a
criminal organization to have weapons that might allow it to become a threat,
when they don't even allow the police access to similar weapons, much less
civilians.

I have no idea what situations are like with respect to weapons in China, so I
have no idea whether he's right or not, but this is not just about the
legality.

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ghotli
The way this is constructed reminds me of "Snow Fall" from the NYT.
[http://www.nytimes.com/projects/2012/snow-
fall/#/?part=tunne...](http://www.nytimes.com/projects/2012/snow-
fall/#/?part=tunnel-creek)

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sliverstorm
Snow Fall was considered an incredible success in online presentation, and a
lot of papers have tried to emulate it since. Any similarities you notice are
probably not accidents.

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titanomachy
I found the quality of writing to be somewhat sub-par for BBC, which is
usually excellent. Very interesting story, though.

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jklein11
Ketamine... just say neigh.

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BorisMelnik
Great story. Some of these content pieces are becoming massive! I mean, that
story was so large I wonder if they considered turning it into a short book,
or expanding it into one and publishing?

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ds_
Here it is on Google maps:
[https://goo.gl/maps/6kZfb](https://goo.gl/maps/6kZfb)

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egypturnash
Someday we'll find it The K-hole connection The ravers, the Chinese, and me.

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perfTerm
Great piece of investigative journalism.

