From birth in a lab to the Vietnam war, continuing on to parties and now clinics to treat depression: this is the complicated history of ketamine. We can consider the current period in time “the second wave of psychedelics”. After booming in the 60s and 70s, psychedelics became controlled substances in the US and thus illegal. Today, psychedelic retreat centers are opening worldwide. There, you can find participants using plant medicine for everything from healing trauma or overcoming addiction to just increasing their creativity.
Ketamine itself is not considered a psychedelic drug but rather a dissociative anesthesiac. Ketamine infusion centers treat patients with treatment-resistant depression and PTSD with great success, and psychedelic therapy is emerging as an ever-popular field of research in universities. While ketamine may seem to have popped out of nowhere to become a star from one day to the next, it has a long and relatively peaceful history. Though it has been abused as a street drug, there have been only 12 ketamine-related deaths in the US from 1987 to 2000. Out of those 12, only three were due to ketamine alone.
Yet as ketamine use grew worldwide over the years, so did its abuse. For example, there were 93 recorded ketamine-related deaths in the UK between the years 2005 and 2013. Some were suicides, road accidents, or drownings, while some were due to organ failure due to long-term ketamine abuse. Going from a field anesthetic in the Vietnam war, to an illegal street drug, to a breakthrough treatment for depression, this is the history of ketamine, from its inception to today.
The 60s-70s: An Accidental Birth
Ketamine was first synthesized in 1962 by an American pharmacist named Calvin Stevens at the Parke Davis lab. Stevens, a professor of Chemistry at Wayne State University in the US, was searching for replacements for PCP at the time. Known initially as CI-581, ketamine was patented a year later in Belgium and quickly became a useful anesthetic.
After being tested on animals and later, human prisoners, accounts of recreational use spread in 1965. The visual distortions, hallucinations, and “strange” feelings that ketamine induced were known as “dreaming”. Until Professor Edward Domino coined the term “dissociative anesthetic” in 1965 to describe the effects ketamine induces.
When used as an anesthetic, ketamine can cause side effects such as feeling strange, woozy, or numb. Dizziness, nausea, dry mouth, and feeling flushed are also common side effects. At high and frequent doses, ketamine can cause liver and urinary toxicity.
Patented as an anesthetic in 1966 by Parke-Davis, the U.S used ketamine as a field anesthetic in the Vietnam war. Ketamine also began its use in veterinary medicine due to its anesthetic and analgesic effects. For a long time, ketamine was primarily known as a “horse tranquilizer”. In fact, one of its street names was “cat Valium”.
The 80s-90s: Emerging Popularity
In 1978, two books came out that further popularized the use of ketamine: Journeys Into the Bright World by Marcia Moore and Howard Alltounian, and The Scientist by John Lilly. Not long after, the DEA announced its intention to make ketamine a Schedule III drug. Eventually, they decided that the incidence of ketamine abuse was not sufficient to justify this move at the time.
Ketamine was added to the “emerging drugs list” in 1995 until finally becoming an illegal Schedule III drug in 1999. Meanwhile, ketamine (known as “Special K” on the street) became a popular party drug worldwide. During this time, you could find ketamine in capsules, tablets, powders, and injectable forms. People snorted, injected, or smoked ketamine in joints. Ketamine was used in the rave scene along with other drugs such as MDMA (“Ecstasy,” “Molly”). However, ketamine is shorter-acting than most other party drugs. It can take effect within ten minutes up. The effects would last for 60 minutes if injected and two hours if taken orally.
Due to the confusion and amnesia, it can cause, ketamine was also used as a “date rape” drug during this time.
The 2000s: A Change of Purpose
As ketamine became a controlled substance, its use as an anesthetic declined. Morphine became the official substitute in hospitals and clinics, while heroin and cocaine became more popular in the streets. But ketamine didn’t just fade away. Researchers started exploring its potential to treat treatment-resistant depression. In 2000, a paper on the antidepressant effects of ketamine was published in the Biological Psychiatry journal. While the study included just 7 participants, it opened a floodgate of interest in NMDA receptors in the treatment of depression, and particularly ketamine.
In the early 2000s, there was a resurgence of research into the use of psychedelic therapy. Using LDS and psilocybin mushrooms as a platform for healing had already begun in the US in the 60s and 70s. However, this avenue of research was shut down once psychedelics became controlled substances. The interest in psychedelic therapy was unique in psychiatry. While during the 80s and 90s, doctors and researchers were searching for pills that one could take to manage symptoms during the 2000s, the idea of using psychedelics to enhance experiences to truly heal was groundbreaking.
In this case, the hallucinatory effects of ketamine are no longer considered merely a fun night out or interesting curiosity. Instead, they can serve as a platform for healing. In fact, spiritual experiences are a core part of healing. But researchers aren’t content to let clients take ketamine alone. Instead, they look for the exact dose to help treat depression while avoiding dangerous side effects, like high blood pressure. Most research today is on intravenous ketamine. A client books several appointments at a ketamine infusion clinic, where they sit in darkness as they are connected on an IV. Some watch a TV show or drift off into thoughts. In 2020, the FDA approved a nasal spray based on ketamine, called Esketamine. While ketamine infusion clinics use both ketamine molecules (“S” and “R”), Esketamine uses only the “S” molecule.
The 2020s and Beyond
As research into ketamine continues, we may see exciting changes in the treatment of depression and mental health conditions. For example, since the effects of ketamine can last up to seven days, teenagers or other depressed individuals won’t have to remember to take medication daily or deal with unpleasant daily side effects like weight gain, insomnia, or sexual dysfunction. Side effects like lack of appetite can be particularly harmful to teenagers, who are still growing.
Scientists are working hard to research the effects of ketamine and other psychedelics in alcohol abuse disorder and various other addictions and mental health concerns. There are many questions to ask. Not only whether ketamine and other psychedelics may be particularly suited for specific issues. Is ketamine suited for depression while iboga is for addiction, or can they both heal both concerns as well as others?
Researchers would also want to know what are the ideal ways to use ketamine and psychedelics. For example, is it enough to consume ketamine, or perhaps therapy sessions or ceremonies may be beneficial? MAPS currently studies MDMA-assisted psychotherapy for PTSD. No matter what happens, the future of ketamine is bound to be as exciting and transformational as its past.