What it does

Ketamine is an NMDA-antagonist dissociative used as a hospital anesthetic and, at lower doses, as a treatment for depression under medical supervision. Recreationally it produces detachment, altered perception of the body, and — at higher doses — full dissociation.

Safer-use principles

• —Do not use alone. Falls and choking on vomit are the most common injuries.
• —Sit or lie down before it takes effect.
• —Frequent recreational use damages the bladder, sometimes permanently. Space it out.
• —The illicit supply is increasingly contaminated with fentanyl. Test before use.

Dangerous combinations

Ketamine + alcohol or opioids sharply raises the risk of choking, respiratory depression, and death. Combining with other dissociatives (PCP, DXM) is unpredictable.

If something goes wrong

Unresponsive, vomiting, blue lips — call 911, turn on side, give naloxone if opioids may be present. Because dissociatives suppress the gag reflex, vomit inhalation is a real risk.