A REVIEW OF KETAMINE ABUSE AND DIVERSION
Depression and Anxiety August 1, 2016 S. Sassano-Higgins, D. Baron, Grace Juarez et al. 200 citations
Ketamine, discovered in the 1960s and released in 1970, is used clinically for analgesia and sedation, and more recently for pain, asthma, and depression. It causes dissociation and emergence delirium, leading to recreational abuse. While death from direct pharmacological effects is rare, disinhibition and altered perceptions increase risk of environmental harm and nonconsensual sexual intercourse. Chronic use may impair memory and cause persistent dissociative, depressive, and delusional thinking, as well as lower urinary tract symptoms, cystitis, and gastric and hepatic pathology including abnormal liver function tests and bile duct dilations. S-ketamine shows hepatotoxicity in vitro. Abstinence is the mainstay treatment; specialized urine testing may be needed for detection.