ABSTRACT
The rst reports of nonmedical ketamine misuse were in 1967 (Jansen 2001a,b) with increasing misuse in the 1970s through the 1990s when it emerged as a recreational drug, particularly in the rave party or nightclub scene in Europe and the United States (Dalgarno and Shewan 1996; Jansen 1993); more recently, it has become a common drug of misuse in Hong Kong and China (Central Registry of Drug Abuse Sixty-Second Report 2013; Patterns and Trends of Amphetamine-Type Stimulants and Other Drugs: Asia and the Pacic 2013). Unlike many other recreational drugs, in addition to evidence of acute toxicity, ketamine is now also recognized to
5.5.1.10 Emergency department data .................................... 121 5.5.1.11 Treatment of acute ketamine toxicity ...................... 121
5.5.2 Risk of physical harm ............................................................... 121 5.5.3 Risk of death .............................................................................. 122
5.5.3.1 More recent statistics on fatalities related to ketamine ...................................................................... 123
5.5.4 Chronic effects of ketamine .................................................... 123 5.5.4.1 Effects on kidneys, bladder, and urinary tract ...... 123 5.5.4.2 Ketamine-related chronic effects on the
gastrointestinal tract and liver ................................. 132 5.5.4.3 Chronic ketamine-related neuropsychiatric
effects ........................................................................... 133 References ........................................................................................................ 136
be associated with chronic toxicity in regular long-term frequent usersparticularly involving the lower urinary tract, bladder, kidneys, and central nervous system. In this chapter, we will discuss the epidemiology of ketamine misuse and the literature describing the patterns of acute and chronic toxicity associated with ketamine misuse.
