Ketamine Usage in the UK 1998-2002

1 Introduction

1.1 Ketamine (2-(2-Chlorophenyl)-2-(methylamino)- cyclohexanone) is one of a class of drugs known as dissociative anaesthetics, other drugs in this class include phencyclidine (PCP/angel dust), dextromorphan, and nitrous oxide). Ketamine is widely used in veterinary medicine, and is not currently a controlled drug. Tablets containing ketamine are commonly found on the illicit market, either masquerading as ecstasy or sold as Ketamine itself (known by devotees as special-K).

1.2 Originally used as an animal tranquilliser, ketamine induces a trance-like state described by some users as an out of body experience or tunnel vision, with the user commonly sedated or even immobilised.

1.3 Ketamine has commonly been associated with fake ecstasy tablets, although these are now less common. To counteract the sedative effect, stimulants such as procaine, ephedrine, caffeine or amphetamine are often included in Ketamine tablets. Although tablets are now the most common form of ketamine, it is also found in injection ampoules, bottles or in powder form.

2 Methodology

2.1 The IDMU regular users surveys have been monitoring changes in patterns of drug use since 1994, and annually since 1997, in surveys with a target of 1000-3000 respondents. In the 1994 and 1997 surveys ketamine was the most commonly-reported other psychedelic, among other named drugs written in by respondents, and merited inclusion in its own right in the 1998 survey onwards.

2.2 Anonymous questionnaires were distributed at pop festivals and other outdoor events. Other than basic demographic information, respondents are asked a number of core questions each year, concerning use of and attitudes to legal and illegal drugs, with other questions, and question order, changing year on year. For Ketamine use, the questions were:

Age first use of ketamine

Frequency of/intention to use ketamine

Monthly spending on ketamine

Overall rating of ketamine (marks out of 10)

Ketamine prices

In 2001-2, users were also asked how much they used per week (doses/tabs) and when they had last used the drug.

2.3The purpose of the surveys is to target populations expected to contain a high proportion of drug users in order to conduct research into the illicit drugs market. The vast majority of respondents have used cannabis in the month prior to the survey. In the context of Drug Misuse Declared data, our population would be more representative of drug users as a whole, rather than of the general population.

2.4Please note that figures for 2001 were collected on a restricted basis, with a more biased population (predominantly London area), the smaller sample also giving rise to greater statistical margin of error.

3Sample Demographics

3.1The overall average age of respondents was 28.03 years with the year on year averages varying by up to a year either way. Female respondents were on average around 9 months younger than males. There was a 3:2 male-female ratio, with 8% of respondents declining to state their sex (table 1), and 3.8% declining to state their age.

3.2 The age range of respondents varied from early teens to late middle-age (fig 1), with the highest numbers in the range of 18-30.

Fig 1-Age Range of Respondents

4 Prevalence of Ketamine Use

4.1 In our 1998-2002 surveys (see table 2), 1329 users (14.8% of respondents) had tried ketamine, the vast majority on an experimental or occasional basis, with 279 individuals (3%) claiming to use occasionally or more often. The proportion of users each year is relatively stable between a low of 13.0% in 2000, and a high of 18.4% in the smaller 2001 survey. Similarly current use remains relatively stable at 2-3%, apart from a blip in 2001.

4.2 On the basis of there being 2-3 million UK citizens using drugs in an average month, possibly 300-500 thousand persons will have tried ketamine, with 60-90,000 current users (occasionally or more often).

4.3 In 2001 and 2002, respondents were asked to quantify their ketamine use in doses or tablets per week, with a range of 0-10 doses (fig 2)

Fig 2-Ketamine Tablets/Doses per Week

4.4  In 2001/02 users were also asked to state when they had last used ketamine (table 3) - note the today figures may be skewed as a result of sampling location.

4.5 A total of 134 respondents (98-02) reported monthly spending on ketamine, with a mean of £19.22 and a maximum of £200 (fig 3)

Fig 3-Monthly Spending on Ketamine

5 Initiation to Ketamine Use

5.1Of those individuals who had not used Ketamine, 2222 indicated whether or not they intended to use the drug in the future, 289 (13%) stating they might use, and 87% stating they would never use the drug. The proportion of non-users willing to consider using ketamine fell from 16% in 1998 to 10% in 2002 (table 4).

5.2 The mean age of initiation is 22 years, 9 months, with a stable or upward age trend. There is no evidence that younger users are at increasing risk of being exposed to ketamine, very few individuals had tried the drug before adulthood, with most first trying ketamine between ages 18 and 30 (fig 4). The vast majority had first used ketamine between 1990 and 2000.

Fig 4-Age of First Ketamine Use (raw & cumulative)

5.3 A significant proportion of those having tried ketamine claimed to have given up using the drug. Of those who had not yet used ketamine, there was a 6:1 ratio between those who stated they would never use the drug, and those who might try it if offered.

6Attitudes towards Ketamine

6.1Ketamine has historically had a bad press among drug users, in the 1970s Furry Freak Brothers comics it was credited as causing a 12 hour nightmare (when sold as bad LSD). Ketamines reputation among the drug subculture is patchy, users generally give a negative rating (mean 2.58/10), with the majority giving it a zero, but an even spread of attitudes among other responses (fig 5).

Fig 5 - Subjective Ratings of Ketamine

6.2 There has been a decline in user ratings since 1999-the drug appears to becoming less popular over time (table 4).

6.3 The user-rating does vary significantly with frequency of use (Table 5), the lowest ratings were given by those who stated would never use the drug (1.18) the highest (7.24) by regular (weekly/monthly but not daily) users.

7. Ketamine prices

7.1 In many instances, a user will buy a ketamine tablet believing it to be ecstasy, with ketamine/ephedrine/procaine tablets very common during the 1990s. More recently, the advent of over-the-counter ecstasy testing kits - available in the UK since early 1998 - coupled with an interactive web database and "users grapevine", has coincided with an increase in the quality of ecstasy tablets (most now contain MDMA, usually within range of 50-100mg), and a reduced incidence of "fake" tablets containing ketamine.

7.2 At the same time, a niche market has developed for ketamine per se either in tablet or powder form, such that the street price of a tablet sold as ketamine is likely to exceed that of a genuine ecstasy tablet (Table 6). At higher levels of the market (10-100 tabs), tablet prices are similar to those for ecstasy. No clear year on year price trends are apparent, as the prices vary widely, with single tablets/doses available from £2 to £20 each (fig 6)

Fig