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WE REALLY NEED to talk about Ketamine. Why? Well, good reasons include the recent spate of tragic fatalities caused by the drug (including a lengthening list of much-loved celebrities) and an even longer list of ordinary people who need to attend urological clinics with grotesque damage to their urinary tracts.
Also, and perhaps the most politically persuasive of arguments, because there is now evidence (in addition to anecdotes and subjective surveys) that the number of people using Ketamine intermittently or regularly has grown exponentially over the past decade, in Ireland and the United Kingdom.
So, firstly, what exactly is Ketamine? Ketamine is a synthetic (man-made) anaesthetic and sedative drug first developed in the early 1960s (and derived from a now-notorious precursor, Phencyclidine, also known as ‘PCP or Angel Dust’).
Initially licensed by the FDA in 1970, Ketamine quickly gained popularity among military surgeons dealing with wounded soldiers in the Vietnam War, as a simple injectable anaesthetic that produced a short-lived trance-like state of ‘dissociation’ (in which recipients felt detached from their bodies, and unable to feel pain).
Crucially – and unlike most other anaesthetic drugs – it didn’t cause patients’ blood pressure to plunge. It actually ‘protected’ their airway and, in places and times of scarce resources, it allowed non-anaesthetists to create a kind of ‘general anaesthesia’ during which urgent life – and limb-saving surgery could be undertaken.
The same qualities meant that it became a drug of choice for treating distressed children in emergency departments, as well as one of the most widely used anaesthetic agents in veterinary practice worldwide, affording sedation and pain relief in both contexts, with an intramuscular injection. And the analgesic effect has been invaluable in the care of (human) patients with chronic pain (e.g. complex regional pain syndrome after injury), albeit with ‘sub-anaesthetic’ doses.
The same applies to so-called ‘treatment resistant depression’ in which patients with disabling mood disorders that have failed to respond to conventional anti-depressant medications have been successfully, and often dramatically, helped with relatively low-dose Ketamine infusions (and, more recently, with a nasal spray).
The drug has also been used, with close monitoring in specialist settings, to help people combat drug and alcohol addiction. So Ketamine is clearly a medically attractive drug, with many useful applications, and it is included on the World Health Organization’s ‘List of Essential Medicines for Anaesthesia and Pain Management’.
But why do people use Ketamine ‘recreationally’? As with so many medicines, Ketamine has proven hugely popular among non-medical users, like clubbers, party- and festival-goers, and so-called ‘psychonauts’ (who employ mind-altering chemicals or other techniques to explore the deepest reaches of the ‘psyche’).
It is relatively cheap, quickly available (from online dealers), and it can be taken in a variety of ways (snorted, swallowed, smoked, or – rarely – injected). The drug is primarily taken for its ‘mind-altering’ effects, and it belongs to a ‘family’ of such drugs, including MDMA, Mescaline, PCP and LSD, that have been popular for decades among (especially young) people who want to experiment with – or enjoy again – a mind-bending blend of auditory and visual hallucinations, detachment from reality, sedation, blissful inertia or ‘peace’, or ‘profoundly spiritual’ experiences.
And one ‘benefit’ of Ketamine (which may be called ‘Special K’ and many other street names) over its hallucinogenic cousins is that the altered mental state tends to last just an hour or two, unlike that following use of the other drugs and, afterwards, there is often amnesia for the drug-induced state and what happened during it. That said, most users combine their use of Ketamine with a wide range of other drugs (like Cannabis, Cocaine and MDMA [‘Ecstasy’]), so the picture is complicated.
What are the ‘downsides’ of Ketamine use? Not all users find the ‘bliss’ that enthusiasts report. And of course, it is the persistent – often ‘dependent’ – consumers who eventually demonstrate the dangers of excessive use of the drug. The ‘mechanism’ of the harm is often predictable from the state of the user as perceived by others: users may be apparently ‘drunk’, agitated and confused, paranoid, fearful, unsteady on their feet, not able to control their muscles or understand what is said to them (or the risks around them), and often unable to remember where they are or what has just happened.
Such ‘visible’ effects were the basis of recent fevered speculation (in The Atlantic and Wall Street Journal) about the behaviour of Elon Musk, who has publicly acknowledged that he relies on Ketamine for his recurrent depression.
However, it is the fatalities that are most worrying. One of the first publicised cases was that of ‘D.M. Turner’, a renowned psychedelic researcher who died in 1996, after injecting an unknown quantity of Ketamine, and drowning in a bathtub, while seemingly incapacitated by the effects of the drug.
Sadly, a near ‘copycat’ case was that of Matthew Perry, the 54-year-old star of the 1990s TV hit series, ‘Friends’, who was found ‘floating face-down in a hot tub at his Pacific Palisades home’ in 2023 due to a combination of Ketamine toxicity and drowning.
He had allegedly been given huge amounts of the drug by two doctors to ‘treat’ his longstanding addictions to opioids and alcohol. And UK Ketamine deaths reported in the past 18 months have included that of ‘RuPaul’s Drag Race’ star, The Vivienne, a 32-year-old, who reportedly suffered a Ketamine-induced cardiac arrest in the bathroom of their home; Rian Rogers, a 26-year-old ‘rising star of the car industry’ who was found dead in his shower after a cardiac arrest, due to the Ketamine he kept taking to ease the pain caused by his shrivelled ‘Ket bladder’; and 20-year-old Sophie Russell, who weighed just six stone when she died following a two-year history of Ketamine use. Sophie first tried the drug in school, while Rian experimented with it first at a festival.
Even more shocking among recent Ketamine-related deaths was the murder-suicide in February 2025 by a Wyoming woman, Tranyelle Harshman, a 32-year-old with post-partum depression, who shot her four daughters and then herself, and was found to have ‘large amounts of Ketamine’ in her bloodstream.
All of these deaths seem to be potentially related to one or more of the complications of heavy Ketamine misuse. These include physical and mental dependence on the drug, with constant cravings for more, despite the increasingly obvious dangers of its use.
Aside from transient nausea, weakness and memory loss (which is why Ketamine is used as a ‘date-rape’ drug), short and long-term effects include cognitive or ‘mental’ decline, memory failure, anxiety, depression, self-harm while ‘detached’ from reality and unable to feel pain, recurrent hallucinations (sometimes – as in getting into a so-called ‘K-hole’ – these can be terrifying) and, most infamously, prostrating abdominal pain due to a combination of bile duct and urinary bladder damage.
The latter can be devastating, with painful bloody ulceration of the bladder lining and ureters, an insatiable need to urinate (up to 50 times a day), and a relentless shrivelling of the bladder that may require ‘ostomy’ bags for urine drainage or even surgical ‘reconstruction’. The abdominal pain often drives users to take a hot bath or shower, and even more of the Ketamine for pain relief, in a fatally ‘vicious circle’ that may only be apparent post-mortem.
What evidence is there of a substantial problem with Ketamine in Ireland? Official data typically takes a year or two to be published, but figures from the National Drug-Related Deaths Index in Ireland reveal eight poisoning deaths where Ketamine was ‘implicated’ between 2011 and 2020. Annual Ketamine-linked admissions to Irish drug-treatment facilities have approached 100 of late, although just 17 admissions were ‘primarily’ driven by Ketamine misuse (which is typically combined with use of other ‘recreational’ drugs).
The UK’s Office for National Statistics reports that nearly 4% of 16-24-year-olds used Ketamine in 2023 but, in Ireland, HSE Addiction Experts are still speculating about the scale of an ‘emerging trend’ of Ketamine use, especially at music festivals. Almost two-thirds of responders to a festival-goer survey had used the drug in the previous year, while EU and UCC surveys of drug users found that Ketamine was the fourth most popular drug among Irish university-level students (of whom 16% had used the drug at least once).
Finally – and most strikingly – in 2023, the Irish Revenue service seized 41.2 kg of Ketamine, valued at €2.47mn, while in 2024 an EU Drugs Agency study involving analysis of municipal wastewater placed Dublin in the top 20 of 128 European cities for levels of Cocaine, Ketamine and MDMA and 15th for the levels of Ketamine. These latter ‘concrete numbers’ probably give us the best available indication of the scale of Ketamine use in Ireland at the moment and, while they should be monitored frequently, and augmented with hospital and autopsy records, they offer a rough guide to the (considerable) level of medical need likely to be created by Ketamine in the next few years.
The Take-Home Message? Notwithstanding the unceasing challenges of legislation, regulation and education, the fact is that Ketamine is now an established ‘major drug’ of misuse in Ireland, and its potentially disastrous impact on users’ brains, bladders and behaviour need to be widely and urgently appreciated, especially by paramedics, emergency physicians, and the staff in every pub, club and festival venue.
Dr Chris Luke is a retired Consultant in Emergency Medicine, co-founder of the Club Cork Drugs and Alcohol Awareness course in 2003 and host of the Irish Medical Lives podcast.
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I spoke to a parent who was at the concert and I believe the condition of some of the young teenagers at the concert was nothing short of disgraceful. Under age girls falling around getting sick Surely something has to be done about this. Can the gardai not have a holding area where these people can be held for their own safety until a responsible guardian collects them.
The article says the met the men in a night club after the concert as for the holding area it is a way to stop underage drinking seen it enforced at an underage disco worked perfectly
I heard it was 2 members of the jason derulo fellas entourage! Not sure how true that was though. I dont know how girls in there got so drunk. Any time i went there you were properly searched before you went in, turned away if you were pissed and could only by one drink at the bar per time so you couldn’t by loads for teenagers. It’s stupid getting that locked at a concert … ruins it for yourself and everyone around ya!
I believe they have done away with searches. Probably cutbacks so these greedy organisers can squeeze every last penny out of teenagers. Also I believe most of these kids were drunk going in so should have been stopped at the entrance if people were doing their jobs
Searches and people being stopped for being drunk all falls down to who was providing security at the event
Comments should be closed on this article.
Castrate them and put them in a cell with a lifer. Unfortunately this is Ireland so they will be out in time for the next big concert
Stan
No need for a trial?
Yes if they are guilty of course. It is true that some women falsely accuse men of sexual assault but that is most likely not the case
I will hold my powder on this
Stan, a bit early in the morning to be grabbing your lighted torch and pitchfork isn’t it? I thought mob rule only came out after dark.
I doubt very much that we have any lifers in Irish prisons.
Ok I relent. I’ll put the pitchfork down.
So Stan you were the car and saw everything ?
Do you not understand what the word “allegation” means? There’s also a principal in the justice system that people are innocent until they’re proven guilty.
Stan … I think you mean castrate them if they’re guilty
Why so many red thumbs for Stan? 29 people think it’s ok to sexual assault young girls? Castration would be too good for these two perverts. Obviously they are guilty or it wouldn’t have made the news, journalist have good sources in the police, this isn’t just hear say. I wish the girls all the strength in the world to get over this horrible act of perversion.
Ah well if it’s in the news it must be true. Cancel the court case so.
Malcom, if someone made an allegation against you and you were arrested by the police do you think that you should be castrated on the spot? Only this week a woman was jailed for making false allegations against a man who was totally innocent. no doubt you would have had him castrated as well.
Look up “due process” and perhaps that will explain the 29 red thumbs for you.
Malcolm, you’ve forgotten that the employees at “thejournal.ie” aren’t actually journalists.
they engage in journalism’s equivalent of the ‘retweet’.
Yes Stan it is most likely not the case … Still can’t castrate someone based in most likely
Personally I think anyone who is guilty of sexual assault should be put in life behind bars for life, if only it was like America here, and that they would be locked up for 23 hours of the day in their own cell. This way they are left to think of what they done for the rest of their lives and eventually they will go mad. Unfortunately we don’t have laws that hold criminals to 60+ years. I really think we should revise our law system and instead of locking people up for minor things we should lock up the seriously dangerous people up for the rest of their lives. You ruin someone’s life then your life deserves to be ruined.
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