Ketamine: An Escape From Reality

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Biology 202
2002 First Paper
On Serendip

Ketamine: An Escape From Reality

Kathryn Rorer

Ever since I was little, people have warned me about the horrible effects that illegal drugs have on your life. My generation has been taught to think of mind altering drugs in a very negative light yet many people still take these drugs. The general reason that people give to explain this is that the drugs feel good. This seems like a very vague response especially since we have been taught that the negative effects outweigh the bad. Why does it feel good and how good do they feel? It appears that there must be a deeper reason why people take drugs since it is such a risky thing to do. Many drug users, especially those who use psychedelic drugs, say that these drugs give them valuable insights that change their lives for the better. Is it possible that a drug can do this? If so, how do they work?

The reason why many drugs feel so good is due to the dopamine reward system. Whenever one experiences an intense feeling of elation due to something good such as a good grade on a test, a delicious dessert, or hearing your favorite song, she is experiencing the brain’s chemicals acting as a reward (1). In 1954, James Olds and Peter Milner discovered that rats would learn to press a lever if rewarded with a brief burst of electric stimulation. This discovery was significant because it suggested the existence of a pleasure center in the brain. The electrical self-stimulation was most effective when applied to the medial forebrain bundle, which goes from the midbrain to the hypothalamus and then triggers the activity of other cells that extend from the ventral tegmental area in the midbrain to the nucleus accumbens in the forebrain. This pathway relies on the neurotransmitter dopamine and possibly norepinephrine which are enhanced by drugs such as cocaine and amphetamine (2). Drugs can trick the brain into thinking that the body deserves a reward and a flood of dopamine is released, which creates an intense feeling of pleasure.

Pleasure is a feeling that all people seek, and experiencing intense pleasure or euphoria is one very important reason why people use drugs. Drugs can also offer the user an escape from the self and reality. Some people want to escape from an undesirable situation, but many probably want to escape from more than this, they want to escape themselves too. Self awareness is highly evaluative and it can be very stressful to maintain a certain image of the self (7). Using drugs allows some to forget the parts of themselves that they find unacceptable and sometimes it allows them to look into different parts of the self that they are not familiar with. Drugs can also provide temporary relief from the stressful burden maintaining one’s identity. Finally, drugs can allow the user to seek transcendence. Loss of the self entails bliss and is another reason why drugs feel so good (7).

Some of those who use drugs to escape the self hope that this separation will offer insights about the self. These people generally use psychedelic drugs such as ketamine, ecstacy, and LSD. The word psychedelic means ‘mind revealing’ (3). Some believe that these drugs may tell us more about how the mind constructs reality, personality, and a sense of meaning or sacredness (3). For these reasons, some psychologists think that these drugs can be effective ways to enhance therapy.

Ketamine is an especially interesting drug because it can induce near death experiences, which many people believe offer great insight into the self. The way ketamine works is it blocks the N-methyl-D-aspartate receptors in the brain for the neurotransmitter glutamate. These receptors in the temporal and frontal lobes of the cerebral cortex play a key role in cognitive processing, memory, and perception. In a near death experience, a flood of glutamate is released, overactivating NMDA receptors which results in neurotoxicity. When this happens, it is very likely that a flood of neuroprotective agents called endopsycosins bind to NMDA sites to protect them from neurotoxicity are released. Ketamine acts the same way as the neuroprotective agents do, leaving an altered state of consciousness (6).

A near death experience is when a person reports leaving the physical body and possibly going through a tunnel towards a light. One way to classify them is on a five stage continuum (6). First the person experiences feelings of peace and contentment. Second there is a sense of detachment from the body. Next they feel as if they are entering a transitional world of darkness, usually through a tunnel. At the end of this tunnel, they emerge into a bright light and finally enter into this light (6). Ketamine can reproduce all of these features. One ketamine user describes the experience as, "I was convinced I was dead. I was floating above my body. I reviewed all the events of my life and saw a lot of areas where I could have down better (6)." Experiences like these can be therapeutic. Some positive changes resulting from an experience like this include an enhanced joy of living, reduced fear of death, increased concern for others, reduced levels of anxiety and neurosis, and reduced addiction (3).

One of the biggest studies involving ketamine and psychotherapy took place in St. Petersburg, Russia. Over 1,000 patients have been given ketamine to aid alcoholism treatment. These trials were well planned with proper control groups, which is not true of many studies with psychedelic drugs. The results of this study seem to show that ketamine can be an effective supplement to treatment. The subjects who took ketamine had very good rates of sobriety at one and two year follow ups compared to the control group. They also seemed to improve in personality changes as well, with decreased depression, anxiety, and increased ego strength. People seemed to think life was more meaningful. Some believe that ketamine psychedelic therapy can reconnect the ego with denied parts of the self (3).

Ketamine seems to be fairly safe in a hospital setting. It can block nerve paths without depressing respiratory and circulatory functions, which is why it can be used as an anaesthetic (5). In low doses, it actually acts like a stimulant rather than a sedative. However, the hospital is not the only place where ketamine is used. It is becoming an increasingly popular club drug. It also has a bad reputation for being known as date rape drug, since it is colorless, odorless, and can cause amnesia. Common street names for ketamine are "K", Special K, Vitamin K, and Ket. It can be taken orally, injected, or most commonly snorted. Its original form is a liquid, but is usually microwaved or boiled into a powder form (4). The dosage used in these setting usually does not induce a near death experience, but if it does occur it is commonly called a "k" hole. Some common negative side effects include muscle spasms, blurred vision, slurred speech, dizziness, and impaired coordination (4). It is not physically addictive like cocaine or heroin, but some can because psychologically addicted. The Drug Enforcement Administration just declared it to be a controlled substance in 1999, and is illegal to possess without a prescription or license.

The reasons why people take drugs certainly seem to be more complex in most cases than the simple answer that people take drugs because they feel good. People often use drugs as a way to escape their situation or themselves, and sometimes even to gather insights about themselves. Ketamine seems to be an interesting drug for escape since it provides an experience that seems like the ultimate escape, death. Many swear that drugs like ketamine can change lives for the better and that these drugs have therapeutic effects. However, there is not any conclusive evidence that supports this. While the user probably does gain some insights from ketamine, how valuable or accurate they actually are is questionable. Another question that is raised is what exactly is reality and why do drugs like ketamine change that reality? It is very interesting that those who use ketamine to escape from reality and themselves can end up becoming more in touch with themselves. Of course not all people that use ketamine do so for a life changing experience. The people who use it in clubs or at raves are probably the ones who are using to feel good and have fun, but at the same time this could be an attempt to escape the self and forget about the aspects of the self that are stressful.


1)About Addiction

2)Timmons & Hamilton: Drugs, Brains & Behavior

3)Ketamine and Quantum Psychiatry

4)Ketamine: Fast Facts

5)Erowid Ketamine Vault: FAQ

6)The Ketamine Model of the Near Death Experience

7)Baumeister, Roy F. Escaping the Self. Basic Books, 1991.

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