Recently, a novel substance called fluorexetamine is being sold as ketamine across the country. Doses of fluorexetamine are lower than ketamine and it can produce different effects. 

If you are using ketamine, test it first with reagents or at a drug checking clinic.

Key things to know

Taking a large amount can put someone into a ‘k-hole’ where they can’t move or speak

K-holes

If snorting, use clean straws and surfaces and rinse out your nose with a saline rinse

Safer snorting

If injecting, visit your local needle exchange for new needles and info on safer injecting

Safer injecting

Use drug checking services to make sure it isn’t mixed with something else.

Drug checking info

Avoid mixing with other drugs, especially other depressants.

Safer using

How does ketamine make you feel?

Ketamine can make you feel relaxed, confused, have ‘out of body’ experiences and relieve pain. Some people take a large dose of ketamine to go into a ‘k-hole’ which is a state where people cannot move or speak. They often feel detached from themselves, their bodies, and the world around them, which is also known as ‘dissociating’.

Remember a low dose for one person can be a high dose for another, as people’s bodies process drugs differently.

A Reddit user talks about feeling detached from their body when they first tried ketamine:

“I think I was in a short-term paralysis, I didn’t even know I had a body.”

Another Reddit user talks about taking ketamine to try and reach a ‘k-hole’:

“I was in another world, I won't say it was exhilarating or good or bad, I had a lot of introspective thought, I wondered how I came to this situation, I lost control, I had a hearing hypersensitivity to the point where I stopped all the noise in my room to look for the background sound, It was a hallucination, it was very strong, so strong that I grew anxious and felt paranoia.”

Keep in mind that when mixed with alcohol or other drugs, ketamine can have different effects to those listed below.

 

Pleasant Effects

Unpleasant Effects

Changes in perception

Mild hallucinations

Relaxed

‘Dream-like’ state

Euphoria

Pain relief

A pleasant sense of being detached from reality

Mild unpleasant hallucinations

Nauseous 

Mild increased heartrate

Confused

Groggy

Anxious

Difficulty focusing or thinking

Tingling or numbness in the body

Slurred speech

An unpleasant sense of being detached from reality

Pleasant Effects

Unpleasant Effects

Sensations of floating

Increased relaxation

Feeling ‘out of body’

Hallucinations

Increased euphoria

 

Hurting yourself without knowing (due to lack of pain)

Intensely nauseous 

Vomiting

Difficulty speaking

Unable to control your body movements

Unpleasant hallucinations

Slowed breathing

Dissociation or depersonalization

Lockjaw

Pleasant Effects

Unpleasant Effects

Intense feelings of being out of body (k-hole)

Full-body relaxation or numbness 

Intense euphoria

Problems breathing or very slow breathing

Complete inability to move your body or speak (‘k-hole’)

Emotionally distressed

Psychosis

Loss of consciousness

Seizures

 

How can you be safer when using ketamine?

Ketamine can effect everyone differently at different doses, so it is always a good idea to practice things that can keep you safer when using. 

Start with a lower dose. 
If you aren’t prepared to go into a k-hole, it can be an upsetting experience. While there is no specific dose that will cause a k-hole, it can be helpful to research your doses and start smaller at first, visit tripsit for information on dosing ketamine. 

Avoid mixing with other drugs, especially alcohol and other depressants. 
Ketamine is an analgesic (relieves pain), and alcohol is a central nervous system depressant (slows brain activity). When combined, they can slow down body functions like breathing to a dangerous level. It is best to avoid even small amounts of alcohol when using ketamine. Similarly, you also should not mix ketamine with similar depressants like GHB, GBL, tramadol or other opiates as these can have the same effect. 

Ketamine can stop you being able to move, which means if you start vomiting (e.g. from having too much alcohol) you could be at risk of choking.

Take care if you are snorting ketamine. 
If you snort ketamine, it will enter the bloodstream faster than taking it orally, so you may feel stronger effects quicker. When snorting, use a clean straw and clean surface, and avoid sharing straws with others. Taking breaks between using drugs this way will reduce the damage done to your nose. You can also do a nasal saline rinse after snorting to clear your nose. 

Use a lower dose and new needles each time if you are injecting. 
Taking ketamine by injecting it is more likely to result in an overdose or unpleasant effects. This is because injecting delivers it to your bloodstream the fastest. If you are injecting ketamine, make sure you use new equipment every time, including needles. You can get these from needle exchanges across New Zealand. This helps to reduce skin infections and the transmission of diseases like HIV and hepatitis that you can get from sharing needles.

Test your ketamine to make sure it isn't mixed with other drugs. Ketamine can be tested at drug checking clinics with a spectrometer. It can also be tested with reagent tests that you can do yourself. However, some reagent tests might give unusual reactions to ketamine analogues, so these are not as reliable. 

For more information on how to be safer when using drugs and alcohol, see Safer using.  

To order self-help workbooks and other free resources for safer use, see Resources

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What do comedowns from ketamine feel like, and how can you feel better?

Similar to other hallucinogenic drugs, most users report that there isn’t a major comedown from ketamine. However, how you feel once ketamine wears off can vary depending on how much you took, how often you use, whether you mixed it with alcohol or other drugs and your individual body.

If you...

  • Have aches and pains
  • Are sweating
  • Feel irritable, agitated, anxious or low
  • Feel very tired or have difficulty sleeping
  • Feel apathetic or unmotivated
  • Have headaches
  • Experience mild memory loss
  • Feel disoriented and or uncoordinated
  • Feel a sense of impending doom
  • Have difficulty urinating or are urinating a lot

Then try…

  • Get plenty of rest and sleep.
  • Remember to eat and drink plenty of water.
  • Get moving to release feel-good brain chemicals.
  • Reach out and talk with friends and whānau for support.
  • Relax and do things that you enjoy to take your mind off not feeling well.
  • Avoid caffeine, alcohol and other drugs.
  • Practise mindfulness and deep breathing, and try writing down your thoughts and feelings.

If any of these symptoms intensify or don't go away then call a doctor or Healthline 0800 611 116. They can talk you through the next steps.

If your symptoms worsen or you are with somebody who:

  • Have pelvic pain or blood in your urine
  • Have impaired vision
  • Experience psychosis
  • Are acting violently towards others
  • Experience emotional distress
  • Experience delirium
  • Have suicidal thoughts

Call 111. These are signs that something more serious is going on. You or the people around you should act quickly.

A Reddit user talks about their experience of coming down off ketamine:

“I had to drive home afterwards and expected to be fine as normally I feel like K flushes out pretty quick. I was wrong. I was 80% fine, but I had very obvious motor skill issues. If I had to perform a sobriety test, I am confident I would fail. I don’t think I had a headache, but I wasn’t clear headed. I ended up drinking a lot of water, a monster, some cheese, and half a can of salty peanuts. Waited 2 more hours then I was 99% fine”

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What happens if you have too much ketamine?

You might salivate excessively, feel groggy or drowsy, have mild heart palpitations, have stomach pains or nausea, feel disoriented, confused, anxious or paranoid, have slurred speech or mild hallucinations, have trouble controlling movements or experience lockjaw.

Try:

  • Focus on breathing - try taking slow, deep breaths.
  • If you are able, call and talk to somebody you trust and ask them to help keep you calm.
  • Do not take more ketamine, caffeine, alcohol, or other drugs, as these can make you feel worse.
  • Move to somewhere quiet - try to sit or lie down and do something relaxing.
  • Drink water to stay hydrated.

If your symptoms worsen or don't improve, or you vomit, injure yourself, experience disturbing hallucinations, are unable to move/speak (k-hole) and find it distressing, have severe paranoia or anxiety, experience changes in breathing (faster or slower) or have very low blood pressure, call a Doctor or Healthline (0800 611 116). You won't get in trouble if you tell them you've used drugs. They can talk you through the next steps.

If you have chest pain, experience persistent hallucinations that don’t go away, have a very slow heartbeat, have trouble breathing, experience paralysis that is long-lasting or very distressing, lose consciousness, experience psychosis or have seizures, these are signs of an overdose or an indication that something isn't right. You or the people around you should act quickly. Call 111.

If you experience unexpected or concerning effects from ketamine you can notify High Alert to help keep others safe.

An Erowid user talks about their challenging experience taking ketamine and entering a k-hole:

“I had no idea what I was, who I was, what it was to be a human or what had happened. But I knew deeply that I had done something very bad. I also felt as if everything was going to end. Nothing from real life existed anymore and I couldn’t recall anything at all. I had no body. Just the same feeling over and over: 'I am lost' 'who am I?'

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What are the long-term effects of using ketamine?

Using ketamine long-term can have impacts on both your body and your mind. The severity of these impacts depends on how much you use, how long you use for, and your individual body and health. For people using low doses of ketamine for medical purposes, the long-term effects are likely to be less severe, but there is limited research on this.

Long-term use of ketamine can cause physical problems. The main issue is the impact it has on the bladder which includes inflammation and troubles with peeing. In bad cases, it can cause ulcerative cystitis. This is a painful condition where the bladder is damaged and causes pain, bleeding, ulcers in the pelvis and bladder failure. Around 1 in 3 people who use ketamine long-term will have problems with how much their bladder can hold. Long-term ketamine use can also cause kidney problems from a back-up of urine in the bladder which in bad cases, leads to kidney failure.

Ketamine can also cause physical problems with the liver, gastric system (like vomiting and reflux) and heart problems. Ketamine can be addictive, and although it is not as severe as other drugs like meth, people that stop using can experience withdrawal symptoms.

Ketamine can also have effects on your brain, especially your memory. Regular ketamine use can cause memory loss, trouble remembering new things, trouble paying attention and reduced spatial awareness. Some of these problems can go away when you stop using ketamine, but others may be more permanent. Some people who use ketamine long-term may experience mental health effects, such as mood swings, paranoia and in some cases, psychosis. As with other hallucinogenic drugs like mushrooms and LSD, ketamine can cause hallucinogen persisting perception disorder (HPPD), which causes people to have ‘flashbacks’ at random times after using the drug.

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How do you manage withdrawal from ketamine?

See the 'Making changes' page for more information on how to Manage withdrawal from drugs and alcohol.

Ketamine can be addictive when used regularly or in very high doses, which may lead to unpleasant symptoms when trying to stop or cut down. Many users think that hallucinogenic drugs do not have withdrawal symptoms, but this is not necessarily true. While the physical withdrawal symptoms from ketamine can be mild for many people, the psychological symptoms can be difficult.

Withdrawing from ketamine is different for everyone. Generally, withdrawal lasts for about 4 to 6 days but it can be shorter or longer depending on the person.

You might:

  • Experience loss of appetite
  • Are sweating or feeling very hot or very cold
  • Feel anxious or low
  • Have nightmares
  • Have mild vision problems
  • Have headaches
  • Have cravings to use ketamine
  • Have difficulty sleeping

You can try:

  • Follow a tapering plan from a health professional to reduce your dose slowly.
  • Consider counselling or support groups if feelings of anxiety and depression are getting worse.
  • Lean on a support network of friends, family and professionals.
  • Stick to a routine – waking up, eating well, keeping active and rewarding yourself with things that bring you joy.
  • Practise mindfulness by writing down your feelings, doing breathing exercises or meditating.

If your symptoms worsen or don't go away, or you experience tremors, vision problems, intense cravings to use ketamine, rapid breathing, fast or irregular heartbeat, migraine, paranoia or panic attacks, call a doctor or Healthline (0800 611 116)

You can talk to your doctor about:

  • other medicines to help you get through withdrawal
  • rehab or withdrawal clinics in your area – visit Health Point to see what services are available.

If you experience psychosis, are acting violently towards others or have suicidal thoughts, these are signs that something isn’t right. You or the people around you should act quickly. Call 111.

One Reddit user talks about the psychological challenges of stopping ketamine:

“I am able to go two weeks at most before I crack and do it again, my main problem is anxiety and depression, without k I sleep all day and am moody/ unmotivated.”

For more information on getting support for drug and alcohol use, see Finding support. 

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How can ketamine affect your daily activities?

In New Zealand, ketamine is rarely prescribed to people. It is most often used in inpatient settings (like hospitals). If you are using ketamine regularly, be aware that even low doses of ketamine may still cause some impairment.

The effects of ketamine start from 5-30 minutes after taking it (depending on how you use) and the peak effects last for about 1-2 hours. If you re-dose, these effects will continue for longer. Some impairment from ketamine lasts up to 24 hours or longer.

Ketamine can put you in a dream-like state, make you sleepy, uncoordinated, and nauseous, so it is unsafe to drive, operate heavy machinery or do tasks that require fine movement. Ketamine can be particularly dangerous to use when working or doing everyday activities as it can suddenly make you unable to move your body or speak (k-hole).  It can also cause hallucinations or make you feel agitated or detached from yourself and reality. This can make interacting with others very difficult. 

Will ketamine show up on a drug test?

Ketamine can be tested for in hair, blood, urine and saliva (spit). The detection times for ketamine are not exact and can sometimes be affected by how much you take, how often you take it and your individual body. It is important to remember that every person’s body is different and will process drugs differently.

It is thought that ketamine can be detected for about 14 days in urine (or 2-4 days for some urine tests), 24 hours in saliva, 1-2 days in blood and up to 90 days in hair. 

If you have had ketamine in your system because of a medical procedure and are expecting a drug test, speak to your doctor and employer about the next steps.

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Is ketamine legal?

Ketamine is used in some medical and veterinarian practices and comes under the Medicines Act in New Zealand. This means that people like doctors can use this drug for medical purposes like surgeries. For non-medical purposes ketamine is considered a ‘Class C Drug’ in the Misuse of Drugs Act. This means that possessing these drugs, buying them, selling them, making them, importing them, or giving them to others is against the law.

You can also be trouble with the law if you are found to be ‘impaired’ by ketamine while driving.

To find out more about the law around legal and controlled drugs, including ketamine, see Drugs and the law.

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