It all began with ‘cave sniffing’. It is assumed that in ancient Greece when consulting the Oracle of Delphi the visions and omens the Pythia (priestess) experienced were produced from inhaling nitrous oxide (laughing gas) which escaped from the rocks of the cave. Many years later, in the 18th century, nitrous oxide was found to numb the senses and was used unsuccessfully in dentistry as an anaesthetic.

It was no accident that an American pharmaceutical company received the credit for first synthesising ketamine hydrochloride in 1962. Americans have had a long history of experimenting with anaesthetics, nitrous oxide being one of them. In fact, one of the greatest contributions that the Americans have made to modern medical science is in the area of anaesthesia with a volatile substance called ether, which could effectively put patients to sleep while they were having major surgery. Before the discovery of ether and its use in surgery, patients were strapped to chairs, held down by several staff and intoxicated with alcohol while doctors would perform amputations under horrendous conditions.

Ketamine was given to a human for first time by Dr Edward Domino in 1964. His wife coins the phrase “dissociative anaesthesia” because to her the patient seemed distant, staring into space and detached from their surroundings. A replacement for Phencyclidine (PCP) had been found. PCP being another dissociative anaesthetic but unlike ketamine lasted 12 hours and could cause a range of complications including death.

In the late 1960s ketamine started to become popular with recreational users, the drug initially diverted from hospitals into local communities by medical staff. It came under a variety of street names such as ‘mean green’ and ‘rockmesc’ which did not accurately describe the substance which generally appeared as a liquid or white powder. It was also used in Vietnam has a ‘buddy’ drug and considered safe for ordinary soldiers to administer it without a doctor or nurse present.

It wasn’t until the early 1990s that ketamine started to gain ground in the UK. During this period ketamine found its way into low quality ecstasy tablets or capsules (‘dud pills’) and were generally avoided by most clubbers who were in search of pure MDMA. This gradually began to change over the years with ketamine use growing among young adults who began ‘bumping’ it in clubs, festivals and ‘after parties’.

On 21 June 2007 Hong Kong Medical Journal posted a report regarding the misuse of ‘street K’. The report suggests that long term use may result in damage to the liver or urinary bladder, or even acute renal failure. However, the researchers suspect that the damage “may be due to other toxins that the ‘street ketamine’ has been contaminated with”. Or a metabolite such as norketamine which stays in the body for longer hours.

There have also been a number of reported droughts of ketamine in the UK and some users have been taking Methoxetamine (MXE, Mket), an analogue, as an alternative or just out of pure curiosity. Online vendors are claiming that Methoxetamine does not cause bladder damage but yet again research in this area is non-existent. Like many research chemicals on the market not much is known about the long-term effects of Methoxetamine, whether it will ever become as popular as ketamine only time will tell.