DR MAX PEMBERTON: Ketamine use is soaring – here’s what to do if your child is in a K-Hole

For the past several years, I have worked in the emergency department with patients with mental health issues. I have been struck by the growing number of people coming in under the influence of the illegal ‘rave drug’ ketamine.

From something I almost never saw when I first started working as a doctor, it has become a regular occurrence over the past decade. I was working last weekend and saw three patients in one night shift. They were all students and they had all been brought in after taking too much ketamine and becoming unresponsive – essentially passing out.

It’s shocking how quickly it has become the drug of choice among young people, with most of the older generation knowing very little about it.

The latest figures, published last week, show that ketamine use among 16 to 24-year-olds was at record levels last year, with almost one in 25 in this group in England using it. This is a jump of a fifth on the 2020 figure, and also four times higher than the level of ten years ago.

Ketamine – also known on the street as ‘ket’ or ‘special K’ – is sometimes referred to as a horse tranquilizer and, when taken in small doses, is said to induce a sense of euphoria and a light, relaxed feeling in the user.

It was first used as an anesthetic during the Vietnam War, but has only been used recreationally since the 1980s. At the time, it was a niche, underground drug used mainly by hardcore clubgoers, and remained so for decades. When I was in college 25 years ago, I never heard of anyone using it. Now everyone seems to be.

The problem, of course, is that it poses serious risks. I often see patients in what is colloquially called a “k-hole” when the drug causes them to become detached from reality. They feel trapped in their bodies, aware but unable to move or communicate. They dissociate and may hallucinate. It can be a terrifying experience that severely distorts their sense of time, causing hours to pass and yet feel like minutes.

This obviously doesn’t happen to all users, although judging by the numbers I’ve seen in emergency room k-holes, it clearly happens with surprising regularity.

Ketamine has been involved in the deaths of 41 people since 1991, including seven in 2021 alone. Many are students who took too much, or mixed it with other drugs, or died while under the influence.

However, when I talk to younger people about it, despite its potentially fatal effects, they do not consider it a serious drug. I think that’s at least partly because it’s still categorized as a class B drug, which gives a false impression of harmlessness.

Even when people are with friends who have fallen into an ak-hole, they often shrug it off and say they will get out soon, not realizing that they are in a coma and could easily die.

Ketamine can also have a profound and long-lasting effect on memory and thinking.

It is also associated with terrible bladder problems. It can cause open, weeping wounds in your bladder and urinary tract, causing them to shrink. This can be so bad that the bladder must be removed completely. The pain of these symptoms can lead some people to use more and more ketamine to numb the symptoms, creating a devastating downward spiral.

Why has it become so popular? Price undoubtedly plays a major role. At £20 per gram, and with 100mg enough to send someone into a k-hole, you can see how cheap it is. I wonder if its potential use as an antidepressant, if prescribed properly, would also generate interest.

Its use for depression is still quite experimental and not at all mainstream, but it helps give it an air of legitimacy, especially among the younger generation who are so obsessed with mental health but don’t realize that prescribing it in a clinical setting is a major challenge. a world away from snorting it in a club toilet.

Campaigners are calling for it to be made a Class A drug, hoping this will highlight how dangerous it is. But in the meantime, what do you do if you find someone who has used ketamine?

If they are upset or behaving erratically, move them to a quiet place and let them sit and drink water while you reassure them. Talk to them about where they are and try to ground them in reality by describing their environment. If they remain very upset or hallucinate, they may need to go to the hospital for evaluation. Never make them vomit as they can choke.

If someone isn’t moving or can’t communicate, he or she can probably still understand you, so offer plenty of reassurance and move him or her to a safe place if possible.

If the person has stomach cramps, difficulty urinating, or blood in the urine, he or she should go to the hospital immediately. This is also the case if their breathing becomes shallow or less frequent, or if they have chest pain.

If they seem to fluctuate in and out of consciousness or are unconscious, call an ambulance. Place them in the recovery position to keep their airways open. Stay with them and don’t leave them with friends (who may have also used drugs).

You have a very low threshold for calling an ambulance and don’t be put off by others who say this has happened before and they didn’t take much with them; neither you nor they know exactly what their friend ingested, how much, or what it was cut with.

If they have a seizure, move them to a safe place. Do not place them in a stable side position during fitting, but place a piece of clothing under their head as a pillow. And call an ambulance.

Newly trained dentists will be forced to join the NHS under a plan to tackle the dental care crisis. It costs the taxpayer £200,000 to train a dentist who can then immediately work privately. This plan is sensible. It should also apply to doctors.

Gio’s mental health will suffer

Giovanni Pernice has promised to fully cooperate with the BBC investigation into his behavior on Strictly, in a bid to clear his name. But what exactly did he do?

We know that Sherlock star Amanda Abbington has claimed he stepped on her foot and allegedly brought others to tears. We don’t know anything else. While he is under investigation, his career is at stake and he is in danger of losing his livelihood.

With these types of accusations there is a tendency to assume that there is no smoke without fire. Of course, I have no idea if they’re true or not, but I know that anyone’s mental health suffers when put in a horrible situation like this.

It’s easy to see people in the public eye as honest game; We love to judge and gossip, but it’s important to remember that behind the glamor of showbiz are real people with real feelings.

The number of diagnoses of type 2 diabetes before middle age has increased by 40 percent. The tragedy is that people still don’t understand the seriousness of this disease. The prognosis for people with type 2 is actually much worse than that for people with HIV, a condition that still strikes fear in people’s hearts.

Overall, people with diabetes die twelve years earlier than people without diabetes. People also think that it can be easily solved with tablets. But this is also wrong. The public needs to be educated about the reality of diabetes. We don’t want to scare people unnecessarily, but this complacency must end.

Dr. Max prescribes Matcha tea

Yes, I know it’s not as tasty as a cup of PG Tips, but this drink, beloved by celebrities from actor Zendaya to Kourtney Kardashian and Bella Hadid, contains a substance called L-theanine, which has been shown to help with menstrual cramps. as well as fighting gum disease. A small study has also shown that it improves memory, attention and reaction time.