Ketamine, a dissociative anaesthetic drug, acts on the central nervous system (CNS) primarily through antagonism of the n-methyl-d-aspartate (NMDA) receptor.1 Methods of administration include intravenous, intramuscular, snorting and smoking.2 Intranasal use, which has a very rapid onset of action, is common among recreational users.3

Ketamine may be used as an antidepressant and for recovery from drug abuse.1 Doses used in abuse are significantly higher than for therapy.3 For recreational use, the usual intranasal dose is 50 mg with abusers regularly using multiple doses to prolong intoxication.2 3

Ketamine’s potential as a recreational drug may have hindered its usefulness in addiction rehabilitation. Studies suggest that ketamine has to …