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Ketamine and Phencyclidine (PCP)

(Special K; Angel Dust)

By Gerald F. O’Malley, DO, Professor of Emergency Medicine, Sidney Kimmel School of Medicine, Thomas Jefferson University and Hospital ; Rika O’Malley, MD, Attending Physician, Department of Emergency Medicine, Einstein Medical Center

(See also Drug Use and Abuse.)

Ketamine and phencyclidine are chemically similar drugs used for anesthesia.

Ketamine is available in powder and liquid form. The powder can be snorted or taken orally. The liquid can be injected intravenously, into a muscle (intramuscularly), or under the skin (subcutaneously).

Phencyclidine (PCP or angel dust) is most often smoked after being sprinkled on plant material, such as parsley, mint leaves, tobacco, or marijuana (some street names are "wet" and "fry"). It can also be snorted or taken orally.

Symptoms

Ketamine and PCP cause giddiness and euphoria, which are often followed by bursts of anxiety. With high doses (overdose), users have a distorted perception of their body, the environment, and time. They feel scattered or as if they are not real (called depersonalization), and they feel detached from their environment (called dissociation).

At even higher doses, hallucinations and paranoid delusions may occur, and the sense of detachment from the world intensifies. Ketamine users often refer to these experiences as a k-hole. People may become combative. Coordination may be lost, and muscles tremble and jerk.

Very high doses may cause

  • A life-threatening high body temperature (hyperthermia)

  • A fast heart rate

  • Hypersexual behavior

  • Very high blood pressure

  • Seizures

  • Coma

  • Death in rare cases

Diagnosis

  • A doctor's evaluation

Doctor's base the diagnosis on history of having used the drug and symptoms. Ketamine is not detected on routine urine drug testing. Special tests (called gas chromatography and mass spectroscopy testing) can be used to confirm the use of ketamine.

Treatment

  • Quiet, nonthreatening environment

  • Sometimes sedatives

Usually, reassurance and a quiet, nonthreatening environment help people recover. People usually return to normal consciousness in 45 minutes to several hours. Benzodiazepines (sedatives) can be used to control agitation and seizures.

More Information

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • KETALAR