HEALTH EXPERTS HAVE warned that the increasing use of ketamine among drug users in Ireland is being overlooked with potentially serious implications for public health.

HSE addiction specialists claim there is an emerging trend in the use of ketamine as a recreational drug often in combination with other “club drugs” for stimulant and euphoric effects when socialising.

They expressed concern that there has been a notable increase in its popularity in Ireland as ketamine has followed the trajectory of other club drugs by moving from the margins into more mainstream use.

In a letter to the Irish Journal of Medical Science, experts from the HSE National Social Inclusion Office said the noted lack of knowledge often expressed by festival goers about the effects of ketamine was concerning as were ketamine-related seizures among users.

They pointed out that the HSE had issued an alert with specific reference to ketamine at the Life music festival held in Belvedere House outside Mullingar, Co Westmeath last May due to the high strength of the drug being used by attendees and the increased risk of harm.

Ketamine, which is a psychedelic type drug, is normally sold as grainy off-white powder but can also be distributed in pills. When used medically as an anaesthetic in human and veterinary medicine, it is usually in liquid form.

“Emerging evidence suggests that the frequent and long-term use of ketamine can have an impact on memory and can lead to recurrent cystitis,” said Nicki Killeen, a HSE project manager on emerging drug trends.

She said a range of other clinical presentations from use of ketamine had been recorded with both short and long-term effects.

The addiction experts claim the Irish drug landscape has been changing significantly for some time with many new types of user groups from a range of social demographics across society in the Republic.

They also noted that new drug trends are not often represented in the findings of traditional surveys on drug use or from data collected by drug addiction services.

However, a review of drug use at festivals in 2019 found 63% had used ketamine at an event in Ireland over the previous 12 months.

The research also identified the intentional mixing of cocaine and ketamine to produce what is known as “CK” or “Calvin Klein.”

Ketamine was the 4^th most common drug used in a survey of third-level students in 2021 with 16% of over 11,500 students reporting to have used the drug in their lifetime.

In addition, 46% of students who declared themselves to be drug users at the time, admitted taking ketamine.

The Irish results of an EU-wide survey on drugs in 2021 found 23% had used ketamine – the 4^th most common drug after cannabis, cocaine and MDMA (ecstasy).

Health experts said they showed usage levels of ketamine in Ireland were considerably higher than the average level of 13% reported from 30 other European countries covered by the survey.

Gardaí also reported a fivefold increase in seizures of ketamine between 2018 and 2019 – rising from 48 to 240 over the space of 12 months.

Findings from the HSE’s “Safer Nightlife Programme” harm reduction outreach work and “back of house” drug checking over the past two years found there is a significant nightlife trend in the use of ketamine which is only surpassed by the use of MDMA pills and powders.

Across four events, a total of 266 substances were surrendered to HSE staff, of which 117 were MDMA, 40 were ketamine and 34 were cocaine.

Ms Killeen together with Sinead McNamara of the HSE National Drug Treatment Centre and Eamon Keenan, the HSE national clinical lead for addiction service and associate professor in addiction at Trinity College Dublin have called for increased prevention and education in post-primary settings to target young people who may begin use of the drug.

They also recommended the inclusion of ketamine in national drug surveys to capture its prevalence over time.

For people already using ketamine in settings like music festivals, pubs and nightclubs, they called for a tailored harm reduction approach including the provision of substance analysis services.

The drug also gained prominence in the past month as post-mortem results on the body of Matthew Perry (54) revealed the Friends star had high levels of ketamine in his system at the time of his death.

A medical officer in Los Angeles confirmed that Perry had been legally taking prescribed infusions of the drug to treat depression and anxiety.