k-hole
{{Short description|Condition after taking ketamine}}
{{about|the effect of ketamine|the trend forecasting group|K-HOLE (trend forecasting group)}}
A K-hole is a transient dissociative state experienced during ketamine intoxication. Often referred to as "K-holing," this state is characterized by total detachment from one's body and environment, rendering users completely immobilized. Although occasionally sought intentionally by users who consider the experience of K-holing spiritually or recreationally valuable, it is typically considered undesirable and frequently occurs due to accidental overdose. The high dosages of ketamine necessary to induce a K-hole are unsafe and carry significant physical and psychological risks associated with both acute toxicity and chronic exposure.{{Cite journal |last1=Wood |first1=Dan |last2=Cottrell |first2=Angela |last3=Baker |first3=Simon C. |last4=Southgate |first4=Jennifer |last5=Harris |first5=Maya |last6=Fulford |first6=Simon |last7=Woodhouse |first7=Christopher |last8=Gillatt |first8=David |date=June 2011 |title=Recreational ketamine: from pleasure to pain: RECREATIONAL KETAMINE |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.10031.x |journal=BJU International |language=en |volume=107 |issue=12 |pages=1881–1884 |doi=10.1111/j.1464-410X.2010.10031.x|pmid=21314885 |s2cid=44450934 }}
Recreational usage
Ketamine is an NMDA receptor antagonist, developed in the 1960s to induce anesthesia in patients but recreational users have found great appeal in its antidepressant, dissociative and hallucinatory effects that are characteristic of the K-hole experience. Whereas the common recreational dose of ketamine is approximately 30–75 mg, a dose of more than 150 mg is required to enter the K-hole.{{Cite web |title=Ketamine |url=https://www.bdp.org.uk/get-information/drugs-information/ketamine/ |access-date=2022-05-17 |website=Bristol Drug Project |language=en-GB}}
Experiences
Experiencing a K-hole varies greatly for each individual. The intensity and length are influenced by the users' current mental state, previous experience and drug dosage.{{Cite journal |last1=Stirling |first1=John |last2=McCoy |first2=Lauren |date=December 2010 |title=Quantifying the psychological effects of ketamine: from euphoria to the k-hole |url=https://pubmed.ncbi.nlm.nih.gov/21039109/ |journal=Substance Use & Misuse |volume=45 |issue=14 |pages=2428–2443 |doi=10.3109/10826081003793912 |issn=1532-2491 |pmid=21039109|s2cid=207520095 }} Ketamine induces dose-related effects that include distortion of time and space, hallucinations and mild dissociative effects. During K-hole, users experience a high level of detachment from the environment, resulting in an inability to respond to surroundings and move their bodies functionally.{{Citation |last1=Rosenbaum |first1=Steven B. |title=Ketamine |date=2022 |url=http://www.ncbi.nlm.nih.gov/books/NBK470357/ |work=StatPearls |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=29262083 |access-date=2022-05-17 |last2=Gupta |first2=Vikas |last3=Palacios |first3=Jorge L.}} During these states, perception seems to lie deep within consciousness so that the reality of the "outside" world appears to reside in the distance. A high number of recreational users report that the most appealing effects of this experience are "melting into surroundings", "visual hallucinations", "out of body experience" and "giggliness".{{Cite journal |last1=Muetzelfeldt |first1=L. |last2=Kamboj |first2=S. K. |last3=Rees |first3=H. |last4=Taylor |first4=J. |last5=Morgan |first5=C. J. A. |last6=Curran |first6=H. V. |date=2008-06-01 |title=Journey through the K-hole: Phenomenological aspects of ketamine use |url=https://www.sciencedirect.com/science/article/pii/S0376871608000550 |journal=Drug and Alcohol Dependence |language=en |volume=95 |issue=3 |pages=219–229 |doi=10.1016/j.drugalcdep.2008.01.024 |pmid=18355990 |issn=0376-8716}} By contrast, the least frequent and most negative effects include near-death experiences, and physical health problems, like the so-called "K-cramps" from gastric pain, bladder failure, and unappealing mental side-effects, like "memory loss". "Decreased sociability" are also reported post-K-hole.
Despite its addictive risks, ketamine is considered by many to be "harmless" and thus a "drug of choice". Recreational users seem to be in discord about the K-hole. Many individuals describe it as a fascinating life-changing experience and a spiritual journey resulting in some form of spiritual realization. They state that this experience provided clairvoyance and assisted them to get through mental disorders like depression and social anxiety.{{Cite web |title=We Asked People About the K-Holes That Changed Their Lives |url=https://www.vice.com/en/article/we-asked-people-about-the-k-holes-that-changed-their-lives/ |access-date=2022-05-17 |website=Vice.com |date=6 November 2017 |language=en}} About half of the recreational users describe the K-hole as a positive experience, as it provides "a short escape from their daily problems". Even though some people seem to enjoy and actively look for the K-hole, for many it is still an unwanted side effect of an overdose of ketamine.
Risks
Frequent K-hole experiences can also result in episodic and semantic memory impairments.{{Cite journal |last1=Curran |first1=H V |last2=Monaghan |first2=L |date=2001-05-01 |title=In and out of the K-hole: a comparison of the acute and residual effects of ketamine in frequent and infrequent ketamine users |journal=Addiction |volume=96 |issue=5 |pages=749–760 |doi=10.1046/j.1360-0443.2001.96574910.x |issn=1360-0443 |pmid=11331033|doi-access=free }} Depending on how long this state lasts, hallucinations and symptoms of psychosis can develop.{{Cite journal |last1=Zuccoli |first1=M. L. |last2=Muscella |first2=A. |last3=Fucile |first3=C. |last4=Carrozzino |first4=R. |last5=Mattioli |first5=F. |last6=Martelli |first6=A. |last7=Orengo |first7=S. |date=August 2014 |title=Paliperidone for the Treatment of Ketamine-Induced Psychosis: A Case Report |url=http://journals.sagepub.com/doi/10.2190/PM.48.2.c |journal=The International Journal of Psychiatry in Medicine |language=en |volume=48 |issue=2 |pages=103–108 |doi=10.2190/PM.48.2.c |pmid=25377151 |s2cid=37137378 |issn=0091-2174}} The K-hole experience can produce physical risks. For instance, bladder damage can be an indication of ketamine-induced (ulcerative) interstitial cystitis.{{Cite web |title=British Library |url=https://www.bl.uk/collection-items/ketamine-a-review-of-use-and-harm |access-date=2022-05-17 |website=www.bl.uk}}{{Cite journal |last1=Morgan |first1=Celia J. A. |last2=Curran |first2=H. Valerie |last3=Independent Scientific Committee on Drugs |date=January 2012 |title=Ketamine use: a review |url=https://pubmed.ncbi.nlm.nih.gov/21777321/ |journal=Addiction |volume=107 |issue=1 |pages=27–38 |doi=10.1111/j.1360-0443.2011.03576.x |issn=1360-0443 |pmid=21777321}}