You’re gearing up for the music festival season and considering your options—which artists you’re keen to see, who’s going, what outfits you need, how you’ll get there and perhaps what substances you’re planning to take.

You’ve heard about ketamine, have thought about trying it, or maybe have dabbled with it a few times. You might have mates who’ve tried it or use it regularly.

In fact, data released today suggests use of ketamine in Australia is at an all-time high.

Here are five things you need to know about ketamine (and other substances) to help keep you and your mates safe this party season.

What is ketamine?

Ketamine was developed in the 1960s and is widely used as an anesthetic for humans and in veterinary medicine. More recently, low-dose ketamine has been used medically to manage pain and as an antidepressant. A growing number of clinical trials are examining whether it may be a useful addition to psychotherapy for substance use disorders and mental health conditions.

Ketamine is used recreationally, known as K, special K, vitamin K, kit kat or ket. It’s commonly sold as a white powder that is snorted, producing stimulant and hallucinogenic effects.

Taking too high a dose can produce uncomfortable and distressing effects known as a “K-hole.” This is when people feel disconnected from their body and environment, experiencing a dream-like state (known as dissociation).

Other effects include nausea, vomiting and in some cases, seizures. Ketamine can irritate the lining of the bladder, with one study showing about one in four people who had used ketamine recreationally had experienced urinary symptoms, such as burning or stinging.

Why is ketamine use so high?

Ketamine is steadily becoming the drug of choice for many people in the party scene.

Australia’s 2022-23 National Drug Strategy Household Survey estimated 300,000 people in the general community had used ketamine in the previous 12 months. This is roughly three times seen in 2016, and coming close to the estimated 400,000 people using MDMA.

Results from around Australia released today show rates of ketamine excreted into wastewater were at an all-time high, in both capital cities and regional areas.

It’s unclear why ketamine use is rising. Perhaps it’s because it’s slightly cheaper than other drugs, such as cocaine. Perhaps ketamine’s dissociative effects have “party drug” appeal to those interested in altered states of consciousness. It may also be perceived as safer and more acceptable because of growing medical use.

Is it ketamine or something else?

In Australia, the purity of ketamine is highly variable. What you buy is likely to be cut with other substances, so it’s difficult to know what you’re getting and how it’s going to affect you.

Ketamine analogs are substances that have similar chemical structures to ketamine but produce different effects. A number of these analogs have been found during drug checking (also known as pill testing). These include CanKet and tiletamine (a veterinary tranquiliser).

These analogs may come on slower (so people may be tempted to take more). Their effects can also last longer than regular ketamine.

You may also have heard about “pink cocaine,” one of several drugs said to be linked to the recent death of former One Direction singer Liam Payne. Pink cocaine is generally a mix of ketamine and MDMA rather than cocaine. It’s also known as tusi.

Worryingly, strong opioid drugs called nitazines have also been detected in ketamine in Australia. They’ve also been detected in cocaine and MDMA.

Can ketamine lead to dependence?

Regular use of ketamine can lead to psychological dependence, where people feel a strong urge to use even though they may have begun to experience harmful effects.

Though numbers are relatively low, an increasing number of young people in the United Kingdom are seeking treatment for their ketamine use. In addition to damage to the liver and brain, chronic (long-term) use of ketamine can result in damage to the bladder, which can require surgery.

Avoid using ketamine regularly, and seek professional help early if you think you need help with your use.

How to stay safe

1. Get your drugs checked

In Australia, drug-checking services are available in some areas. These non-judgmental, friendly services can test your drug while you wait, giving you important information on what’s in it (or not in it). You can then decide what you want to do with it.

You can either go to a fixed site such as CanTest in the Australian Capital Territory or CheQpoint in Queensland before the festival to test your drugs. Some festivals or events have these services on site, including this year’s schoolies on Queensland’s Gold Coast.

You can also look out for local drug alerts (for ketamine and other drugs on the market) issued by websites such as our own—TheKnow.org.au.

2. Start low, go slow

If you’re planning to take ketamine (or any other drug), start with a small amount to begin with to allow yourself to feel the effects before taking any more. Wait a few hours before re-dosing.

3. Avoid mixing your drugs

Avoid using ketamine with other substances as they can interact and increase your risk of harm. Alcohol and ketamine can cause nausea and vomiting at low doses, and more serious effects such as stroke and cardiac arrest at higher doses.

If mixed with ketamine, depressants such as GHB, opioids and benzodiazepines (for example Valium) can cause loss of consciousness, difficulty breathing and in some cases, death.

4. Let your mates know

If you’re planning to take ketamine, use it around people you feel safe with. Let others know what you have taken, and if possible, have a friend with you who is not using. Seek help if you are concerned about the effects of the drug.

Music festivals often have supportive teams of people with experience taking drugs (such as DanceWize). These peers can give you advice about safer partying and drug use.

5. Be prepared

As ketamine may contain opioids, everyone should be prepared to recognize the signs of an opioid overdose—altered or lack of consciousness, slow or labored breathing.

Naloxone can reverse an opioid overdose, and is provided free and without a prescription through certain pharmacies in Australia.

This article is republished from The Conversation under a Creative Commons license. Read the original article.