Fake Ketamine has Flooded the Market. How Worried Should We Be?

Over the past few years the illegal use of Ketamine has rapidly grown, resulting in higher street prices and lower availability. Another troubling development has emerged — An influx of Ketamine copycat drugs are dominating the market. These drugs look and feel very similar to the real thing.

For almost twenty years we have tinkered with K, from low doses in social settings to deep, fully transcendental and dissociative states. We’ve had amazingly positive experiences. We’ve also lost a good friend to organ failure following years of daily Ketamine dependency. K is a substance we don’t take lightly, but find very rewarding.

We always test our compounds using test kits like the ones sold by DanceSafe or Narcocheck. For the past few years we have encountered a significant number of substances being marketed as K that failed to pass the basic dropper tests, and often produced results that left questions about what the substance was.

To shed light on whats going on, one of our research partners acquired eleven samples of Ketamine from a variety of sources. Each sample was submitted to a commercial lab, which applied deformulation techniques to identify the chemical composition of the mixtures and compounds. The results: 9 samples contained little or no Ketamine whatsoever. Only one sample tested for pure Ketamine.

The Lab Testing

The first challenge was to acquire Ketamine from as many sources as possible. Our research partner purchased from eight dark web sources compounds advertised as Ketamine or Ketamine S(+) (Ketamine is a mixture of two mirror image compounds: Ketamine S(+) and Ketamine R(-). She also received four samples from sources selling Ketamine, two in San Francisco and two in New York city. Three of these were advertised as Ketamine S(+), one as standard blended (racemic) K.

It’s important to note that we do not know where any of the sellers obtained their product. It’s possible that multiple sources were purchasing from the same manufacturer or middleman. It’s even possible that a single online seller is selling under multiple identities.

The results:

1 sample purchased in San Francisco tested as pure racemic Ketamine. Appearance was similar to salt crystals.

1 sample purchased in San Francisco tested as 30% DXE (2'-Oxo-PCM, aka DCK), 30% racemic Ketamine, 40% Inositol, with trace amounts (<1%) of Phencyclidine (PCP). Appearance was a fine white powder.

2 samples purchased in New York tested as pure 2-FDCK (2-Fl-2'-Oxo-PCM or 2-Fluorodeschloroketamine). One sample was 1/4” white rocks. One sample was a fine white powder.

1 sample purchased online tested as 50% racemic Ketamine, 40% 2-FDCK, 4% milk protein, 6% Inositol. Appearance was a fine white powder.

1 sample purchased online tested as 60% MXE (2-MeO-2-deschloroketamine, Methoxyketamine), 40% mix of inert fillers. Appearance was a fine white powder. Note: we found this result surprising, given the scarcity and high cost of MXE. We repeated the test and confirmed the result. The seller was also advertising MXE for sale. The cost of the MXE was $180/g. The cost of the “K” was $110/g, which at 60% pure MXE results in a cost of $183/g for the MXE actually delivered.

1 sample purchased online tested as 15% O-PCE (2'-Oxo-PCE or N-ethyldeschloroketamine), 85% mix of inert fillers. Appearance was a fine white powder.

1 sample purchased online tested as 10% O-PCE, 40% 3-MeO-PCE, 50% inert fillers. Appearance was a fine white powder.

4 samples purchased online tested as 100% 2-FDCK. Appearance varied from 1/4” white rocks to smaller (1/2 mm) crystals of varying uniformity.

Subjective Experiences

We interviewed two people who sampled the pure racemic Ketamine and one batch of the pure 2-FDCK. Both are long time and regular users of K (one or two times per month). Both snorted the compounds. After some trial and error, they reported similar intensity of effect at 225 mg of the pure K and 195 mg of the 2-FDCK.

Both reported the experiences with K and 2-FDCK to be extremely close subjectively. They both knew the correct identity of each substance, and both noted that they likely would not have noticed any difference between the 2-FDCK and the Ketamine had they not been focused on looking for differences.

The subjective differences noted: 2-FDCK had less defined visualizations, and they were darker, both in color pallet and emotionally. There was a feel of dying initially for one subjected, accompanied by minor panic, which quickly passed. The “hole” felt less deep, but lasted longer than with K.

But both people emphasized these were subtle, and they had both had very similar experiences with Ketamine from time to time. Both reported the experiences to be largely positive, but expressed a preference for the real K.

Safety

A major question that remains unanswered is whether people are being put at additional risk by using the counterfeit products being sold. Each of the compounds are close analogues to K. For example, as shown in the illustration, 2-FDCK is a Ketamine analogue where the chlorine group has been replaced by fluorine. Minor changes also produce the other analogues we encountered.

The similarity in structure helps explain why the various molecules have similar subject effects. However, the exact mechanism of how Ketamine works is poorly understood.

We know Ketamine blocks a channel in the brain known as the N-methyl D-aspartate receptor (NMDAR), altering the brain levels of glutamate, a neurotransmitter that stimulates nerve cells which allows for more effective communication between them. But Ketamine acts on other parts of the brain as well, and these mechanisms are less well understood.

We know that Ketamine is generally well-tolerated, although persistent use of K can lead to ulcers and kidney problems. Heavy use (daily for an extended period) has also been associated with memory issues, while users taking Ketamine once or twice a month did not suffer from similar memory impairment.

Typically, closely related compounds will have a similar risk profile [fn]. Therefore, there is some reason to believe the analogues being sold as Ketamine will present similar risk factors as Ketamine. However, until a compound is actually studied for toxicity and other harms, it is impossible to know with certainty the physiological impact it will have on the body. Certain other closely related compounds, such as methamphetamine and MDMA, which are very close in chemical composition, have different toxicity and potential for abuse.

Finally, because several of the analogues are more potent than Ketamine, it would be easy for an experienced Ketamine user to take too much of the analogue. The most likely outcome would be the same as overdoing it with Ketamine… blacking out, wetting oneself, etc. But how easy would it be to die from an overdose of a Ketamine analogue?

The LD50 (the dose that would kill half the people who took it) for Ketamine taken orally is estimated to be 4.2 grams for a 155 lb human. A high dose of oral Ketamine would be 250 mg, and therefore the risk of accidental overdoing on Ketamine is relatively small, and deaths by Ketamine toxicity are rare. LD50 of common Ketamine analogues have not been established. We suspect that analogues have a similar LD50 as Ketamine, but we have found any published data on lethal toxicity for the analogues we encountered.

Finally, several of the sample purchased included a mix of two compounds. Drug interactions are tricky, including the interactions of analogues (even 5 mg of methamphetamine added to 125 mg of MDMA produces a wildly different experience than pure MDMA, for example).

Conclusions

First, if you pay $100 per gram for Ketamine, you should be receiving K, not an analogue. For example, 2-FDCK can be purchased for around $25/g, and significantly less if you purchase in bulk. O-PCE costs $60 per gram, but is potent, and one sample tested only contained 10% active ingredients, or $6 per gram. Being ripped off isn’t cool.

Moreover, no one know the long term health effects of Ketamine analogues. We suspect they will be similar to Ketamine, but until they are studied, this is just informed speculation. Because fraudulent sellers are mixing multiple analogues, the risks of unpredictable outcomes is increased. Finally, because the potency of the various analogues vary, it will be important for any user to take conservative doses until they become familiar with the compound.