Ketamine is unique in the pharmacopoeia of psychedelic and psychedelic-adjacent drugs, not least because it is the only one included on the World Health Organization’s Model List of Essential Medicines.

Its rapid onset makes it invaluable for health professionals in both anaesthesiology and critical care medicine, thanks to its ability to maintain cardiorespiratory stability while providing effective sedation and analgesia.

However, the notorious ‘tranquiliser’ is also making headlines for how it is being used outside supervised inpatient healthcare settings.

Ketamine first started to be administered in psychiatric contexts in the 1970s. But down the decades, recreational use of the drug surged worldwide as people pursued its psychoactive effects, including dissociative, euphoriant and psychedelic-like mechanisms of action.

Though these subjective properties could be key to why the drug is showing promise as a mental health protocol in combination with talking therapy, the apparent hazards of unsupervised use are coming to the fore—with growing evidence of irreversible health problems, adverse psychological symptoms and addiction.

In the United Kingdom, this has led to renewed calls to reschedule ketamine into the most severe drug classification, which would condemn ketamine to the same restrictions as psilocybin and MDMA, making future research more challenging.

With all this in the balance, Psychedelic Alpha spoke to an expert about the current state of ketamine…