Overall, there is evidence to suggest that ketamine is likely to be consistently available in some national drug markets and may have become an established drug of choice in some settings. It is also reported to be used in combination with other substances, such as stimulants. In Ireland, for example, the intentional mixing of cocaine and ketamine has been identified at music festivals, as have ketamine-related medical incidents during 2022 and 2023. In 2022, Euro-DEN sentinel hospital emergency departments in Europe reported that cocaine was the substance most often reported in combination with ketamine in acute toxicity presentations. Ketamine is commonly snorted, but can also be injected, and has been linked to various dose-dependent acute and chronic harms, including neurological and cardiovascular toxicity, mental health problems, such as depression, and urological complications, such as bladder damage from intensive use or the presence of adulterants.
Ketamine may also be added to other drug mixtures, including MDMA powders and tablets, potentially making inadvertent consumption an issue. Ketamine has also been found in mixtures sold as ‘pink cocaine’ or ‘tucibi’, which are more likely to contain ketamine and other synthetic drugs, such as amphetamines or MDMA. In contrast to some other parts of the world, mixtures sold as pink cocaine are less likely to contain the synthetic drug 2C-B, which has historically been associated with this product. At least 10 countries reported the detection of pink cocaine to the EU Early Warning System’s database on new drugs, with most of the cases reported by Spain. It is also interesting to note that while the overall figure remains low, both the quantity of 2C-B seized and the number of countries reporting seizures increased in 2022, with 14 countries reporting seizures amounting to just under 6 kilograms of this drug.
The number of clients reported to receive treatment for problems related to ketamine use remains low. However, it has risen from around 240 cases reported in 2018 to 600 in 2022. Moreover, this data set is not likely to capture all those having health problems with this drug. For example, those who have developed urological problems may be poorly represented.
https://www.euda.europa.eu/sites/default/files/pdf/31875_en.pdf?658827: European Drug Report 2024
