In the mid 1970s, John C. Lilly, a physician and neuropsychiatrist at the University of Pennsylvania, searched for a cure for his migraines. A leading figure in the counterculture movement, Lilly was known for pushing the bounds of neuroscience research. He promoted the use of LSD and other hallucinogenic drugs, developed a saltwater isolation tank to test sensory deprivation and, funded by NASA in the 1960s, began attempting to communicate with dolphins.
Then he stumbled upon an interesting new drug.
Synthesized in 1962 as a safer alternative to Phencyclidine, or PCP, ketamine — a dissociative anesthetic — was first tested on prisoners in Jackson, Michigan, before being used to treat wounded soldiers in the Vietnam War. In addition to relieving Lilly’s migraines, “Vitamin K” as he called it, was revelatory in his work on expanding human consciousness; he began to frequently write about it and incorporate it into his research. In the coming decades, ketamine became standard in veterinary clinics and emergency rooms, while recreational use ebbed and flowed in America, finding niches in underground rave scenes.
Today, evidence suggests ketamine is on the path to the mainstream, both clinically and recreationally. Between 2017 and 2022, law enforcement seizures of illegal ketamine increased by 349.1%, according to a recent study done by the New York University School of Global Public Health. A new industry of ketamine clinics is forecasted to reach $6.9 billion in revenue by 2030. Its rise has ignited debates — both nationally and on Tulane’s campus — over its wide range of uses, from treating depression to safer partying.
Names of sources who preferred to remain anonymous have been changed or omitted, fearing personal and professional repercussions.
“I think it’s had a presence at Tulane for a while, but I think in the past two years, it has gotten way more popular,” said Christian, a senior from New Jersey. He attributes the rise in use among Tulane students to studying abroad. “During our COVID year, no one was going abroad. But after that, when people started going again and coming back, I saw a huge rise.”
Christian still remembers the first time he tried ketamine at a date party junior year.
“I didn’t even know what it was,” he said. Since then he describes using it once every few weeks. “You take a bump and you feel it instantly … you feel so euphoric.”
Others dispute study abroad’s influence. “Since being back, especially during Mardi Gras, I’ve seen way more ketamine usage than I did in Spain. It seems to be super accessible here now and is getting more and more normalized,” wrote one Tulane junior.
“If you’re in Greek life, it’s very accessible,” Christian said.
Growing influence
Even tamer students, assuming they have internet access, have likely become familiar with the drug. Elon Musk touts its use for depression, “Friends” actor Matthew Perry died of its acute effects and subreddits like r/Ketamemes poke fun at its use. Ketamine even made an appearance in season one of the popular show “White Lotus.”
In its recreational uses, ketamine has a history in nightlife scenes. Ed Gillet, in his book “Party Lines,” detailing the history of UK dance music, suggests ketamine’s possible connection to minimal techno music. A Rolling Stone article describes ketamine’s presence in San Francisco’s queer club environments.
Some even attribute “Ketamine chic,” a fashion movement that debuted at London Fashion Week, to the underground rave scene. And various songs implicitly or explicitly mention the drug.
Tulane, no stranger to party or pop culture, fits the mold.
‘Euphoric, inebriating effects’
“It’s going to induce experiences that to a certain extent, feel like a psychedelic, but it’s not a classical psychedelic,” said Senior Professor of Practice James Cronin, who teaches a graduate course on psychedelics at Tulane.
Drugs like LSD and psilocybin, or magic mushrooms, target the brain’s 5-HT2A receptors, which normally bind to serotonin, the body’s mood-regulating neurotransmitter. When signals from these receptors are enhanced by psychedelics, it can disrupt areas like the thalamus, which processes sensory information before it reaches consciousness.
“Now you’ve got information bouncing around in ways that it shouldn’t,” Cronin said, “that’s a trip … you see sound and you taste colors.”
Though research is ongoing, one theory is that ketamine blocks NMDA receptors on inhibitory interneurons in the brain, responsible for regulating its main excitatory molecule, glutamate.
“You inhibit the inhibitor,” said Cronin. “What happens? You get a big upregulation of glutamate in the cortex.”
When glutamate floods this outer portion of the brain, the main source of consciousness, it disrupts communication with the rest of the brain.
“That disassociation also has euphoric, inebriating effects,” said Cronin.
The surge in glutamate is also believed to have downstream effects that may contribute to neuroplasticity, the brain’s ability to form new or reorganized connections between neurons. These connections, or synapses, are thought to be damaged by stress and depression.
In recent years, the drug has garnered massive attention as a possible alternative for treating depression in populations resistant selective serotonin reuptake inhibitors. SSRIs are the most commonly prescribed antidepressants.
“Ketamine seems to give immediate dramatic relief to depression in this population,” said Cronin, though after returning from a psychedelics conference, maintained researchers “don’t know squat” on how it actually does this.
Despite the uncertainty, its potential as an antidepressant has given rise to what many media outlets call a “Ketamine Boom” in America. Hundreds of clinics have popped up around the country, offering intravenous ketamine infusions in exchange for a few hundred bucks. Silicon Valley has taken notice too. Startups like Mindbloom and Tripsitter now offer subscription services to mail ketamine lozenges.
“The problem is it wears off in two weeks,” Cronin said. Patients are told to come back to sustain its therapeutic effects.
Recently the FDA approved a nasal spray, esketamine — or Spravato — a slightly altered molecule with similar effects. But most clinics administer off-label, or unapproved ketamine, and the burgeoning industry operates largely without regulations.
Therapeutic frontier
Still, the novel treatments offer hope to many.
Cole, a Tulane junior, struggled with depression his entire life.
“I was on Prozac for years,” he said, “it was really difficult.”
When nothing seemed to work, Cole was eventually prescribed ketamine. At first, a friend would drive him to his psychiatrist’s office twice a week, where he was administered ketamine prepared at a local compounding pharmacy. The effect wasn’t a trip for him, but rather a calm, drawn-out mellow feeling. In the morning his depressive thoughts would be gone.
“When you’re on ketamine, especially in a clinical setting, it’s a place to reflect on everything that might be causing your depression,” he said. “You start to talk to yourself and know yourself better and learn ways of talking yourself off the ledge that you didn’t necessarily know that you could do before.”
Gradually, infusions were tapered off to once a month before Cole stopped them completely, feeling he gained new tools to deal with his depression.
“At this point, I feel like more of a person, whereas I felt hollow before.”
Is it safe(r)?
Outside the sterile confines of a clinical environment, questions of safety become murkier.
Matthew, a senior majoring in finance, recalls taking too much ketamine at a DJ concert over Mardi Gras and feeling “exhausted and out of it.”
Other than that, he believes there are few risks.
As a sophomore, Matthew recalls seeing ketamine use rise in his fraternity, driven by fears of fentanyl-laced coke.
“It just seemed like more of a safer drug than cocaine,” Matthew said, who along with Christian, believes its granular nature makes it easier to tell whether it’s the real thing or not.
Many students also see it as a less addictive alternative to cocaine, with a reduced likelihood of overdosing. It also doesn’t keep you up all night, they say, and there’s little hangover.
A source familiar with drug distribution on campus, offered a more sobering view. “It’s a powder,” he said. “The quality control on certain powders in New Orleans can be poor.”
“Years ago, most recreational ketamine was stolen from local veterinarian offices,” said Joseph Palamar, co-author of the NYU study. According to the DEA New Orleans Division, most illegally obtained ketamine comes from legitimate sources or is smuggled in from Mexico.
“I’m gonna tell you now it’s not from medical facilities,” said the source familiar with Tulane’s supply, “I’ve seen some come from Pakistan or China, but India seems to be the biggest source.”
Oftentimes it’s not actually ketamine, he says, but an analog known as 2-Fluorodeschloroketamine that’s reported to be stronger than ketamine, though its pharmacological effects remain unclear.
First synthesized in 2014, 60 cases of confirmed exposure to this new drug have been reported, according to the World Health Organization.
For most users though, the biggest fear is entering the “K-hole,” an intense, out-of-body experience resulting from overconsumption of the drug. This detachment from reality can last for hours.
“I’ve seen kids do lines and just turn into absolute zombies,” said Christian. During his sophomore year, he witnessed one of his closest friends enter the K-hole.
“He couldn’t tell you a thing from what happened that night,” said Christian.
Known short-term side effects of ketamine include elevated blood pressure and vomiting. When used in conjunction with alcohol or other depressants, it can lead to respiratory depression and death.
As someone who went to Loyola University in the 1970s, drug fads are not a novel idea for Cronin. He’s seen the popularity of LSD and even Quaaludes rise and fall with each decade and theorized that the process is likely accelerated today by social media.
“There’s a difference between 1976 and 2024,” he said. “There wasn’t something out there remotely comparable to fentanyl.”
In addition to the risks of fentanyl poisoning, there’s little known about ketamine’s long-term effects on the brain.
John C. Lilly never quite established communication with dolphins, even with the help of ketamine. The project was halted after rumors surfaced of bestiality and dolphins being injected with LSD. He did, reportedly, encounter other-dimensional beings on the drug.
“That evening I took 150 milligrams of ketamine,” Lilly said in one interview. “And suddenly the Earth Coincidence Control Office removed my penis and handed it to me.”
Years of self-administering ketamine landed Lilly in a psychiatric ward. Around the same time, the Nixon administration’s “War on Drugs” largely banned other promising research into psychedelics.
Today, ketamine’s solutions — for depression — and setbacks — for substance abuse — are mostly uncharted.
And decades after Lilly’s migraines, the drug is still a mystery that Tulane students seem to be exploring.
“The undergraduate population is a longitudinal study,” Cronin said.
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