Psychology/Spirituality/Popular Culture Karl Jansen M.D., Ph.D. Ketamine: Dreams and Realities Ketamine: Ketamine: Dreams and Realities Ketamine: “Karl Jansen’s book Ketamine: Dreams and Realities is a goldmine of information on this fascinating substance that combines in a unique way the properties of an anesthetic and a psychedelic. It is clearly written, well researched and documented, and presents a balanced and objective view point. The author’s broad perspective, which covers all the aspects of ketamine from pharmacology to its Karl Jansen M.D., Ph.D. use at raves, makes this book interesting for clinicians and researchers, as well as the general public.” LONDON researcher – Stan Grof, M.D., author of Psychology of the Karl Jansen, M.D., Ph.D., Future: Lessons From Modern Consciousness and Member of the Royal Research and LSD Psychotherapy College of Psychiatrists, is the world’s leading expert on “Indispensable reading for those with any interest ketamine. He has studied in ketamine. Entertaining, thought-provoking, ketamine at every level: from photographing the receptors and thorough.” to which ketamine binds in – Rick Strassman, M.D., author of the human brain, while DMT: The Spirit Molecule: A Doctor’s earning his doctorate in Revolutionary Research into the Biology clinical pharmacology at of Near-Death and Mystical Experiences the University of Oxford, to publishing papers on his “It is an excellent book… a well done comprehensive discovery of the similarities review of the entire history of ketamine.” between ketamine’s psycho- Karl Jansen M.D., Ph.D. – Evgeny Krupitsky, M.D., Ph.D. Pioneer researcher active effects and the near- into the use of ketamine-assisted psychotherapy in death experience during his the treatment of alcoholism and heroin addiction study of medicine in New Zealand. Dr. Jansen believes 100% of the profits from the sale of this book will that ketamine can have be devoted to psychedelic psychotherapy research. potent healing powers when used as an adjunct Ketamine: Dreams and Realities Published by MAPS [Multidisciplinary Association to psychotherapy but warns for Psychedelic Studies] www.maps.org of the addictive nature of ketamine. Because of this risk, he has developed new $14.95 ISBN 0-9660019-7-4 methods for the treatment 51495> of ketamine addiction. Dr. Jansen left Oxford in 1993 to train in psychiatry at With a new preface by the author. the Maudsley and Bethlem 9 780966 001976 Royal Hospitals. He is now a psychiatrist in London. Introduction by Cover photo: Cat’s Eye Nebula; NASA, Hubble Space Telescope MAPS Emanuel Sferios, Founder of DanceSafe Ketamine: Dreams and Realities “It is in my opinion, an excellent book… a well done comprehensive review of the entire history of ketamine!” — Evgeny Krupitsy, M.D. “Ketamine: Dreams and Realities is by far the most authoritative and comprehensive book on the subject of ketamine ever scribed. While the ketamine experience can be vast beyond imagination, Dr. Karl Jansen has managed to capture nearly every facet of this slippery beast in fine detail. Going well beyond an introductory text for the ketamine novice, Dreams and Realities explores in depth both the shimmering insights and existential horrors wrapped up in this elusive molecule. A must read for anyone serious about unraveling ketamine's many mysteries.” — James Kent, TRP Magazine Indispensable reading for those with any interest in ketamine. Entertaining, thought-provoking, and thorough. — Rick Strassman, M.D. i Ketamine: Dreams and Realities Ketamine: Dreams and Realities Ketamine: Dreams and Realities ii iii Ketamine: Dreams and Realities Ketamine: Dreams and Realities Ketamine: Dreams and Realities ISBN 0-9660019-7-4 Ketamine: Copyright ©2000, 2004 by Karl L.R. Jansen, M.D., Ph.D. Dreams and Realities All rights reserved. No part of the contents of this book may be reproduced in any form or by any means without written permission of the publisher. Inquires welcome. Published by: Multidisciplinary Association for Psychedelic Studies (MAPS) 2105 Robinson Avenue Sarasota, FL 34232 USA voice: (941) 924-6277 fax: (941) 924-6265 e-mail: [email protected] web site: http://www.maps.org Editor: Jon Hanna Project Coordinators: Carla Higdon, Brandy Doyle Indexing: Mercedes Paulino Cover & Book Design: Mark Plummer Printed in the United States of America Karl L.R. Jansen, M.D., Ph.D. Text set in Adobe Sabon, Palatino, and Emigré Tarzana. iv v Ketamine: Dreams and Realities Ketamine: Dreams and Realities Table of Contents Preface to the Second Edition ix Introduction 9 Prologue 13 Part I : The Light Within 1. Introduction: K Waves and K Raves 23 2. The Priestess and The Psychonaut: Marcia Moore and John C. Lilly 50 3. Dreams and Realities 71 4. Ketamine, Near-Death, and Near-Birth Experiences 92 5. The Metaphorical Mental Modem 137 Part II: The Dark Side 6. Ketamine Dependence (Addiction) 166 7. Exit from Planet K: The Treatment of Ketamine Dependence 203 8. Journeys into the Fright World: Ketamine and Mental Health 224 9. The Body Electric: Physical Effects and Harm Minimization 266 Part III: Unity 10. Psychedelic Healing 282 References 302 Index 336 vi vii Ketamine: Dreams and Realities Ketamine: Dreams and Realities Preface to the Second Edition Since this book first went to press at the end of the year 2000, the realization that ketamine is a fascinating substance has spread rapidly through several spheres. These include academic research, the dance culture, anesthesia and emergency medicine, psychonaut pioneers, and many others. This generated an unexpected demand for the book, and supplies were soon exhausted. We now find ourselves heading toward the second printing to meet the demand for Ketamine: Dreams and Realities, even though the book was rarely for sale in bookstores and never had a distributor. An important reason for the wider interest in this book may have been that it addresses considerably more than just ketamine: its scope includes fundamental questions about the nature of the psychedelic experience, drug-induced spirituality, and the near-death experience, while also addressing more practical issues, such as the true nature of ‘drug-induced psychosis,’ and the forces which drive drug dependence (and how to defeat them). Ketamine was invented in 1962. By late 2000, there were about 6,500 papers in the Medline/PubMed database about ketamine. Just three years later, there are 8,400 papers – an increase of almost 30%. This is mostly the result of a massive revival of interest in ketamine by anaesthetists, emergency doctors, and pain specialists, due to the ex- cellent safety profile of the drug. Relatively few countries have chosen to follow the USA and Australia into making ketamine a controlled drug, although the World Health Organization/United Nations is con- tinuing to mull the question. However, despite this avalanche of papers appearing since 2000, there are few truly new findings that require a mention. Many of the ‘new’ publications are covering old ground. So while I was originally planning an entirely new book called Ketamine Reconsidered, I have decided to wait until there have been more important advances and changes. I have included a list of some interesting new references be- viii ix Ketamine: Dreams and Realities Ketamine: Dreams and Realities low, which should be added to the 600 on which this book is based. New References of Interest Most of the research since 2000 has continued to emphasise the Breitmeier D., Passie T., Mansouri F., Albrecht K., Kleemann W.J. safety of ketamine, especially in children and in emergency settings. (2002) “Autoerotic accident associated with self-applied ket- The key development in the dance culture has been a move interna- amine,” International Journal of Legal Medecine 116(2):1136. tionally toward sourcing cheap ketamine from factories in China, and the rapid growth of ketamine as a recreational drug throughout Asia. Dillon P., Copeland J. & K.L.R. Jansen (2003) “Patterns of use and A test of urine samples from a rave party in Taiwan found that nearly harms associated with non-medical ketamine use,” Alcohol and half were positive for ketamine (Lua et al. 2003). Drug Dependence 69 (1): 23-28. There is still no evidence that ketamine can cause ‘Olney’s lesions’ in primates. These experimentally-induced brain cell changes appear Gough, N. (2003) “Ketamine: China’s other white powder,” to be confined to small brains, such as those of rats, which have a high Time Asia.com metabolic rate. Studies of memory and other cognitive functions in http://www.time.com/time/asia/covers/1101020520/ketamine.html. ketamine users still suffer from many methodological flaws, for in- Gross S.R., Barrett S.P., Shestowsky J.S., Pihl R.O. (2002) “Ecstasy stance failing to provide urine test results to prove that subjects were and drug consumption patterns: a Canadian rave population not affected by drugs at the time of the testing. study,” Canadian Journal of Psychiatry 47(6): 546-51. However, the period since this book was first published has seen one landmark event in the history of ketamine: the passing of pioneer Hocking G., Cousins M.J. (2003) “Ketamine in chronic pain psychonaut and neuroscientist Dr. John Lilly in September 2001, aged management: an evidence-based review,” Anesthesia and 86. Dr. Lilly was the world’s most famous self-experimenter with ket- Analgesia 97(6): 1730-9. amine and flotation tanks, and a saver of dolphins. He was the model Huddy N.C. & K. Kiff (2004) Preservative-free ketamine. for films such as Altered States and The Day of The Dolphin. Curi- British Journal of Anaesthesiology 92(1): 152. ously, the ‘official’ obituaries in many newspapers entirely failed to mention the central role that self-experimentation with ketamine played Jansen K.L.R. (2000) “A review of the non-medical use of ketamine: in John’s life for thirty years.