Ketamine was one of the first new psychoactive substances to emerge in Europe during the 1990s. Since then, it has become an established feature of the drug market in some countries.

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, although 2021 data from drug checking services show that these are generally less adulterated than other illicit drugs.

It can also be found in mixtures sold as ‘pink cocaine’ or ‘tucibi’, which are more likely to contain ketamine and stimulant drugs, particularly MDMA.