National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy.
School of Law, Camerino University, Camerino, Italy.
Curr Pharm Des. 2022;28(15):1213-1220. doi: 10.2174/1381612828666220510115209.
Discovered in the United States of America (USA) in the 1960s, ketamine was introduced as an anaesthetic drug to specifically replace phencyclidine. Briefly, the substance moved from the medical world to recreational users, since it was discovered that intense psychedelic experiences were obtained with dosages lower than those prescribed for anesthesia. At the end of the 90's, it was circulated in London nightclubs as a drug itself and as counterfeit 3,4-methylenedioxymethamphetamine tablets. In 1997, the Drug Enforcement Administration (DEA) alerted the United States (US) government about the increasing diffusion of ketamine in American 'clubs', and in 1999, the substance was added to Schedule III of drugs controlled by federal authorities. In 2002, ketamine epidemics moved to Europe, and the European Monitoring Centre for Drugs and Drug Addiction carried out a risk assessment monitoring of the phenomenon. An estimated ninety-nine percent of all global ketamine seizures occurred in Asia. Its growing popularity is due to the fact that this new psychoactive substance is cheaper than other stimulants, such as MDMA. Moreover, the amount used for recreational purposes does not cause respiratory depression and its legal use as a drug makes it widely available for a diversion towards illicit markets. Nevertheless, acute intoxication and several deaths have been related to exclusive ketamine use both in Europe and internationally. Since 2015, there has been an increasing rise in the illicit ketamine market, and currently, the drug is being used with unprecedented peaks and a consequent significant increase in seizures and clinical cases worldwide.
氯胺酮于 20 世纪 60 年代在美国被发现，最初被用作一种麻醉药物，专门替代苯环己哌啶。简单来说，这种物质从医疗领域转移到了娱乐用途，因为人们发现，使用低于麻醉规定剂量就能产生强烈的迷幻体验。90 年代末，它在伦敦夜总会作为一种药物本身，以及作为假冒的 3,4-亚甲二氧基甲基苯丙胺片剂流通。1997 年，毒品执法局（DEA）向美国政府发出警告，称氯胺酮在美国“俱乐部”中的扩散日益加剧，1999 年，该物质被添加到联邦当局管制药物的附表 III 中。2002 年，氯胺酮的流行转向欧洲，欧洲毒品和毒瘾监测中心对这一现象进行了风险评估监测。据估计，全球 99%的氯胺酮缉获量发生在亚洲。它的日益普及是由于这种新的精神活性物质比其他兴奋剂（如 MDMA）更便宜。此外，用于娱乐目的的用量不会导致呼吸抑制，而且它作为药物的合法使用使其广泛可用于向非法市场转移。然而，在欧洲和国际上，仅因使用氯胺酮而导致的急性中毒和数人死亡的情况时有发生。自 2015 年以来，非法氯胺酮市场不断增长，目前，该药物的使用达到了前所未有的高峰，导致全球缉获量和临床病例显著增加。
