Max HeyraudHow the drug market is changing and what you need to know to party safely.
We’ve teamed up with the HSE to bring you the latest information to help you have safer nights out.
Ireland now ranks in Europe’s top 10 for ketamine use, so we’re teamed up with the HSE to share some of their substance analysis results to help you understand the current drug market and what you need to do to reduce harms.
Ketamine can be described for its different effects: dissociative, aesthetic (pain relief) and psychedelic. It is a drug that is dose-dependent – the type of effects you experience will be based on how much is taken.
How you react to ketamine will be influenced by three main areas:
- The drug – the contents, how much you take, how you take it, if you use it with other drugs
- Your set – how you feel, your physical/mental health and if you have any underlying concerns
- Your setting – where you use and who you use with. Using with new people or in new places can impact the effects.
While ketamine is not a new drug, it has peaked and dipped throughout the 90s and 2000s, often within different music scenes. It has positioned itself now as one of the most commonly used drugs in Ireland. Similar to MDMA, it has moved from the cultural margins to the mainstream and is used across a range of settings among a diverse range of people.
Despite ketamine peaking throughout different points in time, there is limited information on ketamine use in Ireland to understand why it decreased and then increased again in popularity.
We first looked at it in a survey among festivalgoers in 2019, where we found high levels of use and mixing with cocaine ‘CK’. This was reflecting the discussions we are having at events. Use has quickly increased since we first started looking at this area, and each year we see more people coming to us to discuss ketamine harm reduction or chat to us after having a difficult reaction.
In 2024, the HSE collaborated with UCD and a network of labs in Europe that looked at drugs in wastewater… Tests found that people in Ireland were using slightly more ketamine than MDMA, putting Ireland in the top ten countries for ketamine use.
Results from substance analysis
Both the HSE and the Loop Drug Checking Service in the UK have expressed concern that higher-strength ketamine could lead to negative effects or emergencies; this can be from people taking too much too soon.
In Ireland, the strength and contents of ketamine can vary. Sometimes, what’s sold as ketamine may actually be a new version called a ketamine analogue or designer drug. These substances are made to act like ketamine but can be much stronger and less predictable.
Some examples include:
- Methoxetamine (mexy, MXE, M-ket)
- Fluorodeschloroketamine (2-fluorodeschloroketamine, 2-FDCK , FDCK, 2-F Ket)
People may choose to take these versions or be sold without them knowing, which can lead to unpredictable effects.
Pink cocaine ‘Tusi’ is likely a ketamine mixture
‘Pink cocaine’ and ‘Tusi’ are terms given to pink powders, which generally contain a mixture of different drugs. Despite the name, these drugs are hardly ever cocaine or 2C-B and are mostly a mixture. Of the powders analysed by the HSE Emerging Drug Trends lab, they have found that each batch is different and can contain a range of mixtures, which are mostly MDMA, ketamine and caffeine. They have also found the designer stimulant 2FMA sold as ‘tusi’ in pink powder. Recently, one sample was found to contain a mixture of caffeine, MDMA, ketamine, 3-MMC, cocaine and 2C-B. The HSE has spoken to people who have had negative mental health reactions to pink cocaine and are concerned about what mixtures it could contain.
It is hard to predict what pink powders can contain. Powders with multiple drugs carry an extra risk of negative effects and drug emergencies.
Greater focus on long-term effects
There is greater attention throughout Europe on high levels and frequent ketamine use, leading to bladder damage. This can cause damage to the lining of the bladder wall, so it can hold less. Look out for cramps, abdominal pain, difficulty peeing, urinary tract infections, cystitis, peeing often and blood in pee. It is best to look at symptoms as soon as possible. Talk to a health professional and be honest about ketamine use to help quickly identify any concerns.
Reduce the risks if you use ketamine
It’s safer not to use ketamine at all, but if you choose to:
1. Be with people you trust and in a safe location.
Ketamine is a general anaesthetic, so it reduces sensations in the body. How you feel, where you are and who you are with can impact your reaction to ketamine. Avoid use if you feel low, anxious, depressed or if you have mental health or heart health concerns. Avoid trying ketamine for the first time at a large event.
2. Start low and go slow.
The effects of ketamine depend on how much is taken. Different people can have different effects depending on the amount taken and the way their own body reacts. Crush and wait. Avoid putting powders in drinks, which can lead to you taking too much too soon.
3. Don’t use alone and don’t leave anyone alone.
If you take too much ketamine, you may have a feeling of complete disconnection from your surroundings called a ‘k-hole’. This can be risky at a busy place like a festival.
4. Avoid mixing with other drugs, including alcohol and prescription medication.
Ketamine used with depressants (alcohol, GHB, opioids, benzodiazepines) can slow down your heart rate and breathing. This can lead to you passing out.
Ketamine and alcohol can make you feel sick and increase your risk of vomiting. Place people at risk on their side. Using ketamine with stimulants (MDMA, speed, cocaine ‘CK’) can increase the strain on your heart.
5. Reduce snorting risks.
Avoid sharing snorters or using banknotes as this can spread infections. Crush the powder finely so it’s less likely to damage your nose.
6. Reduce how much you use and how often.
Frequent and long-term use can impact each person differently.
7. Look out for the signs of urinary/bladder concerns.
Look out for cramps, abdominal pain, difficulty peeing, urinary tract infections, cystitis, peeing often and blood in pee. Stop use and discuss with a health professional.
8. Limit how often you use.
Check in with your mental health and get support if you are feeling low, depressed or have suicidal feelings.
9. Be a good bystander
Support others if safe to do so, let staff know if you are concerned about vulnerable people alone
10. Don’t be afraid to get medical help
Your well-being is the medic’s main priority.
How does the ‘Back of house’ drug checking service work?
- Once a festival attendee submits a drug to the HSE harm reduction bins, the onsite lab can quickly identify what is in the substance.
- The HSE will review the drug to check if there is an extra risk due to potency and if extra potentially risky substances are present, such as opioids.
- The HSE will then work with organisers to communicate issues of concern with attendees.
- Collective results from the day will be used to inform harm reduction discussions
- A summary of concerns or results can be provided from the trends identified throughout the day by the harm reduction teams, who will be supporting attendees with the best available advice to help them reduce harms.
