"The quantity of ketamine seized and reported to the EU Early Warning System on new psychoactive substances has varied over time, but has remained at relatively high levels in recent years, suggesting that this drug is likely to be consistently available in some national drug markets and may have become an established drug of choice in some settings. 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 other synthetic drugs, such as amphetamines or MDMA, but less likely to contain the synthetic drug 2C-B. As noted elsewhere in the 2023 European Drug Report, people using mixtures of drugs may be unaware of the substances they are consuming, and drug interaction effects can expose them to elevated health risks. While the numbers of clients entering treatment for problems related to ketamine use remain low overall, some EU Member States have seen increases and there is a strong case for improving the monitoring of both the use of this drug and the extent to which it is associated with negative health outcomes."


European Monitoring Centre for Drugs and Drug Addiction (2023), European Drug Report 2023: Trends and Developments, DOI: 10.2810/161905.