Ketamine's Two-Way Street

Edit: I realize I should probably note why I wrote this article.  I was told about ketamine's medical administration while shadowing a pediatric dentist.  It may have just been my naivety, but my first thought has always been about ketamine's recreational abuse, and it intrigued me that such a drug was a common anesthetic for children.  I found this article during my research.  It is written by the Juvenile Bipolar Research Foundation in an attempt to break the bad stigma that is associated with ketamine.
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Ketamine is a fascinating drug.  It was first approved by the FDA in 1970 as an anesthetic for soldiers in the Vietnam War, and is now a common analgesic and anesthetic during surgery for both humans and animals.  It can combat short-term depression, and its effectiveness for epileptics has recently become a topic of debate.  It is usually injected in medical settings.

Shortly after FDA approval, ketamine found its way to the recreational world.  Its popularity started as a club drug, but has made its way to private settings as well.  It is used for its dissociative properties, causing hallucinations, sensory deprivation, confusion, and amnesia.  The latter two effects, along with its clear liquid appearance, make ketamine a dangerously effective date rape drug.  It can also come as capsules, powder, crystals, and tablets.

The short-term effects of ketamine (both medical and recreational) reads like the end of a TV drug commercial: “High incidence of adverse effects, including anxiety, chest pain, palpitations, agitation, rhabdomyolysis, flashbacks, delirium, dystonia, psychosis, schizophenic-like symptoms, dizziness, vomiting, seizures, and paranoia.”

Long-term effects of ketamine are usually only seen in frequent (4 days/week, 20 days/month) users.  Frequent use can result in cognitive impairment (reduced vigilance, verbal fluency, short-term memory, and executive function, as well as schizophrenia-like perceptual changes) and depression.  Urinary tract symptoms have also been found in ketamine-dependent users.  Because of recreational use and its destructive long-term effects, the United States placed ketamine in Schedule III of the United States Controlled Substances Act in August 1999.  Because of this, it is not administered chronically in a medical setting.

Today, we know how to safely use ketamine.  Doctors must adhere to strict guidelines when administering the drug, and patients are advised never to receive it without the presence and supervision of an anesthesiologist.  Ketamine has also been used as a pediatric sedation in dentistry and emergency rooms.

Concise articles on ketamine are linked here, here, and here.

Wikipedia gives a great summary of the CSA, along with why ketamine is classified a Schedule III Controlled Substance.