Evidence map›Paper›PMID 41323548›Full record

ArticleLancet regional health. Americas2025

Trends in nonmedical ketamine use, poisonings, related deaths, pharmaceutical diversions, and law enforcement seizures: results from annual population-based repeated cross-sectional studies.

Joseph J Palamar, Caroline Rutherford, Katherine M Keyes

Abstract read
In one paragraph

Article in Lancet regional health. Americas, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Joseph J PalamarDepartment of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
Caroline RutherfordDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
Katherine M KeyesDepartment of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.

Funding

National Drug Early Warning System (NDEWS) COVID-19 SupplementU01DA051126 · NIDA · UNIVERSITY OF FLORIDA · PI Linda B. Cottler, Joseph J Palamar · 2020 to 2026
$6.3M
New psychoactive substance exposure among NYC nightclub and festival attendeesR01DA057289 · NIDA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Joseph J Palamar · 2023 to 2026
$2.7M
Investigating the Ketamine Landscape: Availability, Medical and Recreational Use, and EffectsR01DA060207 · NIDA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Joseph J Palamar · 2024 to 2026
$2.1M
NIDA NIH HHS R01 DA057289NIDA NIH HHS R01 DA060207NIDA NIH HHS U01 DA051126
6 · The paper itself

Abstract

Background: The ketamine landscape in the USA is rapidly shifting, especially given recent increases in off-label prescribing of ketamine as a psychiatric treatment. Research is needed to determine the extent to which illicit ketamine is available, nonmedically used, and associated with morbidity and mortality in the USA. Methods: This observational study used eight unique annual repeated cross-sectional datasets to examine illicit ketamine availability (using seizure data as a proxy), use, and consequences of use, including self-reported nonmedical use among noninstitutionalized individuals aged ≥12 years (2006-2014, 2015-2019, and 2021-2023) and among 12th grade students (2000-2023). Further, it assessed reported ketamine-related poisonings (1991-2023) and mortalities (2020-2023), diversion of undispensed pharmaceutical ketamine (2008-2024), drug seizures testing positive for ketamine (2001-2024), and the number and total weight of ketamine seizures from two additional law enforcement agencies (2017-2024 and 2019-2024). Piecewise linear regression models were used to estimate annual trends. Findings: Nonmedical ketamine use among individuals aged ≥12 years increased between 2021 (0.19%) and 2023 (0.34%) (b [slope] = 0.08 [SE = 0.001], p = 0.0072). Regarding reported poisonings, there was initial increase from 1994 to 2000 (from 0.17 to 1.40 per 1,000,000 population; b = 0.20 [SE = 0.02], p < 0.0001), a decrease through 2003 (0.58 per 1,000,000 population; b = -0.34 [SE = 0.08, p = 0.0002) and an increase from 2017 through 2023 (from 0.76 to 1.54 per 1,000,000 population; b = 0.12 [SE = 0.03], p = 0.0002). The number of reported diversions increased from 2008 (n = 23) to 2017 (n = 202) (b = 18.72 [SE = 2.20], p < 0.0001) and again from 2021 (n = 183) to 2024 (n = 286) (b = 39.00 [SE = 12.04], p < 0.0001). Regarding seizures, there was an increase in ketamine reports to one agency from 2015 (n = 1448) through 2024 (n = 4008) (b = 201.41 [SE = 57.83], p = 0.0023). In another source, there was an increase in seizures from 2022 (n = 247) through 2024 (n = 502) (b = 127.50 [SE = 10.40], p = 0.0003). Rates of ketamine-involved deaths did not significantly shift between 2020 and 2023. Nonmedical use declined among 12th grade students, first from 2000 (2.49%) through 2005 (1.61%) (b = -0.19 [SE = 0.06], p = 0.0039] and then again from 2005 through 2023 (0.9%) (b = -0.04 [SE = 0.01], p = 0.0019). Interpretation: Ketamine poisonings, pharmaceutical diversion, and seizures have increased; trends in nonmedical ketamine use vary. Prevention and harm reduction are needed as use and morbidity are expected to continue to increase. Funding: National Institute on Drug Abuse at the National Institutes of Health.

Indexed as

Drug seizuresKetamineMortalityNonmedical usePoisonings

Identifiers

PMID41323548
PMCPMC12664584

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.