The Stud was packed wall-to-wall with shirtless men, but JP and their friends were in their own dimension. The traveling party Horse Meat Disco had commandeered the San Francisco bar, filling it with pounding dance music and the carnal stench of amyl nitrate poppers, but for three and a half hours, JP’s group sat at a booth behind a curtain passing back and forth their little white baggie of ketamine. After a few bumps, they became so absorbed in each other that they barely noticed the hordes of people passing by the sheer curtain, as if their booth had left the party and was voyaging through space. “That was one of the funnest nights I’ve ever had going out,” says JP, who giggles with remembered joy recounting the story by phone.
JP, a 34-year-old non-binary software designer and amateur pop musician who asked to be identified by their nickname, was introduced to ketamine in 2017 at a festival in Los Angeles. One small bump tuned out their usual self-conscious worries, which felt revolutionary for someone who’d long struggled with body dysmorphia, bulimia, and depression. “I love dancing, but there’s a lot of reservation that comes with being queer,” JP tells Rolling Stone. Ketamine helped them feel safer letting go.
The day after the festival, instead of a hangover, JP felt “like Snow White waking up in the morning with birds chirping — I could actually face life.” The mood boost lingered for days. Naturally, they continued to seek out this magical powder that worked as both dancefloor drug and antidepressant, encouraging friends to try it.
Over the next year, JP, then working full time “in corporate America,” progressed from using ketamine at parties to taking it at home alone. “I remember one time looking in the mirror and feeling like I really saw myself for the first time,” they say. “I cried and cried — there was so much acceptance. I was so far removed from my eating disorder and that negative voice that was there 24 hours a day.” They bought ketamine from a dealer but viewed it “almost like a pharmaceutical,” comparable to the drugs they took to prevent HIV. “Sure, I’m spending $800 [a month], but this is what it costs,” JP recalls thinking. “Why wouldn’t you want to meet the day not wanting to die?”
By 2018, everyone seemed to have ketamine on them all the time, offering it to each other at parties as a casual greeting. In private, JP was struggling: their neck muscles wobbled after days of heavy use; they couldn’t hold their bladder; they intentionally entered K-holes, an immobilizing state of dissociation that can involve terrifying hallucinations, for the “brightness and pep” that followed. Soon, JP was visiting their dealer constantly, spending thousands of dollars each month to consume a gram a day, but as their tolerance grew, the effects waned, so they began boofing — taking it rectally with a plastic syringe — for a more intense high.
“I would go to daytime parties in San Francisco with my syringe and little vial that I had prepared beforehand. It got so bad that every 30 minutes, I’d be running to the bathroom to take another dose,” they say. “People are pounding on the door like, ‘Why are you taking so long?’ I wish I had the awareness that I have now, to be like, what am I doing here?”
Soon, JP wasn’t consistently showing up for work, and the accumulating stress triggered bulimic episodes. Yet JP only discussed these problems anonymously on Reddit, ashamed to bring them up with friends. “If this is happening to me, is it happening to others?” they wondered. “If it’s not, what does that say about me? Am I not cool? Will I be the kid on the playground that doesn’t get played with anymore?”
While JP’s story was extreme, hearing it didn’t shock me; a queer and trans person myself, I’ve witnessed and experienced similar things. I first encountered ketamine in 2013, when friends began purchasing it on the dark web. Originally a medical anesthetic, “ket” was a popular club drug in Europe, but hardly anyone I knew stateside had tried it. Six years later I couldn’t cross a San Francisco or Brooklyn dancefloor without seeing several people snorting K, and it was also on its way to becoming a mental health treatment popular with Wall Street execs and moms. As me and my friends’ usage ballooned during the pandemic, and some began using daily, I wondered what ketamine was doing for us: why in this time, in this community, was it having such a moment?
QUEER PEOPLE IN PARTICULAR have long wrestled with the promise and peril of ketamine, but as its popularity exploded in the past five years, it was also proliferating in psychiatric settings. When prescribed, it is usually administered by infusion therapy, in which patients receive a larger, but typically non-psychedelic dose of the drug intravenously under clinical supervision (often while reclined in cushy chairs, listening to curated playlists) to relieve symptoms of depression, or ketamine-assisted psychotherapy, which involves taking smaller amounts by lozenge or nasal spray and engaging in talk therapy, to rewrite thought patterns while the mind is receptive.
Many associate ketamine with escapism, and the drug is classified as a “dissociative.” Yet while K distances me from my feelings, often what follows the high is a re-association: I return to sobriety with the dots of my mind and body connected differently, helping me adapt to an ever-changing world. Studies attest to great results: one 2018 paper deemed ketamine “arguably the greatest breakthrough in the field of depression in over 60 years.” Legal and abundant, the drug has become a darling of the burgeoning psychedelics industry, with sessions costing hundreds of dollars.
Ketamine, or “K,” was developed in the 1960s as an anesthetic meant to replace PCP, which has similar but more intense effects on the brain (and was also once popular in gay life and clubs). It quickly became popular as battlefield medicine; soldiers returned home from Vietnam with tales of unexpected psychedelic trips on the operating table. By the 1970s, scientists were studying its potential to treat conditions like addiction and bipolar disorder, while psychonauts injected the drug with consciousness-expanding aims, finding that outcomes vary widely from person to person.
Though psychedelics are not generally considered addictive, “ketamine seemed to be the exception,” Dr. R. Andrew Sewell noted in a 2007 bulletin from the psychedelic research institute MAPS. It has “a reputation for insidiously trapping those who really knew better,” including neuroscientist Dr. John Lilly and author D.M. Turner, who detailed his years of experimentation with ketamine and other drugs in The Essential Psychedelic Guide, published in 1994, two years before he drowned in his bathtub beside a vial of K, which he regularly injected at strong doses. He’d previously called the drug “psychedelic heroin” because of its addictive nature, and said the spirits he communicated with while on DMT warned it was a “Frankenstein molecule” unsuited for shamanic purposes. The DEA classifies ketamine’s abuse potential as moderate to low.
K’s quick onset, short duration, and tendency to initially leave people feeling better (or at least not worse) have long made it popular in underground settings, where it is typically snorted in powdered form. In 2019, about one percent of U.S. teens and adults reported using ketamine recreationally in the past year, but for partygoers, closer to 40 percent may have used it — some without even realizing it. In 2021, NYU and Columbia researchers said that consumption was generally rising; in the U.K., ketamine-related deaths doubled to about 30 per year between 2017 and 2020. Both anecdotal and scientific accounts suggest the Covid-19 pandemic further increased the popularity of the drug, which lends itself well to staying home. Subscribers to Reddit’s /r/ketamine more than tripled between March 2020 and November 2022.
According to one small study, queer and trans people may be about twice as likely as heterosexuals to use the drug, in part because we tend to be “early cultural adopters, including which substances are being dispensed and used in which ways,” according to Alex Belser, a psychologist who studies psychedelic use among LGBTQ people. While data remains sparse, Belser thinks ketamine use is “exploding” in queer communities, where high rates of loneliness and rejection often lead to depression and other challenging conditions. While underground K use is often deemed “recreational,” many users (such as JP, initially) say they seem to be getting some of the antidepressant effects the drug shows in clinical settings.
These days, “people are just doing a little bit of it here and there, the way one does a little coke or smokes a little weed,” says Hannah Baer, author of Trans Girl Suicide Museum, a book that unpacks gender and ketamine. “Especially for people experiencing really high levels of stress and internal turmoil, it can be tempting to use it all the time. People can get addicted to anything [that] makes it more tolerable to live in a really fucked up situation” — such as “the aggregate effects of degradation, humiliation, and sometimes literal violence” that queer and trans people face.
Yet as part of a vanguard exploring K’s potential, queer people are also staring down its dark side, including high tolerance and dependency, the risk of deadly fentanyl contamination, and side effects like delusions, cramps, and bladder damage that can become permanent. (In some rare cases, patients have had their bladders removed as a result of ketamine overuse.) At clubs and afterparties, it is commonly mixed with substances like cocaine, psilocybin mushrooms, and poppers. Things can get particularly ugly when ketamine is combined with alcohol (which happens often, whether planned or on the fly), leading people into states verging on catatonic. “Sure, you’re not dying,” says one source who observes heavy usage at the queer parties they frequent in Atlanta, “but now you’re slumped over in the corner, and no one can communicate with you.” According to studies from England, Australia, and Italy, most ketamine-related emergency room visits and deaths involve alcohol, opioids, and/or stimulants.
Health professionals and psychedelic advocates are increasingly concerned by K’s rapid proliferation in both legal and underground settings. “I spent the first 16 years of my career trying to convince people to use this tool,” says Raquel Bennett, a psychologist who has studied the drug since 2002. “I spent the last four telling people to stop and exercise restraint.” Bennett has observed a “big spike” in reports of ketamine addiction since the onset of the pandemic. While the drug is less physically addictive than opioids, two psychedelic specialists shared fears that its ever-expanding availability could soon resemble a new opioid crisis, in which a drug touted as medicine enters into widespread over-use.
Over the past three years, DJ Erick Morillo and Justin Clark, producer of drug docuseries Hamilton’s Pharmacopeia, have died from ketamine-related causes. For those of us in the queer community, such losses are becoming increasingly familiar: This September, a queer friend of mine drowned in a lake after suffering a head injury while on ketamine and possibly other substances. In 2020, a trans friend died in a pool under similar circumstances, just weeks after a long phone call in which we giddily bonded over starting hormones.
“We run the risk of 10 or 15 years from now talking about the number of people we’ve lost through ketamine-complicated scenarios,” says addiction psychiatrist Dr. Eva Altobelli. “Some part of me has a terrified fear around that.”
There is a middle ground between “just say no” and all-out indulgence. Belser thinks harm-reduction strategies could cultivate safer ketamine use. Queer people may be getting “a lot of benefit from psychedelic use in underground settings,” but when people “have no ritual or cultural practice, and are not working with a facilitator, [that] leads to some of the worst outcomes.” The dangers of alcohol have fostered a culture of designated drivers, counting drinks, and cutting people off at the bar. With ketamine, dosing thoughtfully, providing psychological support in party spaces, and testing drugs are the “cultural practices that [can] arise in queer communities for how to care for each other,” says Belser.
Ketamine and other potentially therapeutic psychedelics call into question traditional models of sobriety. Michelle Lhooq, the veteran drugs and nightlife journalist who coined the term “California sober,” has suggested re-imagining sobriety as a spectrum to allow individuals to choose what is healthy for them and in what contexts. “People [who tell] a clinician that they want to stop drugs face an abstinence-only paradigm, when that may not be their goal,” says Belser. “Through the creation of new synapses, [ketamine] may open a critical learning window for people to give up old, ingrained behavior and take up new habits,” particularly when used within an evidence-based treatment program.
While ketamine can “enhance resilience,” says Bennett, its effects usually wear off; it is no substitute for a comprehensive plan including remedies like therapy, mentorship, and exercise. “Life has gotten so hard, and whatever gets you through the day, I feel compassionate,” she says. “At the same time, this is a very powerful tool that needs to be used with restraint and respect.”
CURIOUS BY NATURE, Walter Wall was drawn to ketamine’s ever-changing effects. While some drugs were simply uppers or downers, ketamine felt “like stepping to the side.” At age 30, after nine years of intermittent use, he returned from Burning Man in 2018 feeling like ketamine “was good for me” and began snorting several bumps a day, partly to cope with the anxieties of living in the closet.
“Every time I came out of using heavily, I would be a better person,” he says. “I referred to it as Walter 2.0.” When Wall told friends he was “microdosing” ketamine, some expressed concern, but he convinced them it was safe: “You can’t overdose, it’s not bad for you. Everything about it felt positive.” Ketamine “helped me be myself and not care what people thought,” Wall says.
Within a year, Wall was spending upwards of $3,000 a month to consume about two grams daily. The first gram he’d bump throughout the day, before doing the rest in large, hallucinogenic doses to venture through alternate realities. His life came to feel “like a Marvel movie,” he says. By night, he was a superhero battling imagined dark forces; in the morning, he’d resume a “boring” life with a touch of afterglow. “Everyday life seems way easier than what you’re fighting in those K-holes,” he says.
What began as compulsive but helpful use came to feel debilitating. Within a year, ketamine was impairing Wall’s memory and causing paranoid delusions. He believed that evil spirits surrounded his home and were using him as a tool — yet he commonly drove while on K. He suffered abdominal cramps so painful he once had to stay at a friend’s house for four days, trying to manage the pain with more K. Constant snorting blocked his nasal passages, so he developed a work-around: by holding his breath long enough, he could trick his body into thinking it was suffocating, opening his nose for a 15-second window that he’d use to snort more ketamine. “I thought I was a genius,” says Wall. When he started peeing blood, he says a doctor told him ketamine was likely to blame, yet still he continued using.
In addition to physical consequences, prolonged self-medication with ketamine can severely warp one’s perceptions. Megan, a queer person who felt she could speak more candidly by not using her real name, recalls taking ketamine so often in college that she once snorted a line off the back of her laptop during a lecture. “That was when I noticed my patterns moving in the direction of a coping mechanism,” she says. Ketamine “gave me distance and perspective on how much suffering I was in, and gave me an out for my physical and emotional pain.” She consumed up to a gram a day, telling herself the benefits were therapeutic. Yet “it felt like I was chasing something, and needed more and more.”
During her senior year, Megan sold ketamine to a roommate who she says was suffering from schizophrenia. According to Megan, that friend used it to dissociate from fear in order to jump off the roof of their house. He survived, but broke all the bones in his legs. Megan spent the rest of the year visiting him in the ICU and didn’t graduate on time. “I realized, ‘we’ve all been fucking around, being petulant and childlike in the mechanisms we’re using to cope with really serious things,’” Megan recalls. “Then I did more ketamine to cope with it.”
Despite its serious risks, what the drug does for us is profound and not easily replicable; it was only after taking K at a party one year after my trans sister died that I was able to confront and sob over my suppressed, otherwise overwhelming grief. Nearly everyone interviewed for this article, including those who struggled with ketamine addiction, expressed complicated feelings about the drug, wanting to recognize both its destructive and life-affirming possibilities. “There are so many existential thoughts and ideas I experienced on ketamine that I still carry with me,” says JP, who has been sober since spending five months in rehab in 2019. Megan expected to swear off the drug forever, but still uses after finding safer patterns with meditation, breathwork, and working with a therapist. She says K helped her integrate the lessons of therapy, leading to a spiritual awakening that she calls “one of the most important things that’s happened to my brain in my life. I have a relationship to divinity now that I simply never had growing up.”
In Wall’s case, there was a way out. During one intense K-hole, a “portal” opened through which he says he saw a version of himself in a parallel universe. He stepped through the portal and immediately collapsed, awakening to find himself lying on the floor. Two days later, his family sat him down and asked him to go to rehab; he agreed. While there, he came out to them as queer, alleviating much of the “shameful” burden that had driven his ketamine usage.
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“If I didn’t have that experience, I would’ve re-upped, my family would’ve approached me, and I would’ve said ‘fuck you.’ I probably would’ve died,” Wall says. Since that breakthrough and the rehab that followed, though, Wall has given up ketamine completely.
“I overdid it and made some dangerous decisions,” he says. Today he likens ketamine to “a girl that I love but I know I can’t be together with anymore, for the benefit of us both.”