When research doesn't quite go as far as you might hope

[sholio]

So this is either the best discovery ever (for writing purposes) or absolutely terrible. I'm not sure.

In one of the White Collar Werewolf Peter AU stories, it is mentioned that Elizabeth keeps ketamine on hand to sedate him in case he gets out of hand as a werewolf. (His idea, not hers. SHE doesn't think he'd ever do anything. He feels better if she has some way of stopping him in case of werewolf attack.)

I mentioned ketamine because I'd looked up veterinary tranquilizers and needed a fast-acting one. Unfortunately for Peter, it appears that I missed a few side effects. There was a post today at ScriptMedic (a resource Tumblr for writing medical stuff) that talks about ketamine, and apparently, um, well:

In low doses, ketamine can relieve pain. It can also make people feel very “stoned”.
In medium doses, it can cause hallucinations. This is what the drug using community refers to as “falling down the K-hole,” and ketamine is indeed known for its illicit uses.

So now imagine a HALLUCINATING WEREWOLF.

But it actually gets EVEN WORSE:

If the patient develops distress shortly after an initial dose, the patient is not fully dissociated and the best maneuver is usually to give more ketamine. [...]

In high doses, ketamine works as an anesthetic, specifically a dissociative anesthetic. It shuts the brain off from outside stimulus completely. Basically what ketamine does is it shuts the brain off from outside stimuli. That means that even though someone’s eyes are open (and possibly twitching, medically referred to as nystagmus) their brain isn’t processing information from them.

Think of it like this: with most anesthetics, the brain is temporarily turned off. With ketamine, the brain isn’t turned off – it’s just disconnected from the outside world.

However, if someone is unprepared for it, those hallucinations can seem like a nightmare. And there is a portion of patients who get ketamine and, as it starts to wear off, they start screaming uncontrollably. This is called an “emergence reaction,” as they emerge from anesthesia and slip into the K-hole.

Someone who has been sedated/anosthetized with ketamine, especially if it’s against their will (used as a “knockout drug”), will likely have very negative hallucinations. To an outsider they’ll be lying on the floor, eyes open and blinking, unable to move or react to anything. It’s a great moment for a horror scene, or a horrific element to an action plot, especially if they have an emergence reaction and come back to reality screaming.

HALLUCINATING, DISSOCIATING, SCREAMING WEREWOLF. Thanks, Google.

Comments

[lilacsigil]

Ketamine is what Mulder had injected into his brain in the X-Files episode "Demons" (4x23) for a great visual on ketamine hallucinations!

[gwyn]

That was exactly where my mind went! Ah, X-Files, you were always ahead of your time.

[lilacsigil]

X-Files, the original and still the best!

[sholio]

... I am going to hope you don't mean injected DIRECTLY into his brain, because that gives me visuals that are seven shades of NOPE. XD

[lilacsigil]

Yes, that's exactly what I mean! Mulder, don't do that!

[nywcgirl]

I think you should write a wc fanfic about this, grin...
Ketamine is not normally used on humans, not in the medical setting anyway, it is a horse tranquilizer...
But Mozzie gives it to Neal in Goodnight Cinderella.

[sholio]

He's a werewolf, so he's somewhere between human and veterinary medicine. *g*

[recessional]

You know this would make a great h/c fic premise, just sayin'.

[sholio]

Obviously that was in no way the first thing that occurred to me. *shifty look*

[umadoshi]

Wow, this is quite the mental picture!

[sholio]

I can't figure out if it's the best idea I've ever had, or the worst.

[rachelmanija]

It can also be used as a treatment for depression. Hurt and comfort in the same package!

[sholio]

Man, body chemistry is so weird. (I was going to say brains, but basically everything biological.)

[kore]

There's at least one ketamine clinic here in Seattle (Bellevue), the doc who administers it is a board certified anesthesiologist who takes referrals from psych doctors (he's an osteopath). You have to find a psych who's willing to refer you though. However since the FDA hasn't approved it for treating depression and no form of insurance, including Medicare, will pay for it, you have to pay the full fee and they don't take checks, and the initial consult was something like $500 and one infusion was IIRC nearly TWO THOUSAND DOLLARS, altho they said that could be 'negotiated.' And then the monthly booster shots after that were $500 apiece. I think ketamine costs something like $10 a vial wholesale for vets.

[kore]

Ketamine is what John Lilly was on when he did those experiments in communicating with dolphins, which NASA paid for because they thought it would help if aliens wanted to talk to us. A friend apparently recommended ketamine to treat his migraines, and Lilly thought it worked so well he injected himself with higher and higher doses and eventually had a friend shoot him up with it while he was locked in a sensory deprivation tank (which he had invented) Fortunately he did not drown. Less fortunately, he became convinced he was actually in contact with a giant extraterrestrial entities which controlled everything on Earth and naturally enough needed to tell this to everyone, which shot his considerable credibility as a scientist forevermore. Paddy Chayefsky based Altered States on Lilly and Clarke had several scientist characters based on Lilly too.

Less scientifically, I had a couple of friends who went down the K-hole (after what must have been pretty large doses) and they said they had never had a worse trip in their lives. One guy was suicidally depressed for weeks.

[rachelmanija]

Wooooow.

Re: $10 for horses, $2000 for humans: I understand the justification (you're paying for medical supervision, not the K itself) but that still sums up a lot of the American medical system to me. In fact I'm surprised it's not $10,000.

[kore]

Yeah, I tried looking into it a few years ago, and unless you have the money saved up, getting into a clinical trial is about it. And it's supposed to be therapy for the people with the most treatment-resistant depression, too (which is what I have) and typically they don't have a lot of resources or money because, well, treatment-resistant.

Of course, the hot new thing now is apparently microdoses of LSD. Which I guess might be similar. https://www.theatlantic.com/health/archive/2017/01/ayelet-lsd-microdosing/513035/