{"id":18353,"date":"2024-11-24T17:33:25","date_gmt":"2024-11-24T16:33:25","guid":{"rendered":"https:\/\/drugprevent.org.uk\/ppp\/?p=18353"},"modified":"2025-02-02T17:53:07","modified_gmt":"2025-02-02T16:53:07","slug":"notes-from-the-field-ketamine-detection-and-involvement-in-drug-overdose-deaths-united-states-july-2019-june-2023","status":"publish","type":"post","link":"https:\/\/drugprevent.org.uk\/ppp\/2024\/11\/notes-from-the-field-ketamine-detection-and-involvement-in-drug-overdose-deaths-united-states-july-2019-june-2023\/","title":{"rendered":"Notes from the Field:\u00a0Ketamine Detection and Involvement in Drug Overdose Deaths \u2014 United States, July 2019\u2013June 2023"},"content":{"rendered":"

Weekly<\/em>\u00a0\/ November 7, 2024 \/ 73(44);1010\u20131012<\/span><\/h1>\n

Alana M. Vivolo-Kantor, PhD1<\/sup>; Christine L. Mattson, PhD1<\/sup>; Maria Zlotorzynska, PhD1<\/sup><\/p>\n

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What is already known about this topic?<\/strong><\/p>\n

Expanded availability of ketamine for management of treatment-resistant depression has resulted in increased use.<\/p>\n

What is added by this report?<\/strong><\/p>\n

During July 2019\u2013June 2023, ketamine was detected in <1% of overdose deaths and was the only drug involved in 24 deaths. During this period, the percentage of overdose deaths with ketamine detected in toxicology reports increased from 0.3% (47 deaths) to 0.5% (107 deaths). Approximately 82% of deaths with ketamine detected in toxicology reports involved other substances, including illegally manufactured fentanyls, methamphetamine, or cocaine.<\/p>\n

What are the implications for public health practice?<\/strong><\/p>\n

Further investigation is needed to better understand the role of ketamine in drug overdoses, particularly when multiple substances are used before death.<\/p>\n<\/div>\n

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Ketamine, a Schedule III controlled substance* that is Food and Drug Administration (FDA)\u2013approved for general anesthesia, can produce mild hallucinogenic effects and cause respiratory, cardiovascular, and neuropsychiatric adverse events (1<\/i>). In 2019, a form of ketamine (esketamine) was approved by FDA for use in treatment-resistant depression among adults\u2020<\/sup>\u00a0(2<\/i>). Ketamine use, poison center calls for ketamine exposure, and ketamine drug reports from law enforcement have increased through 2019 (3<\/i>), but recent trends in ketamine involvement in fatal overdoses are unknown. Data from CDC\u2019s State Unintentional Drug Overdose Reporting System (SUDORS) were analyzed to describe characteristics of and trends in overdose deaths with ketamine detected or involved during July 2019\u2013June 2023.<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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Investigation and Findings<\/h2>\n

Data on drug overdose deaths with unintentional or undetermined intent come from SUDORS, which includes information from death certificates, medical examiner or coroner reports, and postmortem toxicology reports.\u00a7<\/sup>\u00a0Data are abstracted on all substances reported to cause death (i.e., involved) and substances detected through toxicology testing.\u00b6<\/sup>\u00a0Decedent demographics and other overdose characteristics were analyzed among 45 jurisdictions (44 states and the District of Columbia [DC]),** and trend analyses were conducted among 28 jurisdictions (27 states and DC).\u2020\u2020<\/sup>\u00a0Analyses were restricted to deaths with toxicology reports or with ketamine listed as a cause of death on the death certificate. Ketamine detection included toxicology results for ketamine or its metabolites.\u00a7\u00a7<\/sup>\u00a0Among deaths with ketamine detected, drug involvement was analyzed to ascertain which drug or drugs caused death. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy.\u00b6\u00b6<\/sup><\/p>\n

During July 2019\u2013June 2023, a total of 228,668 drug overdose deaths were identified in 45 jurisdictions. Ketamine was detected in 912 (0.4%) overdose deaths, listed as involved in 440 (0.2%) deaths, and was the only substance involved in 24 (0.01%) deaths (<\/a>Table<\/a>). A majority of deaths with ketamine detected involved illegally manufactured fentanyls (IMFs) (58.7%), followed by methamphetamine (28.8%) and cocaine (27.2%). Overall, 82.4% of deaths involved either IMFs, methamphetamine, or cocaine. Approximately one third (34.8%) of decedents in whom ketamine was detected were aged 25\u201334 years, and approximately three quarters were males (71.3%) and non-Hispanic White persons (73.7%).<\/p>\n

Among 172,475 overdose deaths in 28 jurisdictions during July 2019\u2013June 2023, <1% had ketamine detected (692 deaths; 0.4%) or were classified as ketamine-involved (348 deaths; 0.2%). The number and percentage of deaths with ketamine detected increased during July 2019\u2013June 2023 from 47 (0.3%) to 107 (0.5%), with notable increases as early as July\u2013December 2020<\/p>\n<\/div>\n<\/div>\n

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Conclusions and Actions<\/h2>\n

During July 2019\u2013June 2023, although ketamine was detected or involved in <1% of all drug overdose deaths, overdose deaths with ketamine detected increased. Almost all overdose deaths with ketamine detected involved other substances, mostly IMFs or stimulants; however, the source of ketamine (e.g., illegally purchased or prescribed) is unknown. Because analyses included a subset of jurisdictions, findings might not be generalizable to the entire United States. In addition, the scope of postmortem toxicology testing varies within and across jurisdictions, and ketamine might not be included in testing panels or be tested for in all postmortem samples (4<\/i>), which could lead to an underestimation of ketamine detection. Despite the lack of uniform testing, ketamine detection among overdose deaths has increased over time, yet both detection and involvement accounted for a small proportion of overdose deaths. As polysubstance use (5<\/i>) and use of ketamine for treatment-resistant depression and in compounded formulations*** increase, continued monitoring is needed to identify potential changes in the detection and involvement of ketamine in overdose deaths and to better understand potential drug interactions or circumstances leading to death.<\/p>\n<\/div>\n

Source: https:\/\/www.cdc.gov\/mmwr\/volumes\/73\/wr\/mm7344a4.htm?s_cid=mm7344a4_w<\/strong><\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Weekly\u00a0\/ November 7, 2024 \/ 73(44);1010\u20131012 Alana M. Vivolo-Kantor, PhD1; Christine L. Mattson, PhD1; Maria Zlotorzynska, PhD1 What is already known about this topic? Expanded availability of ketamine for management of treatment-resistant depression has resulted in increased use. What is added by this report? During July 2019\u2013June 2023, ketamine was detected in <1% of overdose […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[68,80,119,19],"tags":[],"class_list":["post-18353","post","type-post","status-publish","format-standard","hentry","category-drug-use-various-effects","category-ketamine","category-prevalence","category-usa"],"_links":{"self":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/18353","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/comments?post=18353"}],"version-history":[{"count":0,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/posts\/18353\/revisions"}],"wp:attachment":[{"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/media?parent=18353"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/categories?post=18353"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drugprevent.org.uk\/ppp\/wp-json\/wp\/v2\/tags?post=18353"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}