• Isabel Gomila Muñiz, Juan Ortega Pérez, Jordi Puiguriguer Ferrando, Jesús González, Gaspar Tuero León, and Bernardino Barceló Martín.
• Servicio de Análisis Clínicos, Hospital Universitario Son Llàtzer, Palma de Mallorca, Baleares, España. Grupo de Investigación en Toxicología Clínica, Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, Baleares, España.
• Emergencias. 2023 Feb 1; 35 (1): 6146-14.

ObjectivesTo describe the epidemiologic, clinical, and toxicologic profiles of patients who used recreational ketamine and experienced acute poisoning.Material And MethodsRetrospective observational study of patients attended by several emergency medical services in the Balearic Islands for analytically confirmed acute poisoning after using ketamine between January 2016 and December 2020. Urine samples were analyzed by immunoassay and combined gas chromatography and mass spectrometry.ResultsOne hundred twenty-two patients were studied. The mean (SD) age was 26.7 (6.5) years. The majority were men (77.9%) and not residents of the Balearic Islands (74.6%). Poisoning cases occurred mainly in the summer and in the island of Ibiza (84.4%). Ketamine use was declared by the patient or clinically suspected in 40.2%. The most common clinical signs were tachycardia (43.4%), hypertension (28.7%), mydriasis (27.0%), altered consciousness (25.4%), agitation/aggressiveness (25.4%), and hypothermia (21.3%). Seven patients (5.73%) required admission to the intensive care unit. The drugs most often detected along with ketamine were cocaine, in 93.4%, and 3,4-methylenedioxymethamphetamine (MDMA), in 78.7%. Multiple-drug use combining ketamine, cocaine, and MDMA, or on occasion additional substances, was detected in 98.4%.ConclusionDetection of ketamine in urine samples from patients poisoned by recreational drugs is associated with a characteristic profile: young men who are not residents of the Balearic Islands, who attend electronic music concerts, and who have taken multiple drugs. A substantial percentage of such patients are unaware of drug intake.

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