HSE Ketamine update 2025

It is safer not to use drugs at all as there are always risks. If you do choose to use, know the risks and steps to help you reduce the harms.

Ketamine is a drug that can make you feel disconnected from your body and surroundings. It can cause feelings of detachment and hallucinations. This could mean extra risks at festivals.
It is usually looks like a grainy white powder but the colour can vary. Crucially, you can’t tell what’s in a powder just by looking at it, and even a small amount could have serious health effects.

New Types of Ketamine = higher risks

In Ireland, the strength and contents of ketamine can vary. Sometimes, what’s sold as ketamine may actually be a new version called a ketamine analogue or designer drug. These substances are made to act like ketamine but can be much stronger and less predictable. These new types of drugs pose significantly higher risks especially if combined with other drugs.

Examples include:

Methoxetamine (mexy, MXE, M-ket)
Fluorodeschloroketamine (2-fluorodeschloroketamine, 2-FDCK , FDCK, 2-F Ket)
Deschloro-N-ethyl-ketamine (O-PCE, DNEK )

These new types of ketamine can cause:

Stronger feelings of disconnection or sedation
More intense confusion or anxiety
Longer-lasting or more harmful effects

You can’t tell what’s in the powder just by looking at it - even a small amount could have serious effects.

What do you need to know?

You might react differently to ketamine each time you use it.

Effects can depend on:

How strong the drug is and what’s in it
Your physical and mental health
Where you use and who you use with

Know the signs of an emergency

Get medical help immediately if someone:

Is drowsy, confused, or collapses
Slowed down breathing or trouble breathing
Has pale, cold, clammy skin, turns pale/blue
Extreme vomiting or has a seizure
Has a slow, weak or uneven heartbeat
Is experiencing severe hallucinations and could be a risk to themselves or others
Has suicidal feelings

Medics are your mates - don’t be afraid to get help.

Ketamine harm reduction information

It's safer not to use ketamine at all but if you choose to:

1. Be with people you trust and in a safe location.
Ketamine is a general anaesthetic so it reduces sensations in the body. How you feel, where you are and who you are with can impact on your reaction to ketamine. Avoid use if you feel low, anxious, depressed or if you have mental health or heart health concerns.

2. Start low and go slow.
The effects of ketamine depend on how much is taken. Different people can have different effects depending on the amount taken and the way their own body reacts.

3. Don’t use alone and don’t leave anyone alone.
If you take too much ketamine you may have a feeling of complete disconnection from your surroundings called a ‘k-hole’. This can be risky at a busy place like a festival.

4. Avoid mixing with other drugs, including alcohol and prescription medication.
Ketamine used with depressants (alcohol, GHB, opioids, benzodiazepines) can slow down your heart rate and breathing. This can lead to you passing out. Ketamine and alcohol can make you feel sick and increase your risk of vomiting. Place people at risk on their side. Using ketamine with stimulants (MDMA, speed, cocaine ‘CK’) can increase the strain on your heart.

5. Reduce snorting risks.
Avoid sharing snorters or using bank notes as this can spread infections. Crush the powder finely so it’s less likely to damage your nose.

6. Reduce how much you use and how often.
Frequent and long-term use can impact each person differently.

7. Look out for the signs of urinary/bladder concerns.
Look out for cramps, abdominal pain, difficulty peeing, urinary tract infections, cystitis, peeing often and blood in pee. Stop use and discuss with a health professional.

8. Limit how often you use.Check in with your mental health and get support if you are feeling low, depressed or have suicidal feelings.