title: First injection of ketamine among young injection drug users (IDUs) in three U.S. cities.
abstract: Ketamine, a dissociative anesthetic, has emerged as an increasingly common drug among subgroups of young injection drug users (IDUs) in cities across the United States. In-depth qualitative interviews were conducted with 213 young IDUs aged 16-28 years recruited in New York, New Orleans, and Los Angeles between 2004 and 2006. While some initiated injection drug use with ketamine, the drug was more frequently injected by IDUs with extensive polydrug using histories. IDUs initiating with ketamine commonly self-injected via an intramuscular mode of administration. The injection group provided crucial knowledge and material resources that enabled the injection event to occur, including ketamine, syringes, and injection skills. Injection paraphernalia was commonly shared during the first injection of ketamine, particularly vials of pharmaceutically-packaged liquid ketamine. Injection events infrequently occurred in a rave or club and more typically in a private home, which challenges ketamine's designation as a 'club' drug. The first injection of ketamine was a noteworthy event since it introduced a novel drug or new mode of administration to be further explored by some, or exposed others to a drug to be avoided in the future. Risk reduction messages directed towards young IDUs should be expanded to include ketamine.
authors.affiliation: University of Southern California, Keck School of Medicine, Department of Pediatrics, 6430 Sunset Boulevard, Suite 1500, Hollywood, CA 90028, USA. slankenau@chla.usc.edu
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Lankenau
authors.forename: Bill
authors.initials: B
authors.lastname: Sanders
authors.forename: Jennifer Jackson
authors.initials: JJ
authors.lastname: Bloom
authors.forename: Dodi
authors.initials: D
authors.lastname: Hathazi
authors.forename: Erica
authors.initials: E
authors.lastname: Alarcon
authors.forename: Stephanie
authors.initials: S
authors.lastname: Tortu
authors.forename: Michael C
authors.initials: MC
authors.lastname: Clatts
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007275:Injections, Intravenous; D007279:Injections, Subcutaneous; D007407:Interviews as Topic; D007649:Ketamine / Q000008:administration & dosage*; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data; D018401:Sample Size; D019529:Sexuality; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D019966:Substance-Related Disorders / Q000188:drug therapy*; D014505:Urban Population
chemical_list: D000700:Analgesics; D007649:Ketamine