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Ketamine
Fatalities / Deaths
by Erowid
NOTES #
While fatalities with ketamine use as the sole cause of death are rare, they are not unheard of.1,2,3 More commonly, however, other substances are involved in addition to ketamine. Depressants such as benzodiazepines, barbiturates, GHB, or alcohol can amplify ketamine's suppressant effects on breathing and heart rate, possibly causing cardiovascular and respiratory functions to slow down to dangerous levels or discontinue altogether. In one fatality case, where the death was attributed to ketamine in combination with another dissociative anaesthetic and tranquilizer known as Telazol, the autopsy revealed cardiomegaly (enlargement of the heart) and hepatosplenomegaly (enlargement of the liver and spleen).4 In another case, asthma was listed as a joint cause of death along with ketamine,2 again most likely due to the respiratory suppressant effect of the substance.

Anaesthesia-inducing levels of ketamine in an unsecured setting can lead to a fatal accidents, such as bathtub drowning.5, 6 Ketamine users who are unconscious and begin to choke or have problems breathing should be put in the Recovery Position (rolled on their side with upper arm and leg folded over, mouth posititioned so it can drain, but neck extended to facilitate breathing).

There is also the possibility that impure ketamine, whether due to problems resulting from illicit synthesis and/or adulteration or from known issues within products marketed to veterinarians, may potentially contribute to fatalities. (See Ketamine Bits & Pieces: Product Recall)

If you know of a confirmed ketamine-related fatality that is not listed on this page, please let us know.

PHARMACOLOGICAL FATALITIES
Pharmacological fatalities are those deaths caused by the direct action of ketamine in the body, not including deaths caused by accidents or as a result of inebriated behavior. Because ketamine is an anaesthetic, it can be dangerous in combination with other depressants, anaesthetics, and sedatives.

Incident: Ellie Rowe, 18 years old. August 8, 2013. #
Mitchell B. "Glastonbury family 'destroyed' by death of teenager after taking horse tranquiliser ketamine". Western Morning News. Feb 2 2014. Believed to have died after insufflating 200 mg of ketamine (within Erowid's K-Hole dose range) combined with alcohol (0.088%, inebriated). Although this article states that this is the second lowest known fatal dose of ketamine, we are unable to confirm that. The emergency medical people on site performed an emergency tracheotomy and there has been speculation that the death might have been from aspirated vomit or a blocked airway. See https://www.ukchemicalresearch.org/Thread-Boomtown-fair-death.
"Ellie Rowe, from Glastonbury, Somerset, took the class C drug while attending the Boomtown Fair festival in Winchester, Hampshire, last summer. An inquest heard that the teenager was volunteering as a steward for Oxfam at the event with a friend, Stephanie Peirce, on August 8 when she snorted a line of ketamine powder having drunk a few cans of Carlsberg lager during the day. [...] Pathologist Dr Adnan Al-Badri told the hearing that toxicology tests showed that Miss Rowe had 2.14mg of ketamine per litre of blood in her system which was the second lowest recorded fatal dosage of the drug recorded. He said that she had 88mg of alcohol in 100ml of blood which is 1.1 times the drink-drive limit. [...] She said that Miss Rowe had snorted approximately 200mg of the drug from two wraps of ketamine that the pair had bought from a 'friend of a friend' at the festival."
Incident: Anonymous male. 1997. #
Moore KA, Kilbane EM, Jones R, Kunsman GW, Levine B, Smith M. "Tissue distribution of ketamine in a mixed drug fatality". J Forensic Sci. 1997 Nov 08;42(6):1183-5.
"While reports of ketamine abuse are increasing, reports of ketamine deaths and tissue concentrations associated with fatalities are rare. We report here a case of a mixed drug fatality involving ketamine and ethanol. Ketamine analysis was carried out by gas chromatography with a nitrogen-phosphorus detector (NPD). We found the following tissue concentrations: blood 1.8 mg/L; urine 2.0 mg/L; brain 4.3 mg/kg; spleen 6.1 mg/kg; liver 4.9 mg/kg, and kidney 3.6 mg/kg. The blood ethanol concentration was 170 mg/dL."
Incident: Anonymous male. 2011.
Erowid. "A death from the non-suicidal combination of ketamine and fentanyl." Erowid.org. May 2013.
Erowid received the report of a death in 2011 from an extremely credible, anonymous source. The decedent had been a long time ketamine user and had recently been experimenting with the combination of ketamine and fentanyl (an extremely dangerous combination). The blood levels from the toxicology report indicated recreational, non-suicidal levels. Breathing suppression was the assumed cause of death.
BEHAVIORAL FATALITIES #
Behavioral fatalities include accidents and deaths resulting from inebriated behavior or from unconsciousness. Because ketamine can alter judgement, people can and do engage in dangerous behavior while under the influence of ketamine. Two cases of people dying in bathtubs while on ketamine have been reported.

Incident: Louise Cattell. 2011. United Kingdom. #
O'Kelly L. "Every parent's worst nightmare: how ketamine killed our daughter". TheGuardian.co.uk. Apr 16 2011.
"The girls watched TV for a while and then Louise's friend went to bed. Louise was tired too but didn't think she'd be able to sleep, maybe because of taking the drug but also because she had things on her mind. She had given up her job [as a visual merchandiser for the fashion chain New Look] before going to Australia and she knew she had to find another one because she had bills to pay. She'd been worrying about that. So she said she was going to take a bath to help her relax. About an hour later her friend woke up and realised straight away that something was wrong. She just had a feeling. She went into the bathroom and found her. She had fallen asleep in the bath and drowned." Horrified, Louise's friend called the emergency services who told her how to try and resuscitate her but by then it was too late."
See also http://www.louisecattell.com/.

Incident: Anonymous Male. 2010. California, USA. #
Erowid. Private Communications. Erowid.org. 2010.

An Erowid visitor provided details confirming the death of a middle-aged male resulting from an anaesthetic dose of ketamine in combination with an unsupervised downward-facing yoga position ("child's pose") that resulted in suffocation.

Incident: Anonymous Male. 2001. Germany. #
Breitmeier D, Passie T, Mansouri F, Albrecht K, Kleemann WJ. "Autoerotic accident associated with self-applied ketamine". Int J Legal Med. 2002 Apr 11;116(2):113-6.
"We present a rare case of an autoerotic accident involving a fatal combination of asphyxia by suffocation and intoxication with self-administered intravenous ketamine. Of note in this case is the fact that the victim was an emergency medical technician.

[...] Toxicological analysis of blood taken from the femoral vein (other specimens like urine and cardiac blood were not available) revealed a ketamine concentration of 2.5 μg/ml, well within the therapeutic range (1.0-6.0 μg/ml). This concentration may have been even higher in the final, agonal stage because ketamine is metabolised with a short half-life period by a hepatic cytochrome P450-dependent enzyme system and will be further conjugated to glucuronide derivatives which subsequently undergo renal elimination."
Incident: D.M. Turner. 1997. California, USA. #
Kent J. "In Memory of D.M. Turner". The Resonance Project. Summer 1997.
"On New Years Eve, 1996, the noted author and lay-psychedelic researcher known only by the pseudonym D.M. Turner drew a hot bath, injected himself with an unknown amount of ketamine, and settled in for the last trip of his life. When his body was found weeks later, the cause of death was determined to be natural causes. It is assumed that Mr. Turner lost consciouness at some point during the evening, slid under the water, and quietly drowned. But no one really knows what happened that night. Taking into account ketamine's extremely low toxicity levels, it is highly improbable that this was an overdose situation. However, since Mr. Turner was also one of ketamine's greatest advocates, it is ominous that his is the first publicly known ketamine-related death. His passing is a truly sad and perplexing loss for all of us, and we will no doubt miss his articulate and insightful voice."
Jansen K. "Ketamine: Dreams and Realities". MAPS. 2001.
In January 1997, D.M. Turner [...] died in a bathtub in San Francisco, aged 34, with a bottle of ketamine next to the bath. The cause of death was listed as 'drowning'. However, it is not easy to slip below the waterline in the average bath. His body was found in a kneeling position, head down, facing the taps. He may have collapsed or (less likely) slipped into the bath while still affected by the drug, ending up with his head below water.
See also D.M. Turner Vault.

Incident: Marcia Moore. 1979. Washington State, USA. #
Jansen K. "Ketamine: Dreams and Realities". MAPS. 2001.
"Moore disappeared from her house on January 14, 1979. Her husband spent a year searching for her, including journeys to Hong Kong and Thailand, places to which she had traveled in the past. Her skeleton was found in early spring, 1981, in the place where she had frozen to death. She had made a journey at night into the dark world of the forest, a potent Jungian symbol, curled up in a tree, and then injected herself repeatedly with all of the ketamine she had been able to find. That night the pond froze over, the moon rose, and the Fire Lady was killed by the ice.

'Marcia became addicted to ketamine and committed suicide. The drug is dangerous and its use should not be encouraged... I told her that it was a seductress, not a Goddess.' -- Howard Alltounian, M.D. (Moore's husband), Interviewed by Karl Jansen (April 1998)

The evidence is more suggestive of accidental death than suicide, and bears similar hallmarks to a death from exposure in a person intoxicated with alcohol. There was nothing to indicate that she was depressed or that her conscious intent was to die, and she did not leave a note. Nevertheless, there may have been powerful subconscious elements that sought to go through the door for the last time, and never return."
SUICIDES #
Suicides involving ketamine have been reported. The famous case of Marcia Moore, the co-author of Journeys Into the Bright World who died after injecting ketamine, was possibly a suicide but was more likely a reckless accident precipitated by Moore's efforts to hide her use from her family. See Marcia Moore Death.

Incident: Caleb Morris. Feb 6, 2010. #
This Is Bristol. "Class C ketamine played large part in son's death". Bristol Post. Oct 13, 2010.
"Caleb Morris, 28, of Fitchett Walk, Henbury, died from multiple injuries and drowning after falling from the bridge on January 28 after taking ketamine, an inquest heard. [...] The inquest heard statements from three witnesses who saw him jump from the bridge. [...] Angela Jenkins, who was walking on the bridge, saw Mr Morris take his jacket off before he jumped. She tried to persuade him not to jump but he said 'it's too late'. [...] Summing up with a narrative verdict Mr Moore said: 'Caleb Morris died of drowning and multiple injuries having jumped from the Clifton Suspension Bridge whilst under the influence of ketamine'."
Incident: Unidentified Male. 2009. #
Dinis-Oliveira RJ, Carvalho F, Duarte JA, Dias R, Magalhães T, Santos A. "Suicide by hanging under the influence of ketamine and ethanol". Forensic Sci Int. 2010 Oct 14;202(1-3):e23-7.
"This report describes a suicide by hanging, under the influence of ketamine and alcohol. The victim was a 29-year-old man, found dead hanging by the neck from a metallic beam in the ceiling of his workplace. Besides characteristic signs of hanging seen at the autopsy, toxicological analysis revealed a femoral blood concentration of ketamine and ethanol of 1.3mg/L and 0.66g/L, respectively. Positive qualitative results for ketamine were also detected, in a powder found near the victim and on the victim's nostrils, which suggests nasal inhaling as administration route. The hallucinogenic effects caused by ketamine, associated with an increased sensitivity of N-methyl-d-aspartate (NMDA) receptors to ketamine as result of the previous history of alcoholism should be considered as potential inducing factors in suicide behaviors."
Incident: Ariel. Year Unknown. Location Unknown. #
Jansen K. "Ketamine and the People". no publication specified / undated.
"One of the few deaths known about from pure overdose (Marcia Moore did not die of an overdose but from freezing) is that of a woman whom I will call Ariel, aged 49, almost exactly the same age as Marsha Moore who died when she was 50. Ariel was American and a co-owner of a New Age food supplements business. She started taking ketamine when she was about 48. She took ketamine every day for seven months and developed the belief that she had an angel lover on the 'other side' called Gabriel, who sent her messages and formed clouds into heart shapes. She had always been very thin and had strange ideas about things, but there was no pre-existing history of any formal psychiatric problem. One day she put on her best clothes and all of her best jewels and lay down on her bed and went 'to join Gabriel'. She did actually manage to die too. The post-mortem noted that she weighed six stone and she had a minimum of 600 milligrams of ketamine per litre of blood. Her death certificate is one of very few to simply read 'ketamine poisoning'."
Jansen K. "Ketamine: Dreams and Realities". MAPS. 2001.
"The death of Ariel, a woman of almost the same age as Moore, is another example. Before taking ketamine, she had been to India with her husband and they embarked together on a spiritual path involving physical celibacy while staying married, which they pursued for almost 3 years before divorcing. Ariel's 7 month, daily involvement with ketamine began shortly afterwards, accompanied by further weight loss as she fell in love with an "Angel on the other side" called Gabriel. Such a fantasy male lover can be seen as an expression of the neo-Jungian "inner masculine." Ariel's suicide suggests that her preference in midlife was for a marriage with a projected part of herself rather than an actual, real man."
MURDERS / HOMICIDES #
There is at least one case of ketamine being used in an apparent murder.

Incident: Unidentified Female. 2003. China. #
Tao Y, Chen XP, Qin ZH. "A fatal chronic ketamine poisoning". J Forensic Sci. 2005 Jan 15;50(1):173-6.
"Determination of ketamine concentrations in autopsy specimens was carried out with gas-chromatography/mass spectrometry (GC-MS). The results showed that ketamine concentration was 21 ug/mL in gastric contents, 3.8 ug/mL in blood and 1.2 ug/mL in urine. Reported LD50 is 224+/-4 mg/kg in mice and 229+/-5mg in rats. The administered doses of ketamine in this case were 100-300 mg, well below LD50, thus ruling out the possibility of acute poisoning. However, the most striking forensic findings were cardiac muscle fibrosis and hyaline degeneration of the small arteries of the victim's heart, which are pathological features of ketamine poison previously reported only in animal studies (4). This led us to consider the possibility of chronic poisoning with ketamine, which the police and Court investigations eventually established to be the case.

The deceased was a 34-year-old female who resided in an apartment with her husband. The husband stated that she was discovered unconscious with no respiration or heart beat shortly after bathing and then drinking a cup of coffee prepared by him. She was transported by ambulance to the emergency room of a local hospital and pronounced dead."
LD50 #
Ketamine LD50 Notes
There is no way to determine an LD50 for ketamine in humans. LD50s are only ever experimentally determined in animals, and extrapolations from one species to another for determining lethal dose are notoriously unreliable. Based on the real-world killing of lab animals, the following results have been published for LD50 studies of ketamine.
Mouse (IP / injected into body cavity)
275+/- 7mg IP baby rats (Swiss Webster strain)
229+/- 5mg IP adult rats (Swiss Webster strain)
Rat (IP / injected into body cavity)
146+/-5mg IP baby rats (Holtzman strain)
224+/-4mg IP adult rats (Holtzman strain)
All above LD50 data compiled in Goldenthal EI (1971).7