Sam Kelly: In many of the interviews I do with authors I find myself asking about changes that took place in the late 60s and the 70s, the consequences of which we’re still living through now. It’s partly for that reason that I find it fascinating that ketamine’s first widespread use was in the Vietnam War. To begin, could you explain where ketamine was produced and why it was first used in the Vietnam War?
Bita Moghaddam: Sure. Ketamine was synthesized for use as a safe anesthetic. At the time anesthetics were mostly dangerous, especially if you administer them in high doses. Not only were they fatal, they were relatively expensive to use because you needed to be in a surgery room with equipment to monitor heart rate, to make sure the anesthetic didn’t kill the patient. Vietnam was a horrific war and there was a demand for an anesthetic that worked well in combat. Ketamine reduces pain perception and has a minimal effect on the respiratory system.
Prior to ketamine, in the 40s, a drug named phencyclidine (PCP or angel dust) was synthesized; this drug is a hallucinogen that remains in use for recreational purposes. Scientists discovered PCP had a calming effect when it was given to animals, which suggested that it could have an anesthetic property. As a result of this, PCP went to clinical trials for use as an anesthetic. It was relatively safe because higher doses were not fatal, however people came out of PCP anesthesia in a psychotic state. It was therefore never approved for use as an anesthetic but there remained a desire for a drug that produced an immediate and transient anesthetic effect without the danger of fatal overdose; this prompted drug companies to synthesize various analogs of PCP.
This led to the synthesis of ketamine which was found to act like PCP, except it was much shorter acting and lacked the psychotic after effects. Shortly after it was synthesized it went into the market, just as the Vietnam War was raging. The qualities of the drug meant it that it could be used by medics to very quickly put individuals under anesthesia safely without the need for a surgical suite. That’s essentially how it got started and the recreational use followed shortly after. It has gone up and down in terms of where it’s used, how often it’s used, but it very much stemmed from the Vietnam era in terms of popularizing its use as a recreational drug.