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Los Angeles Times - December 3, 2001

http://www.latimes.com/news/local/l...es%2Dcalifornia

Health: Erin Rose, 18, suffered brain damage after taking the anesthetic ketamine. Experts are alarmed by its growing popularity.

By JENIFER RAGLAND and WILLIAM LOBDELL, TIMES STAFF WRITERS

The tattered photo shows Erin Rose and her boyfriend hugging on the beach. It was taken before her overdose and the brain damage she now suffers, and has become a kind of security blanket for her.

But the damage is so severe that Rose, 18, often forgets where she has put the snapshot. This is one of those times, and it triggers momentary panic until she finds it in a back pocket.

He's the one who gave me 'Special K,' " she says, pointing to the smiling teenager who now goes to college back East. "He's the one who saved my life. He gave me CPR," she adds, unaware of the irony. The drug that put Rose in this condition is ketamine, a chemical cousin to PCP that is known to its users as Special K. It has become increasingly popular in California's youth rave culture. And casual use of the drug, a powerful anesthetic used for major surgery on the battlefields of Vietnam, is a growing concern for law enforcement officials, drug counselors and emergency-room doctors.

Ketamine can cause respiratory failure and is becoming more widely used as a "rape drug" because of its quick-acting nature and the inability to detect it in drinks, authorities said.

"We've never seen this kind of abuse with the drug, and recent research is showing it's addicting, and that it causes brain damage," said Los Angeles County sheriff's narcotics Det. Glen Stanley, a club drug expert. "There's a huge gap between reality and the information the kids in the rave scene are getting."

Rose, who lives in Laguna Niguel, snorted ketamine with her boyfriend one night in May at a Newport Beach condo. She had tried it at least once before at a rave party. Within seconds, as her boyfriend watched television, Rose's lungs stopped working; her body convulsed. The boy, also high on the drug, gave her CPR.

But for eight minutes, she did not take a breath. It took three electric shocks by paramedics to get her heart going again.

The lack of oxygen to her brain caused severe damage. It took two weeks for her to begin to come out of her coma. It would be a few more weeks before she could do anything as simple as eat a bowl of pudding. Today, in many ways, mentally and physically, she has only advanced to the toddler stage.

Rose had been a straight-A student, an honored employee at Starbucks and a talented athlete. But she also fought depression, had bulimia and experimented with drugs.

Her parents have only been able to piece together parts of what happened the night of May 12 from Rose's boyfriend, police and doctors. Many details, including who actually purchased the ketamine, remain unclear.

"I had gone through in my mind the thought of Erin dying," said her mother, Maryanne Rose, a former PTA president. She now wants to warn other parents about the dangers of ketamine.

"I never thought of this in between," she said, "this kind of limbo. The daughter I knew is dead. She's gone."

Statistics on the use of ketamine are hard to come by because systems in place track only those who are arrested or who land in the emergency room, drug experts said.

While there have been ketamine-related arrests throughout California, many police officers still do not know what the drug is, Stanley said. Its white powder form makes ketamine difficult to distinguish from more common drugs such as methamphetamine or cocaine, he said, and the effects displayed by the user make it easy to mistake for PCP.

Also, it is found almost exclusively in the rave culture, where people hide it in special compartments built into their pants, hats and shoes. They also smuggle ketamine into dance parties in sealed candy containers or dissolved in water bottles.

"Law enforcement on the whole is not really familiar with this rave culture and how kids are hiding these drugs," Stanley said. "We're starting to do more training, and word is getting out, but we're always playing catch-up."

But one recent report by the Drug Abuse Warning Network, a project of the federal Substance Abuse and Mental Health Services Administration, shows increased use. Although ketamine cases were reported only 19 times in hospital emergency rooms in 1994, the drug came up 263 times last year.

Still used legally by veterinarians to sedate cats, ketamine is known on the street, in addition to its "Special K" nickname, as "Vitamin K" or "cat Valium." In humans, the drug causes hallucinations, delirium, impaired motor function and, as in Rose's case, respiratory problems that can cause severe brain damage, even death. From 1994 to 1998, 46 deaths associated with the drug were reported by 140 medical examiners who participate in the Drug Abuse Warning Network.

Ketamine comes in liquid form and is cooked in microwaves, on stove tops and even on car heaters to dry it into powder form for users to snort.

Most of the supply in Southern California is smuggled from Mexico, according to federal law enforcement authorities. In other parts of the country, ketamine has been stolen from animal hospitals.

Ketamine has a mix of stimulant, sedative, anesthetic and hallucinogenic properties, said Ronald K. Siegel, a UCLA psychopharmacologist. It can also produce severe flashbacks.

"It is a very unusual drug," Siegel said. "It gives you a sense of being apart and separate, which means you are separated from the pain."

Users have also described the sensation--dubbed a "K-hole"--as an out-of-body experience, or one in which the rest of the world seems on the other end of a tunnel.

That quality made it a useful anesthetic during the Vietnam War, especially for napalm accident victims, Siegel said. And the drug is still used on humans occasionally in burn wards.

Though new in its popularity among ravers, ketamine has been used as a recreational drug for decades. Originally known as "green," it was discovered in the 1960s and '70s--mostly by hard-core drug users--before it became illegal to possess.

In August 1979, Timothy Leary, the former Harvard professor and '60s psychedelic drug guru who urged his generation to "turn on, tune in and drop out," was arrested on suspicion of cocaine possession after police found what turned out to be ketamine in his Beverly Hills apartment.

Twenty years later, in 1999, the U.S. Drug Enforcement Administration labeled ketamine a controlled substance and listed it as one of the agency's 14 "drugs of concern."

But the penalties, established in California in 1991 when the local rave scene was in its infancy, are still not harsh. The law singles out ketamine possession as only a misdemeanor, while other street drugs, such as cocaine, carry felony charges.

Though ketamine is rising in popularity, its harder edge still makes it less attractive to ravers than other drugs such as Ecstasy, LSD, or GHB. In fact, its presence as a "club drug" has perplexed some experts.

"It's weird that people enjoy a drug that gives them such a bad feeling," said Dr. James Keany, an emergency room physician at Mission Hospital Regional Medical Center in Mission Viejo, where he has seen young people on ketamine suffering from anxiety-provoking hallucinations, usually involving images of death.

Raves--parties marked by thumping, electronic dance music and elaborate light shows--are tailor-made for drugs like Ecstasy and LSD, which are perceived as heightening the senses, Stanley said.

Taking ketamine would not make you want to dance, he said, but it fits in with the culture of the scene. It also attracts users because the high lasts only about 45 minutes, compared with the effects of LSD or PCP, which can last several hours.

"The average raver is 14 to 25 years old, and that's the age group that is very willing to take risks," Stanley said. "Ketamine is a risky drug."

In higher dosages, experts said, the drug can make a person immobile, which is why ketamine is included among the so-called "rape drugs" such as GHB, or gamma hydroxybutyrate. There are several known cases of ketamine being connected with rapes, said Trinka Porrata, a former Los Angeles police officer often used as an expert witness in club-drug cases.

"Unlike GHB, it doesn't make you unconscious, but you wouldn't be able to resist an attack and you wouldn't necessarily remember anything that happened," she said.

And when taken over extended periods of time, ketamine can become psychologically addictive, drug experts and counselors warn.

"From what I've seen, it's highly addictive," said Jose Rodriguez, a program counselor with Action, a parent and teen support program with groups and treatment centers from Hollywood to Ventura. "We have a few kids in our program battling it right now."

One of them, a 17-year-old Simi Valley boy, said he got hooked on the drug before many of his peers knew what it was.

At the time, he said, it didn't show up on most basic drug tests. The high came on quickly, and after taking one hit he said he felt drunk, stoned and on hallucinogens all at once.

He has been trying to quit the drug for several months, he said, after three years of staying out all night going to raves and hip-hop parties. Twice a week, he would drive to Mexico to buy it.