Mis-anaesthetized society: expectancies and recreational use of ketamine in Taiwan

Chao-Ming Chang,Tat Leong Wu,Lien-Wen Su,Te-Tien Ting,Wei J Chen,Chuan-Yu Chen

doi:10.1186/s12889-019-7616-1

Abstract

BackgroundThe popularity of ketamine for recreational use has been increasing in Asia, including Taiwan. Still, little known about the pattern of ketamine expectancies and whether such patterns are related to ketamine use. This study aimed to examine whether the positive and negative ketamine expectancies are differentially associated with ketamine-using behavior, and whether such relationship may differ by early-onset use of tobacco or alcohol.MethodsParticipants were recruited using respondent-driven sampling (RDS) among regular tobacco and alcohol users, aged 18 to 50, residing in Taipei from 2007 to 2010. Totally 1115 participants (with an age distribution skewed to the right, median = 26; interquartile range: 22–32) had information on substance use and completed a 12-item ketamine expectancies questionnaire (with 6 positive and 6 negative statements). Using two axes of High and Low expectancies, the four combinations of binary positive and binary negative ketamine expectancies were created. Each participant’s drug-using experience was categorized into illicit drug naïve, exclusive ketamine use, polydrug ketamine use, or other illicit drug use. Using the weights in the network output by RDS Analysis Tool, multivariable logistic regression analysis was then conducted.ResultsThe weighted prevalence was 2.4% for exclusive ketamine use, 9.0% for polydrug ketamine use, and 9.1% for the other illicit drug use. Ketamine users (11.4%) had greater positive expectancies and lower negative expectancies, particularly the combination of High Positive with Low Negative, as compared to the illicit drug-naïve or other illicit drug users. After adjustment for early-onset tobacco (or alcohol) use and sociodemographic characteristics, High Positive, Low Negative, and their combination of High Positive-Low Negative expectancies remained strongly associated with ketamine uses, without evidence of moderation from early-onset use of tobacco or alcohol.ConclusionsPositive and negative ketamine expectancies were associated in opposite directions with ketamine use, independent of early-onset use of tobacco or alcohol. Our results indicate ketamine expectancies as possible targets for future intervention and prevention of ketamine use, with a less confrontational feedback on decreasing an individual’s positive expectancies is essential in preventing young people from the initiation of ketamine use.

Highlights

Ketamine, synthesized as a dissociative anesthetic in the 1960s, was initially used for surgical anesthesia during the Vietnam War [1]
The increasing popularity of ketamine was found among adolescents surveyed via street outreach [24] and young adults ascertained by respondent driven sampling (RDS) during the period of 2007–2010 [25]
This study aimed to examine whether the positive and negative ketamine expectancies are differentially associated with ketamine-using behavior, and whether such relationship may differ by early-onset use of tobacco or alcohol

Summary

Introduction

Ketamine, synthesized as a dissociative anesthetic in the 1960s, was initially used for surgical anesthesia during the Vietnam War [1]. In Taiwan, the popularity of ketamine surged since early 2000s. Comparing two series of national surveys among school-attending adolescents, the most commonly consumed illicit drugs or inhalants changed from methamphetamine, sniffing glue, and flunitrazepam in the early 1990s [22] to ecstasy, ketamine, and marijuana in the period from 2004 to 2006 [23]. The increasing popularity of ketamine was found among adolescents surveyed via street outreach [24] and young adults ascertained by respondent driven sampling (RDS) during the period of 2007–2010 [25]. The popularity of ketamine for recreational use has been increasing in Asia, including Taiwan. This study aimed to examine whether the positive and negative ketamine expectancies are differentially associated with ketamine-using behavior, and whether such relationship may differ by early-onset use of tobacco or alcohol

Objectives

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Conclusion