{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T11:04:40Z","timestamp":1772190280735,"version":"3.50.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T00:00:00Z","timestamp":1622246400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Ketamine is a dissociative anesthetic used in veterinary and human medicine since the 1970s. Its clinical use has expanded to control of seizures, by pre-hospital emergency medical services (EMS), and is finding new purpose as an analgesic alternative and antidepressant. Ketamine brings hope for effective management of chronic pain in the absence of opioids and decreasing suicidal ideations; however, its persistence as a recreational drug for its hallucinogenic properties remains. In the wake of expanding medicinal purposes, the diversity of New York City\u2019s population was explored to better understand its misuse. This retrospective study looks at the prevalence of ketamine in driver fatalities over a period of 18\u2009years (2003\u20132020) and cases involving suspected driving under the influence of drugs (DUID) over a period of 6\u2009years (2015\u20132020). Ketamine was identified in 6 driver fatalities and in 47 DUID cases. None of the driver fatalities were suspected of ketamine misuse, due to administration either in hospital or by EMS. In the DUID cases, an increasing trend was observed over the 6-year study period with 100% (n\u2009=\u200947) of the cases confirmed as non-hospital\/non-EMS administered ketamine. Of the DUID cases, 94% were male with the majority between the age of 21 and 39\u2009years (85%) and were predominantly Hispanic (36%) and Asian (34%). Blood concentrations of ketamine ranged from 27 to &amp;gt;2000\u2009ng\/mL with polydrug use prevalent. The most common drug classes detected in addition to ketamine were cannabinoids (38%), ethanol (32%), benzodiazepines (26%), cocaine (19%) and amphetamines\/3,4-methylenedioxymethamphetamine (15%). In 2019, 2-fluoro-deschloroketamine was identified in two cases for the first time. Despite its increased acceptance for mental health disorders, ketamine\u2019s persistence and misuse as a recreational drug remains and should continue to be monitored by relevant toxicological, clinical and law enforcement communities along with emerging illicit ketamine analogs.<\/jats:p>","DOI":"10.1093\/jat\/bkab057","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T03:32:05Z","timestamp":1622259125000},"page":"799-806","source":"Crossref","is-referenced-by-count":17,"title":["Increasing Prevalence of Ketamine in Drivers in New York City Including the Identification of 2-Fluoro-Deschloroketamine"],"prefix":"10.1093","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7996-769X","authenticated-orcid":false,"given":"Elba","family":"Arango","sequence":"first","affiliation":[{"name":"Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison","family":"Toriello","sequence":"additional","affiliation":[{"name":"Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoila","family":"Rosario","sequence":"additional","affiliation":[{"name":"Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8637-8674","authenticated-orcid":false,"given":"Gail","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,5,29]]},"reference":[{"key":"2021091705521144000_R1","article-title":"Drug-Impaired Driving: Marijuana and Opioids Raise Critical Issues for States \u2013 May 2018","author":"Governor\u2019s Highway Safety Association","year":"2018"},{"key":"2021091705521144000_R2","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1038\/aps.2016.5","article-title":"Ketamine use in current clinical practice","volume":"37","author":"Gao","year":"2016","journal-title":"Acta Pharmacologica Sinica"},{"key":"2021091705521144000_R3","article-title":"Consistent With Nationwide Trends, Overdose Deaths Rise in New York City in First Quarter of 2020","year":"2020"},{"key":"2021091705521144000_R4","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1007\/978-3-030-42917-1_26","volume-title":"Principles of Forensic Toxicology","author":"Jenkins","year":"2020","edition":"5th 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