{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:34:01Z","timestamp":1780936441056,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T00:00:00Z","timestamp":1594080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007281","name":"National Drug and Alcohol Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007281","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015539","name":"Australian Government","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015539","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Ketamine is used for anaesthesia, sedation and the treatment of mood disorders, but is also widely used for non\u2010medical purposes. This study aimed to: (1) determine the characteristics and circumstances of all recorded cases of self\u2010administered ketamine\u2010related death in Australia, 2000\u201319 and (2) determine the toxicology and major organ pathology of cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective study of all Australian cases in which self\u2010administered ketamine was a mechanism contributory to death, retrieved from the National Coronial Information System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Australia\u2010wide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Cases<\/jats:title><jats:p>Sixty\u2010eight cases, with a mean age of 35.2\u00a0years (standard deviation\u00a0=\u00a011.5, range\u00a0=\u00a016\u201363), 76.5% male.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Information was collected on cause of death, demographics, circumstances of death, toxicology and major organ pathology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Death was attributed to toxicity in 82.3% of cases (accidental, 58.8%; deliberate, 23.5%), suicide by violent means (8.8%) and traumatic accident (8.8%). In six cases the decedent had been prescribed ketamine. In 32.4% the final route of ketamine administration was by injection. The fatal incident predominantly occurred in a private environment (72.1%). Ketamine was present in the blood of 90.1% and other biomarkers in the remainder. The median blood ketamine concentration was 0.2\u00a0mg\/l (0.02\u20136.9\u00a0mg\/l). Other drugs were detected in 95.5% of cases: opioids (59.1%), hypnosedatives (57.6%), psychostimulants (50.0%), alcohol (27.3%), \u0394\u20109\u2010tetrahydrocannabinol (18.2%), antidepressants (28.8%) and antipsychotics (9.1%). Pulmonary oedema was present in 82.2% of cases that underwent autopsy and pneumonia in 26.7%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The typical case of self\u2010administered ketamine\u2010related death in Australia, 2000\u201319, was a male in his mid\u201030s who had used multiple drugs, with the fatal incident most commonly occurring in a private setting. Death due to accidental drug toxicity was the most common manner of death, but suicide was highly prevalent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.15154","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T11:29:55Z","timestamp":1592047795000},"page":"339-345","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Characteristics and circumstances of death related to the self\u2010administration of ketamine"],"prefix":"10.1111","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8718-7055","authenticated-orcid":false,"given":"Shane","family":"Darke","sequence":"first","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5863-635X","authenticated-orcid":false,"given":"Johan","family":"Duflou","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney NSW Australia"},{"name":"Sydney Medical School University of Sydney  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7008-8130","authenticated-orcid":false,"given":"Michael","family":"Farrell","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Peacock","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5946-2144","authenticated-orcid":false,"given":"Julia","family":"Lappin","sequence":"additional","affiliation":[{"name":"National Drug and Alcohol Research Centre University of New South Wales  Sydney NSW Australia"},{"name":"School of Psychiatry University of New South Wales  Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,7]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Goodman & Gilman's The Pharmaceutical Basis of Therapeutics","author":"Brunton L.","year":"2011"},{"key":"e_1_2_7_3_1","volume-title":"Karch's Pathology of Drug Abuse, 5th edn","author":"Karch S. 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