Alcohol and special K — formally known as ketamine — can both be found in some party scenes, but that doesn’t mean they go well together.

Mixing booze and ketamine is risky and potentially life threatening, even in small amounts.

Healthline does not endorse the use of any illegal substances, and we recognize abstaining from them is always the safest approach. However, we believe in providing accessible and accurate information to reduce the harm that can occur when using.

It depends on how much you’ve taken and what symptoms you’re experiencing.

The first thing to do is stay calm, and let someone you trust know what you’ve taken. If you’re alone, call a sober friend to come and stay with you.

Keep an eye out for the following signs and symptoms. If you or someone else experiences any of them, call 911 or your local emergency services number:

If you’re concerned about law enforcement getting involved, you don’t need to mention the substances used over the phone. Just be sure to tell them about specific symptoms so they can send the appropriate response.

If you’re caring for someone else, get them to lay slightly on their side while you wait. Have them bend their top knee inward if they can for added support. This position will keep their airways open in case they begin to vomit.

Ketamine is a dissociative anesthetic and sedative. It carries its own risks and downsides when used without medical supervision. But things get much riskier when you combine ketamine with a central nervous system (CNS) depressant like alcohol.

Here’s a look at some of the specific effects of mixing alcohol and ketamine.

Cognitive effects

Alcohol and ketamine both affect cognition. When combined, they can lead to a rapid decline in your ability to move or communicate properly. This is why ketamine is sometimes used as a date rape drug.

These cognitive effects can also make it harder for you to process just how much each drug is affecting you, which is more likely to lead to overdose. Plus, not being able to move or communicate can make it impossible to ask for help.

Slowed breathing

Ketamine and alcohol can cause dangerously slowed breathing. In higher doses, it can cause a person to stop breathing.

Slow, shallow breathing can make you feel extremely tired and confused. It can also make you pass out. And if you vomit while passed out, it puts you at risk for choking.

If someone’s breathing is slowed for too long, it can result in coma or death.

Cardiovascular effects

Ketamine is linked to several cardiovascular effects. Combined with alcohol, the risk of heart trouble is even higher.

Cardiovascular effects include:

In higher doses, ketamine and alcohol can cause stroke or cardiac arrest.

Bladder issues

Ketamine has been linked to lower urinary tract issues, including hemorrhagic cystitis, which is inflammation of the bladder.

Bladder issues from ketamine are so common that they’re collectively known as ketamine bladder syndrome.

In some cases, the damage to the urinary tract is permanent.

Based on an online survey of people who recreationally use ketamine, those who drank while using ketamine were much more likely to report bladder issues, including:

Along with CNS depression and the other risks we just covered, there are more ketamine risks to be aware of. Entering what’s known as a K-hole is one of them.

K-holing is described as an out-of-body experience of sorts. Some people enjoy it and compare it to an enlightening spiritual event. For others it can be frightening.

The comedown can be pretty rough, too. For some, the comedown is accompanied by:

  • memory loss
  • aches and pains
  • nausea
  • depression

Long-term ketamine use can cause:

Mixing ketamine and alcohol is very dangerous. If you’re going to use them, it’s best to keep them separate.

If you do find yourself combining them, though, there are a few things you can do to make things a tad safer.

For starters, it’s crucial to recognize when things go south.

Here’s a refresher on signs and symptoms that warrant calling for emergency help right away:

Here are a few other things to keep in mind:

  • Test your K. Ketamine is a controlled substance that can be hard to get. There’s a chance that what you have is counterfeit and contains other substances. Use a drug test kit to make sure you know what you’re taking.
  • Don’t eat for an hour or two before starting. Nausea and vomiting are common effects of intoxication. Your chances of it are a lot higher when mixing alcohol and ketamine. Avoid eating for 1 to 2 hours before starting. Try to remain upright to reduce the risk of choking on your vomit.
  • Keep your dose low. This goes for the K and the alcohol. They work synergistically, which means the effects of both will be enhanced. Keep your dose really low to reduce the risk of overdose, which is possible even with low doses.
  • Don’t do it alone. The effects of ketamine are unpredictable enough, but adding alcohol makes them even more so. Have a sitter with you the entire time. Your sitter should be sober and not using ketamine but be familiar with its effects.
  • Choose a safe setting. The chances of being unable to move or communicate are high when you combine ketamine and alcohol. This puts you in a vulnerable position. Choose a safe and familiar setting.

Healthline does not endorse the use of any illegal substances, and we recognize abstaining from them is always the safest approach.

However, we believe in providing accessible and accurate information to reduce the harm that can occur when using. If you or someone you know might be struggling with substance use, we recommend learning more and consulting a professional to get additional support.

The risk of overdose is high when you combine even small amounts of ketamine and alcohol. Both substances also have a high potential for dependence and addiction.

If you’re concerned about your drug or alcohol use, you have a few options for getting confidential support:

Adrienne Santos-Longhurst is a freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.