The Cornell rape case has put ketamine in the spotlight. What is it? - USA Today

New York prosecutors have reopened a sexual assault investigation at Cornell University after a young woman accused members of a fraternity of raping her in October 2024.

The woman, known anonymously as Jane Doe, alleged that she was pressured to use the anesthetic drug ketamine with multiple fraternity members, along with using marijuana and drinking alcohol before the seven fraternity members allegedly assaulted her.

The plaintiff claimed that she was pressured into snorting the white powder multiple times throughout the night, and that a number of the fraternity members snorted ketamine off of her body, according to reporting from the Cornell Daily Sun.

Ketamine has garnered the nickname “Special K” and has notoriously been abused as a party drug. The dissociative anesthetic has received new attention amid the assault case at Cornell.

Here’s what to know about ketamine and what it does to the brain.

Ketamine is a dissociative anesthetic that has some hallucinogenic effects, according to the U.S. Drug Enforcement Administration.

It binds to the NMDA receptors in the brain and is essentially a “stop” signal. It starts to interfere with the connection between your brain and your body. 

The effects are dose-dependent, but it generally leads to a “disconnected” feeling from you, your person – and your body. Symptoms range from unconsciousness to an “out of body” experience or hallucinations. 

Ketamine is not an opioid. Ketamine works by suppressing glutamate signaling in the brain.

The body's endogenous (naturally occurring) opioid system helps regulate things like pain, stress and mood. Opioids "hijack" this system by binding to the same receptors.

Ketamine is a legal medication and is used as an injectable, short-acting anesthetic for use in humans and animals, according to the DEA.

Esketamine, a ketamine derivative sold under the brand name Spravato, is FDA-approved as a nasal spray to treat depression in adults, according to the National Institute on Drug Abuse. Ketamine has also been used off-label in dozens of clinics across the U.S. to treat other mental health conditions, such as anxiety, in combination with talk therapy.

However, most of the ketamine distributed in the United States is done so illegally, according to the DEA. It's often diverted or stolen from legitimate sources, like veterinary clinics, or smuggled into the country.

Ketamine is classified as a Schedule III drug by the agency, which denotes substances "with a moderate to low potential for physical and psychological dependence."

Dr. Ryan Marino, a medical toxicologist, emergency medicine physician and associate professor at Case Western Reserve School of Medicine in Cleveland, Ohio, previously told USA TODAY that ketamine is considered a general anesthetic, but can be used for many different medical purposes. 

“Ketamine was primarily developed for anesthesia for surgical procedures, and it is still used for that indication today. It is also used as a general sedative – so for people who are on ventilators or if they have some other kind of critical illness and need continuous medication for comfort and sedation,” Marino said.

He added that it’s also used in the emergency department for some minor procedures like treating fractures and dislocations. It can also be used to sedate agitated people who are at risk of harming themselves or others.

Ketamine has recently received attention because of the role it played in actor Matthew Perry’s death. Perry was using ketamine under the care of a physician for the treatment of depression, although the levels of ketamine in his system at the time of his death weren’t related to his last infusion. Elon Musk has also discussed using ketamine.

Doctors say ketamine therapy for depression and anxiety can provide life-saving support in instances where other medications have failed. But there are risks involved, including the potential for dependence when improperly administered. Ketamine works by stimulating the brain’s resilience mechanisms, Chair of Psychiatry at Yale School of Medicine John Krystal previously told USA TODAY. The chemical targets a different system in the brain than standard antidepressants, triggering the release of glutamate, which stimulates the growth of new synapses between brain cells. 

“The detrimental effect on the brain of growing up with severe treatment-resistant depression is far worse than the whatever risk that we associate with the very sporadic dosing of these low doses of ketamine,” Krystal said. However, he adds there’s little research about ketamine therapy’s effect on young adults, and as such, it should be a last resort.

Marino told USA TODAY that generally, the risk of addiction is low since people don’t get the same kind of tolerance as with some drugs associated with long-term dependence like opioids. However, the risk is not zero.

Ketamine is a tool in a medical professional's belt for the treatment of pain. Like all medications, there are benefits and risks associated with it. The best practice is to be as informed and prepared as possible so you can make the best decisions for your health and well-being.

Delaney Nothaft contributed reporting.

Rachel Hale’s role covering Youth Mental Health at USA TODAY is supported by a partnership with Pivotal and Journalism Funding Partners. Funders do not provide editorial input. Reach her at rhale@usatoday.com and@rachelleighhale on X.