Introduction. Ketamine is an essential medicine used as an anesthetic in low andmiddle-income countries and in veterinary medicine. Recreational use is widespreadthroughout the world, especially owing to its lower price compared to other substances.In Western countries its use has been mainly linked to subpopulations of young peoplewho use drugs recreationally. Ketamine misuse is associated with amnesia, dependence,dissociation, lower urinary tract dysfunction and poor impulse control. Regular ketamineuse is associated with abdominal pains.Aims. The aims of this study are to analyze characteristics and main symptoms of ketamineabusers attending emergency departments (EDs) in the metropolitan area of Bologna,Emilia-Romagna Region, northern Italy.Methods. We identified 74 records of ketamine-related visits: 30% female; 22% nonnatives;mean age 25.6 years. Forty-two percent reported ketamine use alone, 46% reportedthe use of other illegal substance (cocaine 19%, heroin 18%), 26% alcohol misuse.Results. The most common reported symptoms were neurological (soporous state 18%,agitation 14%, confusion 7%, panic attacks 7%, mydriasis 7%, tremors 7%), gastro-intestinal(abdominal pain 15%, vomiting 11%), urological (6.8%) and cardiac (palpitations5%, chest pain 5%). Complications secondary to falls and cuts (7%) were the mostfrequent trauma complications. We highlight a significant number of visits regardingsuicide attempts (10%) and overdose (4%).Conclusions. The results highlight a particular population of problematic ketamine usersidentified using the hospital’s ICT system. In particular, poly-drug users who consumeketamine in combination with heroin or cocaine presenting to the ED representa specific target for targeted prevention projects on non-lethal overdoses and suicideattempts
