A therapy session between a patient and therapist discussing cocaine and ketamine misuse.

The Dangers of Mixing Cocaine and Ketamine

Mixing cocaine and ketamine, often called “Calvin Klein” or “CK”, carries extremely high risks; however, the combination of the two drugs, and each drug individually, is becoming ever more popular among young people and in nightlife, the Health Service Executive warns. This page explains what happens when these two drugs are combined or consumed at the same time, the dangers for both physical and mental health, and the treatment options available at Smarmore Castle for anyone struggling with this combination.1

What Happens When You Mix Cocaine and Ketamine?

Mixing cocaine and ketamine, a practice referred to as taking “Calvin Klein” or a “designer cocktail,” is becoming more common in club and party settings. People often mix these two drugs to balance the stimulant effects of cocaine with ketamine’s sedative properties. This combination can place excessive strain on the heart, potentially leading to significant health complications.2

How Do Cocaine and Ketamine Interact in the Body?

Mixing ketamine and cocaine (also known as cocaine and ketamine polydrug use) overwhelms the central nervous system. The stimulant drugs increase adrenaline and dopamine, while ketamine depresses respiratory and neurological activity. This tug-of-war puts serious strain on the heart and brain, increasing the likelihood of overdose, seizures, or sudden death.3

Short-Term Effects

Taking both cocaine and ketamine can produce:

  • Severe confusion
  • Intense hallucinations and paranoia
  • Poor coordination and blurred vision
  • Risk of cardiac arrest, seizures, and unconsciousness3,4

Long-Term Consequences

The risks of using ketamine with cocaine over a long-term period can lead to both physical and psychological disorders. The constant dopaminergic surge and neurological disruption increase the risk of addiction, relapse, and deterioration of mental health. This pattern of polysubstance use complicates treatment and recovery.5

Questions About Polydrug Use?

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Recognising the Signs of Cocaine and Ketamine Misuse

Behavioural and Psychological Symptoms

  • Secretiveness, lying, or erratic behaviour
  • Rapid mood swings and irrational thoughts
  • Isolation from friends or family
  • Increased engagement with illicit drugs

Physical Health Indicators

  • Nosebleeds, sniffling, or nasal damage from cocaine use
  • Unsteady gait, blurred speech, or slumped posture from ketamine use
  • Visible weight loss and signs of physical exhaustion
  • Track marks or other evidence of drug misuse

The Risks of Repeated Poly-Drug Use

Repeatedly mixing cocaine with ketamine or other substances significantly raises the risk of overdose, long-term brain damage, and death. Many individuals take higher doses unknowingly, due to the effects of one drug masking the effects of the other.

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When to Seek Professional Help

If you or someone you know is misusing more than one drug, it’s crucial to seek support. Warning signs like changes in mood, physical health, or behaviour could signal a developing substance use disorder. Support groups, therapy, and professional detox can lead to safer outcomes. Treatment for cocaine and ketamine use disorder is available at Smarmore Castle. Contact our team to find out more.

Cocaine and Ketamine in Ireland: A Growing Concern

  • Street Names and Trends (“CK” or “Calvin Klein”)

    This drug combination is often referred to as “CK”, “Calvin Klein”, or a designer cocktail that is known as the new “Speedball”. It has gained popularity in nightlife circles where recreational drug use is often normalised. The influence of alcohol and other substances compounds the danger.3

  • Patterns of Use Among Young Adults

    Many young people experiment with stimulant drugs like cocaine alongside depressant substances such as ketamine. This form of polydrug use increases the risk of developing serious mental health disorders, including addiction and depression.3

  • The Overlap with Trauma, Mental Health, and Nightlife Culture

    There is a well-documented connection between trauma, mental health, and substance use. People may turn to drugs to escape feelings of pain, anxiety, or emotional numbness. Unfortunately, this can lead to a dangerous cycle of dependence and deteriorating physical and psychological health.

Treatment for Cocaine and Ketamine Misuse at Smarmore Castle

All assessments, as well as all detox and therapies at Smarmore Castle for cocaine and ketamine treatment, are conducted under the direct supervision of qualified health professionals. Our clinical team includes registered medical practitioners, qualified nursing staff, and licensed therapists who maintain current professional registration with appropriate regulatory bodies. Every aspect of your care, from initial assessment through to discharge planning, is overseen by qualified professionals with relevant expertise in addiction medicine and mental health.

During detox and treatment from both cocaine addiction and ketamine addiction, our team takes your personal circumstances into account to ensure you receive the right support when withdrawing and recovering from these substances. Our multidisciplinary team will assess your situation closely throughout your treatment, and consideration will be given to all aspects of substance use and dual diagnosis concerns.

  • Medical Detox: Safe Withdrawal Management

    Smarmore Castle offers supervised detox for patients misusing two or more drugs. Our clinical team helps manage withdrawal symptoms and ensures patients are physically stable before starting further treatment.

  • Group and Individual Therapy Models, CBT, DBT

    Our therapeutic approach combines evidence-based models like CBT and DBT with personalised care plans. This method supports patients in identifying triggers, developing healthier responses, and improving emotional regulation.

  • The Importance of Long-Term Abstinence from All Substances

    True recovery begins with complete abstinence from mind-altering substances. Our programme emphasises avoiding all forms of drug abuse, including illicit drugs, prescription medications, and alcohol.

  • Trauma-Informed and Holistic Treatment Approaches

    Our trauma-informed model addresses underlying emotional wounds that often lead to substance use. We also integrate holistic therapies, such as mindfulness and physical wellness practices, to support long-term health.

  • Family Support and Continuing Care

    Addiction affects the entire family. We offer therapeutic support for loved ones and ongoing care planning to help ensure recovery continues long after discharge.

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Why Choose Smarmore Castle?

  • Over 35 years’ experience treating addiction and polydrug use
  • Expert knowledge in managing cocaine use disorder and ketamine abuse
  • Compassionate, confidential, evidence-based care

At Smarmore Castle, you’ll find a clinically led residential programme for people experiencing polysubstance addiction, when more than one substance is used at the same time or in close succession. The clinical team provides careful medical management and therapy tailored to the complexities of mixed substance use, focusing on the physical, emotional and psychological effects of combined substances. With a structured, evidence-based treatment model and a peaceful, private setting, the programme supports long-term recovery through abstinence, personal responsibility and peer-supported community.

If you or someone you care about is struggling with polysubstance use, call 041 986 5080 to speak confidentially with a member of the admissions team. Help is available

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Recovery from cocaine mixing and polysubstance use is possible with the right care and support. At Smarmore Castle, we provide a safe, therapeutic environment where patients can begin their recovery journey with a strong foundation. No matter how complex your substance use feels, recovery is always within reach.

Local Self-Help Resources

If you are looking for free local resources in your area that can help provide support during your recovery from cocaine and ketamine use, Narcotics Anonymous (NA) offer meetings all across Ireland. If you need to talk to someone confidentially, the Samaritans provide support over the phone, by text, and by email.

Frequently Asked Questions

  • What are Calvin Klein drugs?

    The “Calvin Klein” drug is a dangerous street name for the combination of cocaine and ketamine. This mix combines stimulant and depressant effects in ways that significantly increase the risk of overdose and death.

  • How dangerous is it to mix uppers and depressants?

    Mixing uppers and depressants, such as cocaine with ketamine or prescription medications, severely disrupts your body’s normal functioning. This combination can lead to overdose, unconsciousness, or death – often without warning.

  • Is addiction to both cocaine and ketamine treatable?

    Yes. While dual addiction presents unique challenges, treatment is not only available but highly effective when approached with expertise and compassion. Smarmore Castle offers specialised care for people struggling with addiction to both cocaine and ketamine.

  • What does detox from cocaine and ketamine involve?

    Detox involves safely removing both substances from your body under expert medical supervision. Withdrawal symptoms vary from person to person, but our trained staff provides round-the-clock support to manage discomfort and prepare you for the therapeutic work ahead.

  • Does ketamine use cause long-term damage?

    Yes, long-term ketamine use can result in serious and sometimes permanent damage, including urinary tract complications, cognitive decline, liver problems, and worsened mental health. However, with proper treatment, many of these effects can be managed or improved.4

  • How do I talk to someone I love about their drug use?

    Choose a calm moment when you won’t be interrupted to speak honestly and compassionately. Avoid judgment or accusations, express your genuine concern, and encourage them to consider professional help. Remember, you can’t force someone into recovery, but you can plant seeds of hope and show them that help is available when they’re ready.

Statistics on Cocaine and Ketamine Use

  • Acute hospital discharges increased with a cocaine-related diagnosis from 1·4 in 2000 to 24·3 in 2023 (per 100,000 population).
  • Ketamine has become a popular nightlife drug that is known to cause feelings of disconnection from your own body and your surroundings, and cause feelings of detachment and hallucinations, which increases the risks in public spaces.
  • Addiction services have issued a warning regarding the increase in ketamine use in Ireland.
  • Ireland ranks amongst the highest in Europe for cocaine use.
  • Cocaine is currently the largest ‘problem’ drug in Ireland, with around 40% of all treatment cases in 2024.6
  • Since 2017, cases involving treatment for cocaine have increased by over 250%.6
  • Polydrug use (mixing substances) occurred in 3 in 5 cases in 2024, with 36.7% reported as mixing with cocaine.6
  • Although used less frequently than cocaine, ketamine is growing in popularity and is now the fourth most commonly used recreational drug.7
  • One study from 2019 demonstrated that 63% of respondents had used ketamine at a gathering within the year.7

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