Thank you for helping us research our forthcoming book about ketamine...

* please answer truthfully & feel free to leave out any questions you’re not comfortable with.

* feel free to include any extra information, opinions or anecdotal evidence that you feel will help us.

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1.	Are you male or female? 

2.	How old are you?

3.	Where do you live? (City, County/State, Country please)

4.	How long have you been a user of the drug?

5.	Have you found that you have developed a tolerance with repeated use?

6.	How long do you think that you will carry on using ketamine?

7.	How do you take it? (Snorting, i.v., i.m., orally, rectally)

8.	Do you use other drugs besides k?

9.	How often do you take k & in what amounts? (I.e. a few lines occasionally, a litre on a week-long bender, etc.)

10.	Do you feel that you have (or have ever had) a dependence on the substance?

11.	What do you feel are the benefits of use?

12.	What do you think are the negative effects of use?

13.	Do you think that using k has affected your life overall a) positively, b) negatively or c) neutrally? Explanations welcome.

14.	Have you ever suffered any health problems arising from use, if so, what? (e.g. “k cramps”, bladder problems, mood swings, psychosis, etc.) 

15.	Where do you generally take k? (I.e. a club, rave, your house, outside, etc.)

16.	How much do you pay for ketamine (per gram, litre or vial please)

17.	Do you feel that the laws in your country relating to k are fair & proportional?

18.	Do you feel that public health services in your country are well informed & capable of dealing with issues relating to ketamine use?   

19.	Do you think that drug dependence agencies in your country are properly prepared for helping habitual ketamine users?

20.	Do you think that the government in your country provides fair & accurate information about k?

21.	Do you know what brands of ketamine you consume? (please list if so)

22.	Do you know which country the ketamine that you consume originates from?

23.	Do you know what kind of drug it is? (E.g. dissociative, tranquiliser, hallucinogen, etc.).

24.	How many types of k are you aware of? Please list.

25.	Are you aware of the differences between the ketamine isomers (S+, S-, R+, and R-)?

26.	Are you aware that some brands of k also contain anti-cholinergics (& that these may add to the effects of the drug / be harmful to humans)?

27.	How would you describe your experiences with k overall?

28.	Would you say that use of the drug has affected your belief system / view of reality? If so, in what way?

29.	Please list any slang names that you know for ketamine or k users.