The term ‘kitty flipping’ might initially evoke images of playful cats or risque activities, but its true meaning is far more hazardous than one might imagine.

Recent findings from a comprehensive study of Australia’s wastewater have highlighted a concerning trend: ketamine consumption has surged by more than double over the past four and a half years.

But what exactly does ‘kitty flipping’ entail, why is its popularity on the rise, and what makes it so dangerous?

In recent years, the recreational use of ketamine has seen a significant increase in Australia, aligning with its escalating popularity in the United States, even among Hollywood celebrities.

Originally developed as a pharmaceutical anaesthetic, ketamine is valued for its dissociative effects and has found use in treating severe pain and depression.

When administered properly in medical settings, ketamine is known for being both safe and effective.

When used correctly in a hospital setting, it’s considered very safe and effective.

In 2020, detections of ketamine in Australia’s wastewater were largely consistent with those kinds of prescribed uses, according to today’s research by a team from Adelaide University.

But that soon changed.

“Patterns started emerging of substantially elevated excretion on weekends, suggesting an increase in recreational, or non-medical use of the substance,” explained Professor Cobus Gerber from the university’s School of Pharmacy and Biomedical Sciences.

Gerber and his team have studied the wastewater of Australia’s major cities and regional centres in every state and territory from 2020 through to 2025.

In December 2020, ketamine use averaged 2.7mg per day for every 1000 people but by April 2025, that had risen to 5.8mg per day – more than double.

The largest doses were found in affluent areas and inner city locations.

But why are people mixing it with MDMA?

Combining ketamine with other drugs isn’t new.

“The drug is often consumed alongside other illicit substances to heighten feelings of euphoria and dissociation,” explained Gerber.

However, online search data in Australia shows a recent rise in searches for the term ‘kitty flipping’.

This specifically refers to combining ketamine with MDMA, ususually by taking MDMA first and then snorting or ingesting ketamine although sometimes combined pills or drinks are used.

Why is ‘kitty flipping’ so dangerous?

Any unprescribed use of ketamine comes with risks, but the typical harm reduction strategies for using single drugs (start low, stay hydrated, test your drugs) cannot account for the way the drugs interact.

For example, MDMA raises body temperature and heart rate, while ketamine impairs the body’s ability to regulate its temperature.

When combined, this can result in an extremely high and unstable body temperature.

The combination of the two illicit drugs can also cause a potentially deadly build up of serotinon in the body, as well as place enormous strain on the heart.

To make things worse, MDMA slows digestion, so the high can hit later or harder than expected.

In Miami alone, 68 people died from an overdose with ketamine in their system in 2023. Prior to 2017, that number was fewer than 10.

Experts are now urging more research be done in Australia to track down where these drugs are originating from.

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