What Hustlers’ Ketamine-MDMA Drug Cocktail Would Really Do

Photo: Courtesy of STX Films.
In one of Hustlers’ funniest scenes, Destiny (Constance Wu) and Ramona (Jennifer Lopez) cook up a drug concoction in Destiny’s kitchen — and then test it. Of course, they end up lying flat on the floor next to each other, unbelievably high. After they perfect this mix — 40% ketamine and 60% MDMA — they take the powder out on the town where they shake it into wealthy men’s drinks. Under the influence, these men willingly run up their credit cards, share their social security numbers, and don't remember much the next day. Though there are a few mis-steps, the plan works pretty much perfectly — at first. But would a MDMA-ketamine combo really work like this?
The 2015 New York magazine article on which the movie is based doesn’t include the exact breakdown of the ketamine/MDMA mixture, but describes a similar process. The women slip potential marks “a special drink spiked with MDMA and ketamine.” Rosie, one of the women involved, described the amount as, “Just a sprinkle. Like a pinch of salt.” Writer Jessica Pressler summarized, “The MDMA made the guys happy, the ketamine screwed with their memory, and they often ended up blacking out.”
First, let’s look at each drug individually. MDMA, also called molly, is taken in either pill or powder form. It’s a “party drug” that works by flooding the brain with the neurotransmitter serotonin. The feeling of being high on MDMA has been described as “the instant right before orgasm.” In controlled environments, researchers are testing MDMA’s potential use in treating PTSD.
Of course, there are risks: potential side effects include memory deficits and confusion, as well as teeth grinding, jaw-clenching, sweating, blurred vision, and hyperthermia. Users have described a comedown period of paranoia and low self-image that can sometimes last for multiple days. An overdose can lead to abnormal heart rhythms, high or low blood pressure, lockjaw, panic attacks, hallucinations, seizures, and, in rare cases, death.
Ketamine, also called K or Special K, is another party drug. It’s a dissociative drug that’s used as an anesthetic in veterinary medicine. It blocks NMDA glutamate receptors, which are involved in creating memories and learning. Users report feeling like their minds are disconnected from their bodies. It can also cause hallucinations, amnesia, lack of coordination, and confusion. High doses can lead to a “K-hole” — an intense experience in which people feel completely detached from their bodies and may hallucinate. Some regard this as a spiritual experience, while others feel panicked or terrified.
Other risks include “ketamine bladder” (damage to the lining of the bladder leading to frequent urination, or a painful inability to urinate), anxiety, and headaches. In clinical settings, researchers are studying ketamine’s ability to treat depression, bipolar disorder, and suicidal ideation. Earlier this year, the FDA approved a nasal spray that contains ketamine for use treating depression. 
In fact, many people intentionally combine ketamine and MDMA — it’s sometimes called “kitty flipping.” One Reddit user described experiencing “crazy hallucinations,” which were a “great end to the night.” Another wrote, “It was easily the most ‘on drugs’ I've ever felt, and I've done a lot of drugs.” They described “an almost overwhelming euphoria,” dissociation, and “laughing about the literal dumbest shit.” 
Both MDMA and ketamine can lead to memory loss, meaning that the Hustlers storyline makes sense. But according to Lucas Richert, Associate Professor at University of Wisconsin-Madison School of Pharmacy and author of Strange Trips: Science, Culture, and the Regulation of Drugs, the women wouldn’t be able to count on the mixture working the same every time. “I'd say that the effects would be highly variable. The size of the dose matters. As does the purity of the drug itself,” he tells Refinery29. “Mix in alcohol (likely lots in the movie) and you have quite a strange brew.” 
This turns out to be true as on-screen hustlers find out that some of the men retain better memories than others… but you'll have to watch the movie to find out more about that.

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