Ketamine Addiction: Signs, Symptoms, Risks, and Treatment Resources

Ketamine is a dissociative, hallucinogenic substance with many surgical and medical applications. First synthesized in the 1960s, the FDA approved ketamine in the 1970s as an anesthetic for surgical purposes. It has also been explored as a treatment for depression in recent years, in addition to being misused as a recreational drug.[1,2]

What is Ketamine?

Ketamine is a dissociative anesthetic that can induce feelings of detachment from one’s physical environment, along with distorting sensory perception. Classified as a hallucinogen, ketamine is approved as an injectable anesthetic for both humans and animals and is also medically approved as esketamine (Spravato), a nasal spray for treatment-resistant depression.[3] When used outside the medical realm, ketamine can come in pill, powder, or liquid forms.

Owing to its growing popularity as a recreational drug, ketamine usage has been steadily increasing in the US. Around 1.2% of high school seniors have taken the drug in the past year in 2022.[4]

Ketamine is currently classified as a Schedule III drug under the DEA Controlled Substances Act, which signifies that it carries less risk for abuse than Schedule I drugs (like heroin) or Schedule II drugs (like cocaine). Nevertheless, abuse of ketamine or any Schedule III substances can still lead to physical or psychological dependence on the drug.[5]
Common nicknames for ketamine include Cat Valium, K, Special K, and Vitamin K.

Side Effects of Ketamine

Ketamine usage can result in several potential side effects when taken in short or long-term duration. These effects can vary depending on the individual and the dosage taken.

Short-term effects may include:

• Feelings of disorientation
• Confusion
• Slow motor functioning
• Dizziness
• Blurred vision
• Nausea or vomiting
• Increased blood pressure and heart rate
• Potential visual or auditory hallucinations
• A general feeling detached from yourself, your surroundings, or environment

Long-term side effects of ketamine use may include:

• Psychological dependence
• Damage to the structures of the nose (if ingested nasally)
• Damage to the kidneys and liver
• Respiratory issues
• Stomach pain
• Memory issues
• Overdose

Furthermore, long-term and recreational ketamine usage (and ketamine addiction) has been associated with lower gray matter volume and less white matter integrity in the brain. Long-term and recreational ketamine use can increase the chances of developing other co-occurring conditions, such as mood or additional substance use-related disorders.[6]

Learn About Other Substance Use Disorders

How is Ketamine Taken?

For medically approved use, doses of ketamine are typically given in either an injectable form or as a nasally administered spray. When used recreationally, ketamine can be swallowed, snorted, or injected and is also commonly mixed into other substances to be smoked or consumed. Ketamine’s effects may be experienced within one minute if injected, 5–15 minutes if snorted, and up to 30 minutes later if swallowed.[7]

Ketamine Quick Reference

Statistics on Ketamine Use, Misuse, and Addiction

The 2022 Monitoring the Future study reported a prevalence of ketamine usage among 12th-grade students at 1.3% in 2020, 0.9% in 2021, and 1.2% in 2022.[8]

Six deaths were reported as being related to ketamine and ketamine-related substances from 2019 to 2021.

Effects of Ketamine Abuse

Misusing ketamine can result in several negative effects on one’s health in both the short and long term, including the potential for overdose. Additionally, ketamine is often combined with other substances, which can lead to other potentially dangerous symptoms.

Ketamine withdrawal symptoms are less severe than other substances. Many of the symptoms are psychological, although physical dependence is possible. However, such symptoms are usually accompanied by strong cravings, which can be difficult to manage. Impaired memory and brain function from ketamine use may increase the risk of accidental overdose due to difficulty in recalling previously taken doses.[9]

Can You Overdose on Ketamine?

Yes, overdosing on ketamine is possible and can result in severe consequences if medical attention is not obtained, particularly when combined with other illicit substances.

Signs and Symptoms of Ketamine Overdose

Some of the signs and symptoms of a ketamine overdose can include:

• Confusion
• Agitation
• Irregular heart rate and breathing
• Paralysis
• Seizures
• Paranoia
• Hallucinations
• Excessive sedation
• Loss of consciousness

What to do if you suspect someone is overdosing on ketamine

If you suspect a ketamine overdose, call 911 immediately.

Dangers of Long-Term Ketamine Use

When used or abused long-term, ketamine can lead to a substance use disorder.[10] In addition, you may experience the potential long-term physical and mental challenges and ongoing risk of overdose associated with long-term ketamine use.

Mixing Ketamine with Other Drugs

Combining ketamine with other drugs can carry serious consequences, as this places individuals at a greater risk for overdose. When individuals combine ketamine and other substances, it may make them less aware of their current levels of intoxication, increasing the risk of an overdose. Many ketamine users will mix the substance with stimulants, alcohol, or other hallucinogens, all of which are dangers due to the increased risk of passing out, asphyxiation, and over-intoxication, along with potential overdose and fatal complications.

Ketamine Use Disorder

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), someone may be diagnosed with ketamine use disorder (classified as a hallucinogen use disorder) if they meet at least 2 of the following criteria over a 12-month period:[11]

• Ketamine is often taken in increasing amounts or over a longer period of time than was intended
• There is a consistent desire or unsuccessful efforts to cut down on ketamine use
• A large amount of time is spent in activities necessary to obtain ketamine or recover from using
• Cravings to use ketamine
• Recurrent ketamine usage results in a failure to fulfill your obligations at work, school, or home
• Continued ketamine use despite ongoing social or interpersonal problems arising from usage
• Important social, work-related, or recreational activities are given up or reduced as a result of ketamine use
• Recurrent ketamine use in situations where doing so is dangerous (such as driving a car)
• Ketamine use is continued despite one’s awareness of having a persistent/ recurrent mental or physical problem that is likely to have been caused by ketamine
• Tolerance, as defined by either:

• A need for increasing amounts of ketamine
• A lessening effect with the previous, typical amount of ketamine

Is Ketamine Addictive?

While ketamine is known to be psychologically addictive, it is less commonly associated with physical dependence compared to other substances like opioids.
While ketamine is primarily understood to be psychologically addictive, users of the drug can also experience physical dependence and withdrawal, both of which may necessitate medically assisted detoxification to cease use safely.

Signs of Addiction to Ketamine

Some of the potential signs of ketamine addiction can include:

• An increase in tolerance, requiring higher doses for the same effects
• Compulsive behavior
• Cravings to use ketamine
• Signs of withdrawal (anxiousness, restlessness, irritability, potential seizures)

Ketamine Addiction and Mental Health

Frequent use of ketamine can cause disruptions in overall mood, functioning, and outlook, creating vulnerability for additional, potential co-occurring conditions (such as depression or anxiety).

Co-Occurring Disorders

Individuals struggling with substance use disorders are also at risk for developing one or more concurrent mental health conditions or chronic diseases.

Some of the more common co-occurring disorders seen in individuals with a diagnosed substance use disorder include:

• Anxiety disorders
• Mood disorders (depression, bipolar disorder, etc.)
• Posttraumatic stress disorder (PTSD)
• Attention deficit hyperactivity disorder (ADHD)

Common Substances Mixed with Ketamine

Ketamine can often be combined or cut with other agents, ranging from other hallucinogens (such as MDMA) to stimulants (cocaine) and even opioids (heroin, fentanyl).

Ketamine Addiction Treatment

Treatment for ketamine addiction will normally begin with a medically supervised detox program where providers can assess, monitor, and treat any severe withdrawal symptoms in a safe environment. Patients will then usually go on to engage in a structured inpatient treatment protocol to work on the underlying factors of their ketamine addiction, along with providing treatment for any potential co-occurring disorders and additional medical needs they may have.

The time and cost of ketamine treatment will vary as it depends on significant influences, including the severity of the addiction, the duration of treatment, and your overall health and wellness.

Ketamine Addiction Treatment Levels of Care

• Detoxification: A place to safely manage withdrawal symptoms under medical supervision
• Inpatient Treatment: Focus on your recovery in a peaceful, supportive environment without the distractions of daily obligations.
• Therapy: One-on-one mental health counseling with a licensed provider can help explore the underlying issues contributing to ketamine addiction and develop strategies for recovery, along with helping to address any potential co-occurring mental health/substance use issues that may also be present
• Group therapy: Group therapy offers a safe and supportive environment where you can connect with your peers, share experiences, and gain insights from others who are facing similar challenges
• Support groups: Participating in support groups provides an ongoing sense of community and guidance for maintaining your sobriety in the long term
• Aftercare programs: Aftercare programs offer ongoing support, relapse prevention strategies, long-term counseling, and other resources to sustain long-term recovery after the initial phase of treatment is complete

The overall length and cost of ketamine addiction treatment will vary depending on several factors, including your own individualized needs and the treatment provider you engage with.

Therapies Used in Ketamine Addiction Treatment

Several modalities may be utilized in the treatment of ketamine addiction, which can include:

• Cognitive behavioral therapy (CBT), which helps people identify negative thought patterns to think more positively and constructively
• Holistic Treatment Approaches: These emphasize treating the entire person, focusing on integrating physical, mental, and spiritual health. Holistic interventions like Reiki, yoga, smudging, sound healing, meditation, music therapy, Ayurveda, massage therapy, and physical fitness training benefit a holistic recovery process.
• Group therapy: Group therapy allows individuals to process their experiences and gain new insights in the supportive environment of their peers, facilitated by a licensed professional.

How to Find Ketamine Addiction Treatment in Connecticut

The process of identifying and accessing quality treatment services for ketamine addiction in Connecticut can be overwhelming, especially when you or a loved one is struggling—but there are several avenues by which to seek help.

Most substance use and co-occurring treatment facilities accept several kinds of insurance, so it’s always recommended that you contact your insurance provider to identify which treatment resources are in-network for you.

Additionally, several useful resources can help link you to qualified treatment providers in your area of the state, including:

• The Connecticut State Department of Mental Health and Addiction Services
• 211/United Way of Connecticut
• SAMHSA’s National Helpline
• 988 Connecticut

Finally, it’s important to research treatment centers and resources by reading online reviews and speaking to potential providers to get a feel for the kinds of services they offer, what kinds of treatment modalities they provide, and how they structure their treatment (both during and after the initial phases) to feel secure and comfortable with taking the best path ahead for you.