Ketamine Abuse: Addiction, Effects, and Treatment

Ketamine is a dissociative anesthetic that was approved for use by the U.S. Food and Drug Administration (FDA) in 1970.^1-2 While it’s widely used for anesthetic procedures in humans and animals—and was the most common anesthetic used in the Vietnam War—ketamine has more recently been employed to manage treatment-resistant depression and has been proposed for treating chronic pain, bipolar disorder, and anxiety.^1-3

That said, ketamine, which is a derivative of phencyclidine (PCP), is also utilized as a recreational drug to produce euphoric and dissociative effects, which users have described as “out of body experiences” and feeling as if they’re “melting into their surroundings.”^2-4 Ketamine has also been employed as a so-called date-rape drug to immobilize victims.⁵ 

In 1999, pharmaceutical ketamine became a Schedule III controlled substance under the Controlled Substances Act. In addition to its therapeutic effects, ketamine has a potential for misuse, which can increase the risk of experiencing several potentially unwanted effects, including both physical and psychological dependence.¹

Compared to potentially less accessible drugs such as cocaine, ketamine offers a lower price point and appears to be growing in popularity as an illicitly obtained drug. However, according to recent national survey results, nonmedical misuse is still relatively low, as 0.7% of the U.S. population uses ketamine illegally.²

Read on to explore the effects of ketamine, signs of ketamine use disorder, and insights on how to get help if you or someone you know is struggling with ketamine use.

What Is Ketamine?

Pharmaceutical ketamine is a drug used for anesthesia and sedation in specific medical procedures. When injected for this purpose, it works quickly and wears off within 30 minutes, making it well-suited for emergencies and short-duration procedures. Additionally, it has sometimes been utilized off-label (i.e., employed for uses not authorized by the FDA) for various pain management scenarios and for treating depression and suicidal thinking. Another form of the drug known as esketamine is FDA approved as an adjunctive therapeutic for treatment-resistant depression.⁶

Known by various street names—e.g., K, vitamin K, special K, cat tranquilizer, jet—ketamine is sometimes illicitly misused for intoxicating effects similar to PCP.^1,3 Producing distorted perceptions of sight and sound along with a feeling of disconnection, relaxation, and amnesia, ketamine sometimes makes users feel detached from pain and their environments.¹ Thus, ketamine’s hallucinogenic and dissociative effects make it a popular recreational drug.^1,3 And thanks to its odorless and tasteless nature—and the fact that it can produce amnesia-like effects—sexual offenders sometimes add it to drinks to enable sexual assaults.⁷

While pharmaceutical ketamine is legally manufactured, much of the illicit supply of the drug is diverted—oftentimes stolen from veterinary clinics—for illegal distribution and use. The drug is typically available in a white or off-white powder form or as a clear liquid. The liquid variety can be transformed into a powdered form via evaporation, which creates crystals that are then ground into powder.¹

According to the U.S. Drug Enforcement Administration (DEA), liquid ketamine is generally mixed into drinks or injected while powdered ketamine tends to be packaged in capsules, paper, aluminum foil folds, glass vials, and plastic bags. Powdered ketamine is usually snorted or mixed into tobacco or marijuana cigarettes and smoked.¹

Delayed Effects of Ketamine Use

According to the National Institute on Drug Abuse (NIDA), ketamine use is also linked to the following physical and mental effects, which may not occur immediately after use:⁵

• Bladder pain and ulcers
• Kidney issues
• Chronic stomach pain
• Depression
• Longer-term memory deficits

Drug Combination Effects

According to the NIDA, ketamine used in combination with alcohol can increase the risk of certain adverse effects.⁵ And based on Ketamine Toxicity, a book made available by the National Library of Medicine, the following potentially dangerous ketamine effects may occur—most often in relation to overdose, when ketamine is combined with other drugs, and via overly rapid administration:³

• Slow, shallow breathing, temporary pause in breathing (aka apnea)
• Low blood pressure, slow heart rate
• Heart attack
• Seizure
• Stupor (near unconsciousness), coma

Ketamine Overdose and Withdrawal

While an overdose of ketamine can lead to dangerously slow breathing and unconsciousness, ketamine overdose is relatively rare.^1,3 Additionally, ketamine is one of a few mind-altering drugs with considerably low (<1%) serious-complication rates.³

Once ketamine use ceases, the individual may experience withdrawal symptoms, such as anxiety, depression, and craving. However, compared to alcohol and opioids, physical withdrawal symptoms of ketamine, such as shaking, heart palpitations, and sweating, are not as common.² Currently, there are no FDA-approved medications to treat ketamine overdose, but there are some options available to manage psychosis and agitation.³

Ketamine Abuse and Addiction

Ketamine is legally recognized as having the potential for abuse and for both psychological and physical dependence.¹ People who use ketamine report that the short-lasting, highly euphoric effects and its role as an access point into social interactions make it particularly difficult to stop using.²

If you or a loved one are misusing ketamine, there are signs to help you recognize when it becomes problematic. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 5^th edition), the signs of a ketamine use disorder can include:⁸

• Taking increasingly larger amounts of the substance or extending its use over longer periods of time than intended.
• Ongoing desire or ineffective efforts to decrease use.
• Spending considerable time trying to obtain the substance, use it, and/or recover from its effects.
• A strong desire or craving to use the drug.
• Failing to fulfill obligations related to work, school, household, etc. as a result of use.
• Continued used regardless of related social and interpersonal issues.
• Abandonment of social, recreational, or employment activities in favor of substance use.
• Recurrent use in hazardous situations (e.g., operating machinery, driving).
• Continued use after developing a physical or psychological issue related to the substance.
• Developing tolerance (i.e., the need for significantly increased amounts of the substance to achieve the desired effect and/or a diminished effect for the same amount of substance).

Ketamine Abuse, Treatment, and Rehab

Treatment for ketamine use disorder  and other substance abuse disorders (SUDs) usually involves a combination of behavioral therapeutic approaches and other psychosocial interventions.⁹

However, treatment options should be tailored to each individual. In fact, matching treatment options (e.g., interventions, services, locations) to each person’s needs is critical to their success.¹⁰

If you or someone you love is struggling with ketamine misuse or another substance use disorder, call to speak to a treatment navigator.