Ketamine Risks, Side Effects, and Treatment

While ketamine has a relatively low chance of addiction, it's potential for abuse has increased in recent years. It's a popular club and festival drug that can have serious adverse effects, even from short-term use.
Evidence Based
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What is Ketamine?

Ketamine is an anesthetic drug used in surgeries on both humans and animals. It is a dissociative drug that alters a person’s awareness of their surroundings, thoughts, and feelings. There are two types of hallucinogens, including:

  • Classic hallucinogens (such as LSD and psilocybin)
  • Dissociative drugs (such as ketamine and PCP)

Both types cause hallucinations or images and feelings that seem real even though they are not.

Most often, ketamine that is sold on the streets comes from veterinary offices. It is an injectable liquid that is evaporated into a white powder and is snorted or compressed into pills.

Street names for ketamine include:

  • Cat Valium
  • Vitamin K
  • Special K

In March 2019, the Food and Drug Administration approved the use of ketamine to treat major depression. Esketamine is a nasal spray prescribed by a doctor that reduces suicidal thoughts or actions and relieves other serious symptoms of depression. Racemic ketamine, the injected form used as an anesthetic, is also used off-label to treat depression. The dose used to treat depression is much lower than the dose used for anesthesia.

A study from 2018 found an estimated 5.6 million people (12 and older) were past-year users of hallucinogens. This is about 2 percent of the U.S. population.

National Survey on Drug Use and Health (NSDUH)
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Risks of Ketamine

Currently, more research is required to fully understand how ketamine works in the brain to produce hallucinations. Most likely, ketamine is binding to NMDA receptors in the brain. This binding generates more of a neurotransmitter, glutamate, in between neurons. Glutamate then activates AMPA receptors, leading to the release of other chemicals that allow neurons to communicate with one another.

The process above is called synaptogenesis, and can affect mood, cognition, and thought patterns. It is the likely culprit for the cause of hallucinations when taking ketamine.

People use ketamine for a variety of reasons, such as recreational and social purposes like having fun and coping with stress. Others may use it for its hallucinogenic properties to have “visions” of higher powers or achieve an enlightened sense of thinking and being.

If someone takes a high dose of ketamine, they may experience a “K-hole” or terrifying feelings of almost complete sensory detachment. This experience can be compared to a bad LSD trip and is a highly unpleasant sensation.

Graphic of person being sick or having side effects.

Side Effects of Ketamine

Due to its dissociative properties, the most common short-term side effect of ketamine is hallucinations. Other side effects include:

  • Disorientation and loss of coordination
  • Increase in blood pressure, body temperature, and heart rate
  • Numbness

12 percent of patients who were administered ketamine as an anesthetic report experiencing:

  • Pleasant dream-like states
  • Hallucinations
  • Vivid imagery
  • Emergence delirium (during the transition from unconsciousness to being fully awake)
  • Confusion
  • Excitement

When someone takes a high dose of ketamine, they can experience other, more serious side effects such as:

  • Panic and anxiety
  • Seizures
  • Memory loss
  • Psychotic symptoms
  • Amnesia
  • Mood swings
  • Trouble breathing
  • Inability to move

The long-term effects of dissociative drugs can last for a year or more after use stops. These include:

  • Memory loss
  • Weight loss
  • Anxiety
  • Speech problems
  • Depression and suicidal thoughts

If someone takes too much ketamine at once, an overdose can occur and result in respiratory depression (difficulty breathing).

Graphic of woman going through withdrawal.

Addiction Symptoms

Ketamine is classified as a Schedule III controlled substance by the Drug Enforcement Administration. These drugs are defined as, “drugs with a moderate to low potential for physical and psychological dependence.”

However, it is possible to become addicted to ketamine due to long-term use. Physical and psychological dependence develop as a result of someone taking ketamine for an extended period of time. A person who uses ketamine daily will need to continue taking it to feel like themselves and function normally. Tolerance also develops over time, and individuals will often increase their dose in order to feel the same effects.

Addiction is characterized by a set of symptoms involving drug use and behavior. Someone who is addicted to ketamine might be unable to stop using it, may continue to do so despite knowing it is harmful, and may have cravings when not taking it. Symptoms of ketamine addiction include:

  • Anxiety
  • Disorientation
  • Insomnia
  • Psychotic episodes
  • Hallucinations
  • Flashbacks
  • Dysphoria

When drug use is stopped, the body experiences shock and exhibits symptoms of withdrawal. These symptoms can be uncomfortable and sometimes dangerous. The Food and Drug Administration states that withdrawal syndrome with psychotic features has been reported after prolonged ketamine use is discontinued.

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Treatment

There are currently no available FDA-approved medications to treat ketamine addiction. Behavioral therapy offered at qualified addiction centers can be an effective option for addressing addiction and the underlying causes.

Individuals who abuse Ketamine often do so in combination with other drugs, such as alcohol, which can become dangerous. This is referred to as polysubstance abuse. Treatment is also available to address polysubstance abuse.

Overcoming addiction to ketamine is difficult to do alone. Find treatment today.


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Resources

Drug Enforcement Administration. “Drug Scheduling.” DEA, https://www.dea.gov/drug-scheduling

Food and Drug Administration. “KETALAR (ketamine hydrochloride) injection.” FDA, https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/016812s040lbl.pdf

Meisner, Robert C. “Ketamine for major depression: New tool, new questions.” Harvard Medical School, May 2019, https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673

National Institute on Drug Abuse. “Common Hallucinogens and Dissociative Drugs.” NIDA, Feb. 2015, https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-dissociative-drugs

National Institute on Drug Abuse. “What are hallucinogens?” NIDA, Apr. 2019, https://www.drugabuse.gov/publications/drugfacts/hallucinogens

Substance Abuse and Mental Health Services Administration. “2018 National Survey on Drug Use and Health Annual National Report.” SAMHSA, Aug. 2019, https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

Zorumski, Charles F., Izumi, Yukitoshi, Mennerick, Steven. “Ketamine: NMDA Receptors and Beyond.” The Journal of Neuroscience, vol. 36, no. 44, 2016, pp. 11158-11164. https://www.jneurosci.org/content/jneuro/36/44/11158.full.pdf

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Updated on: June 24, 2020
Author
Addiction Group Staff
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