ketamine and painKetamine is a dissociative anesthetic used to treat chronic and acute pain. In addition to working as an anesthetic, this drug’s dissociative properties have made it popular as a “club drug”. Abuse of ketamine leads to a distortion of the user’s perceptions, including sight and sound, as well as feelings of detachment. Many users experience hallucinations.

When used for medical purposes, ketamine is injected in liquid form. People who abuse this drug typically evaporate the injectable liquid into a fine white powder that is then snorted or ingested. Illicit ketamine is typically diverted from pharmacies and veterinary clinics.

Ketamine Tolerance and Addiction

Ketamine abuse typically begins as recreational drug use. Most people who abuse ketamine were introduced to the drug in a social setting, rather than through medical means. Tolerance to ketamine, in which the body requires higher doses of the drug in order to achieve the desired effect, can develop very rapidly. This can lead an individual to quickly begin using larger and larger amounts of the drug with increasing frequency.

Many people who abuse this drug fall into a “binge” pattern of abuse, in which the drug is used repeatedly within a short amount of time, in order to prolong its effects. A single dose of ketamine will typically only affect the user for approximately 30 minutes. The amount of time it takes for the drug to take effect is dependent on the method of use. Snorting ketamine will cause an effect in 5-15 minutes, while oral ingestion takes effect after 5-30 minutes.

It is unclear whether or not addiction to ketamine involves a physical dependence on the drug. While some people may experience drug cravings when attempting to stop use of ketamine, few physical withdrawal symptoms have been reported. According to the Journal of Psychoactive Drugs, addiction to ketamine may have similarities to cocaine addiction, in which the individual experiences cravings and a high drug tolerance, but does not display any symptoms of a physical withdrawal syndrome. Most of the difficulty in ceasing ketamine use seems to stem from high tolerance and a psychological dependence on the drug.

Effects of Ketamine Abuse

The effects experienced when using ketamine are dependent on the dosage used and the tolerance of the individual. According to the Center for Substance Abuse Research (CESAR), lower doses of ketamine produce a sensation of floating, dissociation (detachment from your environment or yourself), and hallucinations. Hallucinations can be visual, auditory, or tactile.

The effects experienced from a large dose of ketamine are commonly referred to as a “K-hole”. This term refers to the experience of being almost fully sedated, but still conscious. This can include effects like slowed respiration, dizziness, muscle spasms, difficulty speaking, nausea, and vomiting. The sedation resulting from large doses of ketamine has made this drug one of the better known “date rape” drugs, which are substances used to facilitate sexual assault.

Ketamine can have a large number of physical effects on the user, including:

  • Flashbacks
  • Difficulty with memory
  • Lowered motor functioning
  • Hallucinations and disorientations
  • Tachycardia (increased heart rate)
  • Loss of touch with reality
  • Poor coordination
  • Muscle spasms or rigidity
  • Feelings of invulnerability
  • Aggressive and violent behavior

Long-term effects

Long-term ketamine abuse can cause severe and sometimes irreparable damage to the body and brain. A study published by the British Journal of Clinical Pharmacology reports that damage to the bladder and renal system and memory deficits are common effects of sustained ketamine abuse.

Brain damage is among the most common, and most severe, results of chronic drug abuse. Some brain damage can be repaired or improved over time if sobriety is maintained; some damage, however, can have lasting consequences. A study from Frontiers in Neuroanatomy, which used magnetic resonance imaging to track changes to the brains of individuals who had been abusing ketamine for six months to 12 years, found that chronic ketamine abuse leads to damage throughout the brain.

In addition, the destruction of the lower urinary tract is a serious problem faced by individuals who have abused ketamine for several years. Damage to the renal system is typically irreversible. Ceasing use of the drug as soon as possible is the best approach to stopping the continued degradation of the urinary tract. Bladder function will sometimes improve slightly after stopping drug use; however, severe problems can result in the need for invasive surgeries to repair the damage.

Treating Ketamine Addiction

An addiction to ketamine is treated in similar ways as addictions to other substances. There are currently no FDA-approved medications for the treatment of addiction to drugs like ketamine; treatment primarily takes the form of talk and behavioral therapy.

People who are addicted to ketamine are often also addicted to other substances, such as cocaine or opioids. Treatment for an addiction should address all present addictions, as well as any mental health disorders and physical conditions that might be contributing to the addiction. Ultimately, addiction treatment should address the entire person on every level and not just the addiction issue.

The Substance Abuse and Mental Health Services Administration (SAMHSA) lists several different components of addiction treatment that can be utilized. Most people will receive a combination of these services throughout their treatment program. Recovery is highly individualized, and what works for one person may not work for another, so the appropriate methods of treatment can vary widely between plans. Common components of addiction treatment include:

  • Counseling, including individual therapy and group therapy
  • Inpatient or residential treatment
  • Intensive outpatient or partial hospitalization care
  • Case management
  • Peer support or 12-Step programs
  • Ongoing aftercare

There are many different methods of behavioral therapy. Several different modalities have been shown by scientific studies to be effective in treating addiction, including Cognitive Behavioral Therapy, Contingency Management, Motivational Enhancement Therapy, and 12-Step facilitation therapy. Often, individuals benefit from recovery programs tailored to specific populations, such as women, teens, or the LGBTQ community. It can be helpful to have the support of others in treatment who can relate to the issues you’re going through in your recovery and in your life.

Comprehensive Care

Ketamine addiction is a complicated issue, and additional research is always forthcoming. High tolerance to and strong cravings for the drug can make it difficult to stop using on your own, but professional treatment can make recovery a reality for you. The key is a comprehensive approach that addresses each person on an individual level. With the right approach and the right care, you can leave ketamine in your past and embrace a better future.