Ketamine Addiction and Effects


Ketamine is a dissociative anesthetic that’s used extensively in veterinarian medicine but also has a variety of specialized therapeutic uses in emergency medicine, pediatrics and pain management.1,2 It is also being explored for its potential to help manage depression and post-traumatic stress disorder.3,4

Ketamine is used illicitly as a “club drug,” primarily by teenagers and young adults.5 The 2019 Monitoring the Future Survey published by the National Institute on Drug Abuse (NIDA) reported that 0.7% percent of high school seniors had tried ketamine at least once in the past year.6

Street names for Ketamine include Special K, K, Kit Kat, Cat Valium, Super Acid, Special La Coke, Purple, Jet, and Vitamin K.5 It may be distributed in a clear liquid form or in a white or off-white powder.7 When abused, it is most often snorted, but ketamine may also be injected, smoked (often in a tobacco or marijuana cigarette), or, rarely, swallowed as a pill.1 It is sometimes added to drinks as a date-rape drug. 6

Short-Term Effects of Ketamine

Ketamine is a hallucinogenic drug that has dissociative and anesthetic effects at varying degrees. The effects last approximately 30 to 60 minutes.5

At low doses, ketamine produces distortions of reality, sedation, and a feeling of being disconnected from oneself.1 Larger doses intensify this, and the severe dissociative state is often referred to as a “K-hole.”1

Ketamine’s use as a date rape drug is attributed to its amnesiac effects, wherein the user may not remember the events that transpired while under its influence.9

The short-term effects of ketamine intoxication include:10

  • Increased heart rate.
  • Increased blood pressure.
  • Chest pain/heart palpitations.
  • Disorientation.
  • Feeling of being disconnected from oneself
  • Sedation.
  • Memory lapses.
  • Hallucinations.
  • Immobility or inability to move.
  • Slowed breathing.
  • Involuntary eye movement
  • Salivation.
  • Dilated pupils.
  • Muscle stiffening.
  • Tearing up.
  • Nausea.
  • Abdominal pain/tenderness.
  • Vomiting.

Ketamine is often used in concert with other drugs or alcohol, which could intensify some of the effects to potentially deadly results.2,10 Combining Ketamine with alcohol, opioids or benzodiazepines will enhance each drug’s respiratory depressant effects.2,10  Co-ingestion of ketamine and stimulants, like cocaine and amphetamines, can enhance the cardiovascular effects of each drug, and potentially lead to heart attack or stroke.2,10

Health Concerns of Long-Term Abuse

Regular long-term ketamine use has been shown to cause lesions and atrophy in parts of the brain.11 Impairments in both short- and long-term memory have been noted in frequent ketamine users.1

Long-term use has also been associated with stomach problems, bladder pain, ulcers, kidney problems, and depression.6

Tolerance to ketamine develops rapidly, which means that at repeated dosing an individual will need to take more of it in order to keep feeling its effects.1,2 Increasing the dosage of ketamine may raise the risk that a person may develop a physical or psychological dependence on the drug, and there’s evidence showing that frequent Ketamine users experience strong cravings once stopping the drug.1 Although stopping the habit of ketamine is well-documented in frequent users, evidence doesn’t yet show that there’s a ketamine-specific withdrawal syndrome.1,2

Treatment for Ketamine Addiction

The severity of a person’s dependency on ketamine will determine the level of treatment required to treat the addiction. If Ketamine is being misused alongside alcohol or other drugs, medical detox may be necessary. Supportive medications such as anti-depressants may be useful. Inpatient or outpatient behavioral therapy will focus on identifying and changing maladaptive behaviors that have resulted in the compulsive use of ketamine (and any other substances of abuse). Mutual help groups can also enhance recovery by encouraging the formation of a healthy network of peers who can support each other in sobriety.

Addiction is a treatable disease, and with the right level of care and support, recovery is within reach.

References

  1. Morgan, C. J., Curran, H. V., & Independent Scientific Committee on Drugs (2012). Ketamine use: A review. Addiction, 107(1), 27–38.
  2. European Monitoring Centre for Drugs and Drug Addiction. (2002). Report on the risk assessment of ketamine in the framework of the joint action on new synthetic drugs.
  3. Wilkinson, S. T., Ballard, E. D., Bloch, M. H., Mathew, S. J., Murrough, J. W., Feder, A., Sos, P., Wang, G., Zarate, C. A., Jr, & Sanacora, G. (2018). The Effect of a Single Dose of Intravenous Ketamine on Suicidal Ideation: A Systematic Review and Individual Participant Data Meta-Analysis. The American Journal of Psychiatry, 175(2), 150–158.
  4. Liriano, F., Hatten, C., & Schwartz, T. L. (2019). Ketamine as treatment for post-traumatic stress disorder: A review. Drugs in Context, 8, 212305.
  5. Diversion Control Division, U.S. Drug Enforcement Administration. (2019). Ketamine.
  6. National Institute on Drug Abuse. (2019). Commonly Used Drugs Charts: Ketamine.
  7. National Institute on Drug Abuse. (2020). Monitoring the Future Study: Trends in Prevalence of Various Drugs.
  8. National Institute on Drug Abuse. (2019). DrugFacts: Hallucinogens: What are Hallucinogens?
  9. Smith, K. M., Larive, L. L., & Romanelli, F. (2002). Club drugs: Methylenedioxymethamphetamine, flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate. Am J Health Syst Pharm, 59(11), 1067–1076.
  10. Orhurhu, V. J., Claus, L. E., & Cohen, S. P. (2019). StatPearls: Ketamine Toxicity.
  11. Wang, C., Zheng, D., Xu, J., Lam, W., & Yew, D. T. (2013). Brain damages in ketamine addicts as revealed by magnetic resonance imaging. Frontiers in Neuroanatomy, 7, 23.


About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More


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