Ketamine Addiction: Signs, Symptoms, and Treatment

Medical Reviewer

Dr Matthew N. Parker

About the Reviewer

Ketamine, also known as Special K or a variety of other names, is a dissociative, short-acting anesthetic used in humans and veterinary practices. Ketamine can produce hallucinogenic effects and distort visual and auditory perceptions, causing you to feel disconnected and out of control.1 Chronic use of the substance can lead to ketamine addiction, which is a pattern of compulsive use despite negative consequences. However, knowing the signs and symptoms of ketamine addiction can help you know when to seek professional treatment to help you reach recovery.

In this article:

Is Ketamine Addictive?
Signs and Symptoms of Ketamine Addiction
Who is at Risk of Ketamine Addiction?
Ketamine Addiction Treatment

Is Ketamine Addictive?

Yes, ketamine can be addictive if used recreationally.² It is a Schedule III non-narcotic substance, which means it has accepted medical uses but has potential for misuse, dependence, and addiction.

Adding to the dangers of ketamine use, in part, are the multiple ways in which it can be used (e.g., injected, snorted, smoked, swallowed, or used as a powder with tobacco or marijuana cigarettes).³ Injecting and smoking ketamine can speed up the development of an addiction—this is because these two methods deliver the drug to the brain extremely quickly, causing an intense and euphoric rush.

Signs and Symptoms of Ketamine Addiction

Ketamine can have potentially cascading effects on your life, ranging from short-term to long-term to effects. Some of its effects can be experienced within minutes, including:¹

Sedation
Feelings of calmness and relaxation
Pain relief
Amnesia while the substance is in your system
Immobility

Other signs of ketamine misuse may include:³

Organ damage, including kidney problems and bladder pain
Allergic reactions, such as swelling or anaphylaxis
Gastrointestinal issues, such as nausea and vomiting
Cardiovascular problems, including increased blood pressure, cardiac arrhythmias, and/or cardiac arrest
Ophthalmologic issues, such as double vision or involuntary eye movement
Breathing difficulties

Additionally, ketamine is sometimes used as a date-rape drug, and when combined with alcohol, the risk of adverse effects is increased. Furthermore, there is a higher risk of HIV, hepatitis, and other infectious diseases if sharing needles to inject ketamine.

Neurological and Mental Health Effects of Ketamine Use

Side effects of ketamine use can also include wide ranging psychiatric disturbances and mental health symptoms. Such symptoms include:³

Depression
Problems with attention and learning
Amnesia
Extreme fear or anxiety
Confusion, disorientation, or dysphoria
Dissociative states, including being unable to intentionally speak or respond to verbal commands
Flashbacks or hallucinations
Irrational behavior
Insomnia

Further, a study examined those under the age of 30 years old who used ketamine at different dosages daily to examine the impacts ketamine had on the brain. In those who had only been using ketamine for a year, imaging results showed lesions as small patches, but after four years of use, these lesions grew to larger sites of atrophy.⁷ This same study also revealed structural damage to the prefrontal, parietal, occipital, limbic, brainstem, and corpus striatum areas of the brain that were affected by ketamine use in their sample of participants.⁷ Additionally, gray and white brain matter (i.e., the neurons and nerve fibers housed in the brain) were also impacted. This study was able to unequivocally confirm that in humans, ketamine damages the central nervous system (CNS).⁷

Who is at Risk of Ketamine Addiction?

Ketamine is a “club drug” known for use at nightclubs, raves, and private parties.1 It has become popular among adolescents and young adults who frequent these venues. However, street sales of ketamine are not common.¹

Those who experience treatment-resistant depression or suicidality, defined as insufficiently responding to at least two antidepressant treatments or having low improvement rates with available antidepressant treatments, often self-medicate with ketamine.⁶

Individuals who use ketamine or other drugs are at a higher risk of addiction due to their use. Additional risk factors include mental health, social, and environmental factors, including:⁶

Parents or guardians who use drugs or engage in criminal activities
Living in an environment with increased drug availability
Childhood abuse
Community poverty
Availability of drugs
Exposure to drugs at a young age
Low peer refusal skills (reduced ability to resist peer pressure)
Lack of parental supervision
Aggressive behavior in childhood
Having a mental health disorder

Ketamine Addiction Treatment

The most effective treatment for ketamine addiction remains detox to get the substance out of your system followed by rehab or other addiction treatment programs.

The severity of ketamine withdrawal symptoms will dictate the level of detox needed. For severe withdrawal symptoms, benzodiazepines may be administered for relief in a medical detox setting.⁵ However, to date, no known FDA-approved medications specifically address the symptoms associated with ketamine addiction or withdrawal symptoms.³

Treatment for ketamine addiction can be facilitated in many levels, including:⁸

Inpatient (residential) treatment
Outpatient treatment
Individual therapy

Inpatient Rehab Treatment

Inpatient rehab can be helpful for ketamine addiction because it is an immersive experience that:^8,9,10

Removes you from distractions and environmental triggers
Removes you from most stressors to help you focus on your recovery
Helps you to establish a consistent schedule
Helps you build and adhere to a structured routine
Helps you avoid caffeine, nicotine, and alcohol
Provides you with 24/7 support from peers and staff
Teaches positive coping skills (meditation, journaling, exercise)
Provides individual therapy
Provides group therapy

Outpatient Treatment Options

Standard outpatient treatment may include attending counseling for a couple of hours per week, split up over one or two sessions. These programs are the least intensive and most flexible option for those seeking ketamine addiction treatment.

Partial hospitalization programs (PHP) or intensive outpatient (IOP) are more intensive forms of outpatient treatment that may be right for your ketamine use treatment plan. PHPs are partial day treatment options throughout the week that last three or more hours a session, whereby a psychiatrist is medically responsible for the direction of treatment.11 IOPs, on the other hand, are less restrictive time-wise because they are a step down from inpatient care and include a prearranged schedule of core services for at least nine hours a week (e.g., case management, individual therapy, group therapy, and family psychoeducation).¹²

Behavioral Therapy

Both cognitive behavioral therapy (CBT) and contingency management are useful behavioral therapies to consider if you are dually diagnosed with a mental health issue as well as a substance use disorder.

The cornerstones of CBT are that thoughts, feelings, and behaviors are interrelated, not mutually exclusive. CBT techniques help to better understand these processes and to address more functional ways to interact with the world that are less disruptive, less distressing, and less maladaptive.¹³

Contingency management (CM) focuses on discouraging unwanted behaviors and reinforcing desired behaviors. It also utilizes some motivational interviewing techniques to allow you space to explore any ambivalence you may have toward change or treatment and abstinence.¹⁴

Group therapy can also be used in addiction treatment and provides you with added peer support during recovery. The therapist can introduce therapy models to improve stress resilience and coping skills while those in recovery can share their stories and support one another. Family therapy may also be used to help address any dynamics within family or loved ones that may contribute to your substance use. It can also help provide family members with tools to support their loved ones in recovery.

Aftercare and Ongoing Support

Paramount to your recovery and facilitating your long-term sobriety goals is ongoing support from friends, peers, family, and your healthcare providers. Ensuring you have a solid aftercare plan can help solidify your commitment to yourself and your goals, especially while in the beginning stages of recovery, in the hopes that one can prevent a relapse. Regardless of the type of treatment you initially entered, aftercare helps you translate what you learned in treatment and effectively apply, practice, and implement it in your life as you transition between levels of care.¹⁵

Aftercare options may include but are not limited to:¹⁵

Support groups: most adhere to a 12-step model and can address substance use issues exclusively, mental health issues exclusively, or both issues simultaneously
Therapy: a broad category that can include motivational enhancement therapy, faith-based drug rehabilitation, experiential therapy, holistic therapy, dialectical behavior therapy, cognitive behavioral therapy, or even biofeedback
Sober living homes: housing that provides structure and support to help you maintain your recovery goals

Call 800-914-7089 (Who Answers?) to find treatment for ketamine addiction near you.

References

Department of Justice/Drug Enforcement Agency. (2020). Ketamine.
Rosenbaum, S.B., Gupta, V., & Palacios, J.L. (2021, November 20). Ketamine. StatPearls.
National Institute on Drug Abuse. (2020). Commonly Used Drug Charts – Ketamine.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Association Publishing.
Substance Abuse and Mental Health Services Administration (SAMHSA). (2015). Detoxification and Substance Use Treatment.
Murrough, J.W., Iosifescu, D.V., Chang, L.C., Al Jurdi, R.K., Green, C.E., Perez, A.M., Iqbal, S., Pillemer, S., Foulkes, A., Shah, A., Charney, D.S., Mathew, S.J. (2013). Antidepressant Efficacy of Ketamine Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial. The American Journal of Psychiatry, 170(10), 1134-1142.
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), 1-8.
National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition)
Rural Health Information Hub. (2022). Opioid Treatment Program (OTP).
Department of Health and Human Services & Substance Abuse and Mental Health Services Administration (SAMHSA). (2019). National Mental Health Services Survey (N-MHSS): 2019
Substance Abuse and Mental Health Services Administration (SAMHSA). (2021). Clinical Issues in Intensive Outpatient Treatment for Substance Use Disorders.
Rector, N.A. (2011). Cognitive Behavioral Therapy: An Information Guide. Center for Addiction and Mental Health.
National Institute on Drug Abuse. (2021). What is Fentanyl?
Mohammad, A., Irizarry, K.J., Shub, R.N., & Sarkar, A. (2017). Addiction Treatment Aftercare Outcome Study. Journal of Psychiatry, 7(1), 51-60.

Medical Reviewer

Dr Matthew N. Parker

About the Reviewer