Ketamine Addiction: Definition, Causes, Signs, Effects, and Treatment Methods

Ketamine addiction is the dependence on ketamine, a powerful anesthetic often misused for its hallucinogenic effects. Causes of ketamine addiction include recreational use, mental health disorders, or self-medicating for trauma or depression. Signs of addiction involve cravings, social withdrawal, increased tolerance, and neglect of responsibilities. The effects of ketamine addiction are severe, ranging from memory loss and cognitive impairment to kidney issues and respiratory problems.

Ketamine addiction treatment methods include behavioral therapy to address underlying issues, counseling for coping mechanisms, and detoxification programs to manage withdrawal symptoms. Support groups and relapse prevention strategies further help sustain recovery.

What is Ketamine Addiction?

Ketamine addiction is a psychological and physical dependence on ketamine, an anesthetic drug initially developed as a derivative of phencyclidine (PCP). Ketamine is classified as a Schedule III controlled substance in the United States, prescribed legally for medical purposes, such as anesthesia and treatment-resistant depression. Ketamine misuse for its hallucinogenic and dissociative effects leads to addiction, characterized by cravings, tolerance, and compulsive use.

Ketamine’s addictive potential comes from its ability to alter brain chemistry, particularly the NMDA receptor, which disrupts neurotransmitter balance and impacts mood and perception over time, according to the research titled “Whole-brain mapping reveals the divergent impact of ketamine on the dopamine system” written by Malika S. Datta. 

Ketamine was first synthesized in 1962 as a safer alternative to PCP and was widely adopted in medical settings by the 1970s. Ketamine became notable for its rapid anesthetic effects with fewer side effects, though recreational misuse emerged soon after due to its dissociative and hallucinogenic properties, according to the research titled “History of anesthesia The ketamine story—past, present and future” published by the European Journal of Anesthesiology.

What is the Other Name of Ketamine?

The other names of ketamine are K, Vitamin K, Special K, and cat tranquilizer. These street names reflect ketamine’s widespread illicit use, particularly for its hallucinogenic effects, which make users feel detached from reality. Ketamine is used as an anesthetic for medical purposes, but on the streets, it is misused for recreational experiences that are dissociative and psychedelic.

What Does Ketamine Look Like?

Ketamine looks like a clear liquid, but it is also found in powder form, which is white/off-white, or in small tablets and capsules. Ketamine’s appearance varies depending on its form and packaging, which range from medical vials for the liquid to small baggies for the powder. Ketamine has a slightly bitter taste, masked when mixed with other substances.

How is Ketamine Consumed?

Ketamine is consumed in the form of tablets, capsules, liquid, and powder, each packaged differently depending on the form. Tablets and capsules are packed in small containers, powder in baggies, and liquid in vials. Ketamine is snorted or pressed into tablets in powder form, combined with other drugs like methylenedioxymethamphetamine (MDMA), known as ecstasy. This combination is popular at parties, as it amplifies the hallucinogenic and euphoric effects, increasing the risk of overdose and adverse side effects.

How Addictive is Ketamine?

Ketamine is a highly addictive substance because of its rapid and intense dissociative effects. Ketamine addiction develops quickly, leading to compulsive use as users seek to recreate the initial euphoric experience. Ketamine addiction if prolonged results in severe health impacts, including cognitive impairment, memory loss, urinary tract damage, and mental health issues like depression and anxiety.

Approximately 1% of the U.S. population has experimented with ketamine, with around 0.1% (about 200,000 individuals) estimated to develop dependence annually. Statistics indicate that ketamine misuse is most prevalent among young adults aged 18-25, a demographic that accounts for nearly 70% of recreational use cases according to the study titled “Ketamine Addiction Statistics” written by Jessica Miller. Men are more likely than women to misuse ketamine, with the majority of cases concentrated in urban areas where club drug use is more common.

What are the Causes of Ketamine Addiction?

The causes of ketamine addiction are genetics, peer pressure, psychological factors, and environment. Below are the details of these causes.

• Genetics: Genetic factors make individuals more susceptible to substance use disorders, including ketamine addiction, according to the study titled “Substance Use Disorders” published by Boston Medical University. Genetics influence the brain's response to drugs, making addiction more likely in some people.

• Environment: Environmental factors, such as exposure to drug use in the family or community, increase the likelihood of ketamine misuse. Environments that normalize drug use create pathways toward addiction, especially among young adults.

• Peer Pressure: Peer pressure and social circles play a crucial role in ketamine use, especially among teenagers and young adults who feel pressured to fit in or experiment with recreational drugs in social settings.

• Self-Medication: Individuals use ketamine to manage underlying mental health conditions like depression, anxiety, or trauma. Ketamine’s dissociative effects provide temporary relief, leading to repeated use and eventual dependence.

• Psychological Factors: Psychological factors, such as anxiety, depression, or a history of trauma make individuals more prone to ketamine misuse as they seek relief from emotional distress.

What are the Signs of Ketamine Addiction?

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 5th edition), the signs of ketamine abuse are ongoing desire, spending notable time to obtain ketamine, intense cravings, failing to fulfill obligations, abandonment of social activities, recurrent use in hazardous situations, and developing tolerance.
Below is the detail of the signs of ketamine addiction: 

• Ongoing Desire: Ongoing desire is the persistent urge or unsuccessful attempts to reduce or control ketamine use.

• Spending Notable Time to Obtain Ketamine: Individuals invest excessive time and effort in looking for and obtaining ketamine and prioritize it over other activities.

• Intense Cravings: Intense cravings are strong urges to use ketamine frequently, making it difficult to resist use.

• Failing to Fulfill Obligations: People struggling with ketamine addiction neglect responsibilities at work, school, or home and fail to fulfill daily obligations.

• Continued Use: Individuals with ketamine addiction continue using the drug despite knowing about its negative impact on physical, psychological, or social well-being.

• Abandonment of Social Activities: Individuals with a ketamine addiction draw out from social activities and hobbies to prioritize ketamine use and hide their compulsive behavior.

• Recurrent Use in Hazardous Situations: Repeated use in hazardous situations, such as driving under the influence, is a common indicator of dependency.

• Developing Tolerance: Developing tolerance means individuals requiring higher doses of ketamine to achieve the same effects as their body gets used to the previous doses.

What are the Effects of Ketamine Addiction?

The effects of ketamine addiction are classified into physical effects, mental effects, delayed effects, and overdose effects.

Below are the details of these effects: 

Physical Effects of Ketamine Addiction

The physical effects of ketamine addiction are sedation, dizziness, clumsiness, slurred speech, loss of consciousness, slow breathing, cardiovascular issues, nausea, muscle stiffening, and urinary tract issues.

• Sedation: Ketamine’s anesthetic properties induce deep sedation and make users feel drowsy and lethargic.

• Dizziness: Ketamine users frequently experience dizziness, leading to balance issues and a feeling of instability.

• Clumsiness: Impaired coordination and motor control resulting from Ketamine leads to clumsy movements, increasing the risk of accidents.

• Slurred Speech: Ketamine has a high risk of impairing cognitive and motor functions, causing difficulty in clear communication.

• Loss of Consciousness: Higher doses of Ketamine lead to blackouts or fainting, which puts users at risk of injuries.

• Unresponsiveness to Stimuli: Ketamine may reduce sensory perception and lead users to react minimally to external stimuli.

• Slow Breathing: Ketamine can depress respiratory function and in severe cases, it becomes life-threatening, according to the research titled “Ketamine Activates Breathing and Abolishes the Coupling between Loss of Consciousness and Upper Airway Dilator Muscle Dysfunction” published by the National Library of Medicine.

• Cardiovascular Issues: Ketamine's long-term use strains the cardiovascular system and increases the risk of blood pressure and heart rate changes.

• Nausea: Ketamine triggers nausea and vomiting, particularly when taken in high doses.

• Muscle Stiffening: Ketamine users experience muscle stiffening or twitching, which can be painful and uncomfortable.

• Urinary Tract Issues: Ketamine’s frequent use is associated with bladder inflammation and urinary tract problems, a condition known as "ketamine bladder syndrome," according to the research titled “Ketamine bladder syndrome: an important differential diagnosis when assessing a patient with persistent lower urinary tract symptoms” published by the National Library of Medicine.

Mental Effects of Ketamine Addiction

The mental effects of ketamine addiction are diminished attention, memory loss, hallucinations, confusion, paranoia, and unease and anxiety.

• Diminished Attention: Chronic ketamine use impairs focus and concentration, making it difficult for users to complete tasks or stay engaged in conversations.

• Memory Loss: Ketamine affects short-term memory, leading to lapses and difficulty recalling recent events, according to the research titled “Heavy ketamine use affects short-term memory” published by University College London.

• Hallucinations: Ketamine-addicted individuals experience vivid hallucinations or altered perceptions of reality, which are unsettling and disorienting.

• Confusion: Ketamine disrupts normal thought processes, resulting in frequent confusion and difficulty making sense of surroundings or situations.

• Paranoia: High doses induce feelings of paranoia, with users becoming suspicious or fearful of others, even in familiar environments.

• Unease and Anxiety: Ketamine heightens anxiety, leaving users feeling tense, uneasy, or on edge, especially during withdrawal or after the effects wear off.

Delayed Effects of Ketamine Addiction

The delayed effects of ketamine addiction are bladder pain and ulcers, kidney issues, chronic stomach pain, depression, and long-term memory loss.

• Bladder Pain and Ulcers: Ketamine is associated with a painful condition known as "ketamine bladder," which includes severe bladder inflammation, pain, and the development of ulcers according to the research titled “Recreational ketamine use lead to irreversible bladder damage” written by Daniel Eaton and Frank Kueppers.

• Kidney Issues: Prolonged ketamine use impairs kidney function, leading to chronic kidney problems due to ketamine’s toxic effects on renal tissues.

• Chronic Stomach Pain: Many users experience lasting abdominal pain, sometimes referred to as "K pains," a result of ketamine’s impact on the gastrointestinal tract according to the study titled “The Special K Constellation, a Rare Presentation of Ketamine Use: A Case Report”.

• Depression: Ketamine has antidepressant effects at low and medically supervised doses, but prolonged misuse leads to worsening depression during and after use.

• Long-Term Memory Deficit: Chronic Ketamine use leads to memory deficits, impacting both short-term recall and long-term memory over time, making everyday functioning difficult.

What are the Adverse Effects of Combining Ketamine with Other Drugs?

The risks and adverse effects of ketamine in combination with other drugs, especially alcohol, are slow, shallow breathing, low blood pressure, slow heart rate, heart attack, seizure and stupor, and coma.

Below are the details of these effects: 

• Slow, Shallow Breathing: Combining ketamine with other depressants, such as alcohol, dangerously slow breathing, increasing the risk of respiratory arrest.

• Low Blood Pressure: Ketamine’s sedative effects are intensified with other depressants like Xanax, leading to a dangerous drop in blood pressure, which results in fainting or shock.

• Slow Heart Rate: Ketamine mixed with depressants slows heart rate, leading to bradycardia, which may progress to severe cardiovascular complications.

• Heart Attack: The combined strain of Ketamine and other drugs like Xanax and Heroin on the cardiovascular system increases the risk of heart attacks, particularly in those with underlying heart conditions.

• Seizure: Ketamine when mixed with stimulants like cocaine increases the risk of seizures due to overstimulation of the brain’s electrical activity, posing a serious neurological risk.

• Stupor, Coma: ketamine’s high dose with other depressants leads to stupor or even coma as both the sedative and dissociative effects of ketamine are enhanced.

What are the Risk Factors of Overdose in Ketamine Addiction?

The risk factors of a ketamine overdose are severe, with symptoms involving critical physical and psychological reactions. Respiratory depression is one of the most dangerous effects, as ketamine significantly slows or even stops breathing, especially at high doses. Ketamine’s powerful hallucinogenic properties increase the likelihood of intense and unpredictable hallucinations, which lead to harmful behavior and self-injury. Loss of consciousness is another major risk, resulting from large doses, which leads to a coma state if medical assistance is not promptly administered.

What are the Withdrawal Symptoms of Ketamine Addiction?

The withdrawal symptoms of Ketamine addiction are nightmares, insomnia, delirium, paranoia, suicidal thoughts, and increased heart rate.

Ketamine withdrawal is the range of physical and psychological symptoms experienced when a person stops or reduces prolonged ketamine use. Ketamine withdrawal symptoms arise as the body and brain attempt to readjust to functioning without the drug, leading to discomfort and a strong urge to relapse.

The common ketamine withdrawal symptoms are listed below.

• Nightmares: Nightmares are disturbing dreams that are frequent during Ketamine withdrawal, often disrupting sleep. Therapy and sleep aids are used to help manage these vivid nightmares.

• Insomnia: Insomnia is the struggle to fall or stay asleep, a common Ketamine withdrawal symptom individuals struggle with. Sleep hygiene practices and sleeping aids assist with improving sleep patterns.

• Delirium: Delirium refers to confusion and disorientation, making it difficult to focus or think clearly during Ketamine withdrawal. Medical monitoring and a calm environment are essential for managing delirium.

• Paranoia: Paranoia, such as feelings of irrational fear or suspicion may develop during Ketamine withdrawal. Paranoia requires counseling or, if severe, antipsychotic medication under professional supervision.

• Suicidal Thoughts: Suicidal thoughts from depression and despair are potential Ketamine withdrawal symptoms, and immediate mental health support is crucial. Therapeutic interventions like counseling or medication help manage these feelings.

• Increased Heart Rate: Ketamine withdrawal leads to a rapid heart rate, a response to physical and emotional stress. Medical supervision is recommended to monitor and stabilize heart rate.

What are the Treatment Methods for Ketamine Addiction?

The treatment methods for Ketamine addiction are detoxification, medications, cognitive behavioral therapy, dialectical behavioral therapy, and inpatient rehabilitation. Below are the treatment methods details:

• Detoxification: Detoxification is the initial phase of treatment, which requires gradual reduction and elimination of ketamine from the body. Supervised medical detox typically lasts 5-10 days, depending on severity. Detox effectively manages acute withdrawal symptoms, but it does not treat the psychological problems of the addiction.

• Medications: Certain medications are prescribed to ease Ketamine withdrawal withdrawal symptoms and reduce cravings, though specific drugs for ketamine addiction are still being researched. Medications are advantageous as they improve retention in recovery programs but are limited by access and side effects, with the recovery process ranging from weeks to months based on individual needs.

• Cognitive Behavioral Therapy (CBT): CBT is a widely used therapeutic approach aimed at changing harmful thought patterns associated with addiction. During sessions, which generally last 12–16 weeks, patients learn coping skills and strategies to avoid triggers.

• Dialectical Behavioral Therapy (DBT): DBT is a form of therapy that combines cognitive-behavioral techniques with mindfulness practices to address emotional regulation and impulse control. DBT sessions last for 12-20 weeks and are highly effective for those with co-occurring mental health issues, such as depression or anxiety, which accompany ketamine addiction.

• Inpatient Rehabilitation: Inpatient rehabilitation provides a structured, supportive environment where patients undergo intensive therapy, often lasting 30-90 days. Inpatient programs offer 24/7 medical support, which is beneficial for severe addiction cases but is costly and requires time away from work or family.

How Can You Prevent Ketamine Addiction Relapse?

You can prevent ketamine addiction relapse by a combination of proactive strategies and lifestyle changes to maintain sobriety. Developing healthy habits, such as regular exercise, a balanced diet, and adequate sleep, strengthen physical and mental health. Establishing a strong bond with family, friends, or support groups, provides essential encouragement and accountability during recovery. Identifying personal triggers, like certain environments or stressful situations, and learning to navigate them is key to avoiding relapse. Regular counseling or therapy offers tools to manage cravings and emotional challenges, avoiding interactions with drug users and high-risk situations further reduces temptation.

How Ketamine Addiction Relates to Other Substance Addictions

Ketamine addiction relates to other substance addictions by co-occurring, complicating recovery, and increasing health risks. Ketamine is a dissociative anesthetic frequently used alongside substances like alcohol, MDMA, or opioids, leading to polydrug use. This combination increases the likelihood of developing multiple dependencies due to the compounded effects on the brain's reward system.

Can individuals experience withdrawal symptoms from ketamine and opioids?

Yes, individuals experience withdrawal symptoms from both ketamine and opioids, despite they differ in nature. Ketamine withdrawal includes symptoms like anxiety, insomnia, and paranoia, stemming from the brain's adjustment to the absence of the drug. Opioid addiction withdrawal involves intense physical symptoms such as muscle pain, nausea, and strong cravings due to its effect on opioid receptors. Ketamine and opioid withdrawal result in cravings and psychological distress, opioid withdrawal tends to be more physically severe and may require specialized medications, whereas ketamine withdrawal is typically managed with supportive care.

Can users of ketamine and phencyclidine experience hallucinations?

Yes, users of both ketamine and phencyclidine (PCP) can experience hallucinations. Ketamine is a dissociative anesthetic commonly used in medical settings and recreationally, and it induces altered states of consciousness, including visual and auditory hallucinations. Phencyclidine, or PCP, was originally developed as an anesthetic but is now misused for its powerful hallucinogenic effects. The relationship between the two is clear as users transition from ketamine to PCP or vice versa, leading to an increased risk of phencyclidine addiction due to their overlapping effects and addictive potential.

Do ketamine and Xanax have the potential to lead to psychological dependence?

Yes, both ketamine and Xanax lead to psychological dependence, but they do so through different mechanisms and effects. Ketamine is a dissociative anesthetic that induces euphoria and altered consciousness, leading to recreational use and dependence. Xanax (alprazolam) is a benzodiazepine used to treat anxiety and panic disorders, promoting relaxation by enhancing GABA effects. Ketamine and Xanax both create feelings of relief and cravings. Ketamine dependence is psychological, while Xanax dependence involves severe physical withdrawal symptoms, such as seizures. The potential for Xanax addiction is significant due to its common prescription and potential for misuse.