Ketamine is a dissociative drug that distorts sights and sounds and spurs feelings of detachment from reality. Once popular as a battlefield treatment and as a tranquilizer for large animals, the drug now is commonly used as an anesthetic.
In 2000, individuals ages 12 to 25 accounted for 74 percent of ketamine emergency department mentions in the United States.
About 1,550 emergency department visits involving ketamine occurred in 2011, according to the Drug Abuse Warning Network.
But ketamine is also misused for recreational purposes. The drug can cause a dissociative high characterized by hallucinations, altered realities, drowsiness and sedation. People who abuse ketamine can develop a physical or psychological dependence to the drug.
Much of the illicit ketamine that enters the United States comes from Mexico, according to a 2013 report by the Drug Enforcement Administration. The drug often is distributed in liquid form or dried powder.
The DEA indicated that ketamine is mainly found in isolation. But the drug has also been combined with amphetamine, MDMA, cocaine, carisoprodol and methamphetamine. On occasion, it has been infused into Ecstasy tablets.
Recreational ketamine use is common in rave culture and is particularly popular among European youths. People who use and deal ketamine usually get their supply through scams or by stealing from pharmacies. Veterinary offices have been robbed by individuals looking for ketamine.
Ketamine is a popular party drug. It often is found in clubs, raves, music festivals and other music-related social events. Generally, ketamine is used by younger people.
About 1.2 percent of high school seniors in the United States reported past-year use of ketamine in 2016, according to a survey by researchers at the University of Michigan.
A 2006 study published in the journal Drug and Alcohol Dependence examined the use of ketamine and other drugs among people aged 16 to 23. Most of the youths who used ketamine were employed. The researchers found that use of any club drug was associated with criminal behaviors and recent alcohol abuse or dependence.
Most ketamine abusers are in contact with medical agencies, according to a 2002 report published in the journal Anaesthesia and Intensive Care. These individuals generally use multiple drugs in addition to ketamine.
Ketamine has been used to facilitate crime. The odorless and tasteless drug can go undetected if slipped into an alcoholic beverage or food. Ketamine causes disorientation, making those who are drugged with it vulnerable to sexual assault and other crimes.
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For more than a decade, researchers have studied ketamine’s potential to treat severe depression. The American Psychiatric Association saw enough evidence of the drug’s therapeutic benefits that it created a task force to analyze the benefits and risks of the drug.
The task force was also charged with creating guidelines for using ketamine to treat depression. A 2016 draft of the guidelines recommended six very low doses during a two-week period. No studies have found cases of addiction from the dosages recommended by the APA task force.
Researchers are still learning how the drug combats depression. In a 2016 study on the brains of animals, researchers determined that ketamine causes dependence and dissociative thinking by interrupting part of the brain that regulates mood. But after the drug’s negative side effects wore off, a metabolite that caused antidepressant side effects remained in the body.
The authors of the study concluded that the drug could be used to develop a new type of antidepressant. A separate 2016 study published in the Journal of Clinical Psychiatry found that repeated exposure to ketamine reduced suicidal thoughts in a small sample of patients with severe depression.
Several factors determine how people respond after taking ketamine, including the person’s height, weight and tolerance. The strength and dosage of the drug also play a role. Combining ketamine with other drugs makes it even more dangerous.
The intensity and duration of ketamine effects depend on the method of administration. The table below depicts how different uses of ketamine have different effects.
|Method of Use||Dosage Range||Onset||Duration|
|Injecting||10–40 mg||3–4 minutes||45–90 minutes|
|Orally||40–75 mg||5–20 minutes||90+ minutes|
|Snorting||10–60 mg||5–15 minutes||10–30 minutes|
Recreational use of ketamine can cause an out-of-body experience known as a K-hole. During a K-hole, people have trouble moving. K-holes can cause a trip similar to an experience with LSD. However, ketamine users appear immobile and disoriented.
Recreational use of ketamine can cause:
Positive ketamine effects are often overshadowed by negative ones. Ketamine causes highs that raise the risk of injury, health problems and overdose.
Negatives effects of ketamine include:
Individuals on ketamine often hurt themselves and do not realize it because of the lowered pain sensitivity.
The risk of overdose is high for ketamine users, especially when ketamine is used with other substances.
If a ketamine user is experiencing any of the following symptoms, call 911 immediately:
Overdosing on ketamine can also lead to death in severe instances. Additionally, ketamine users put themselves at greater risks of dying from other causes.
Long-term ketamine use can lead to a multitude of negative consequences, including many health problems.
Some of these effects include:
Long-term ketamine use can lead to a health condition known as ketamine bladder syndrome, a painful condition in which patients experience bladder damage, incontinence, difficulty holding in urine, infections and blood in the urine. In some cases, bladder complications become so severe that ketamine users must have their bladder removed.
As a Schedule III drug, ketamine can cause low to moderate physical or psychological dependence. Ketamine users have compared the hallucinogenic effects of the drug to those of PCP or LSD.
A 2014 case study published in the Indian Journal of Psychological Medicine described an anesthesiologist who developed significant tolerance to ketamine without noticeable physical withdrawal symptoms. Researchers concluded that medical professionals in proximity to the drug may have a greater risk of developing a substance use disorder.
The psychological consequences of the drug can negatively affect an individual’s performance at school or the workplace. Ketamine abuse can worsen existing addiction problems, according to a 2011 report published in the journal Addiction.
Evidence shows that frequent ketamine use causes people to develop a tolerance to the drug that can lead to dependence. People who are dependent on ketamine often engage in binge use, taking excessive amounts of the drug over a short period.
Physical withdrawal symptoms associated with ketamine use are poorly understood, but researchers continue to study the effects. Tolerance can have rapid onset, and over time, ketamine users no longer experience a full high. Withdrawal occurs when an addicted individual tries to detox from ketamine.
Ketamine withdrawal symptoms include:
Ketamine withdrawal symptoms usually last four to six days.
Although ketamine use can lead to psychological dependence, more research is needed to determine whether behavioral therapies, such as cognitive behavioral therapy or dialectical behavior therapy, can help treat people addicted to dissociative drugs. Additionally, the Food and Drug Administration has not approved any medications for the treatment of ketamine dependence.
If you or someone you know is struggling with ketamine addiction, seeking treatment could be the difference between a life of harm and a happy, healthy life.
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