Understanding Ketamine Addiction: Definitions, Symptoms, Causes, Effects, Treatment, And Prevention Strategies

Ketamine addiction is a compulsive need to use the drug ketamine despite adverse health and social consequences. Ketamine has a reputation for abuse due to its hallucinogenic and dissociative properties. 

The U.S. Drug Enforcement Administration (DEA) categorizes ketamine as a dissociative anesthetic because it makes patients feel detached from their pain and environment, which is why it’s abused.

Symptoms of ketamine addiction include a strong desire to use the drug, increased tolerance and withdrawal symptoms when not using, behavioral changes, impaired motor functions, confusion, and amnesia.

The causes of ketamine addiction are linked to both genetic, psychological, and environmental factors. These factors make the risk of ketamine addiction higher. 

The effects of ketamine addiction include urinary tract problems, liver damage, persistent memory issues, strained relationships, isolation, financial difficulties, and reduced performance at work or school. According to Chaves, T. V.’s 2023 study, ‘Overdoses and deaths related to the use of ketamine and its analogues: a systematic review.’,  a review of 34 studies documented 312 overdoses and 138 deaths from ketamine use, with ketamine present in 89.1% of deaths and 79% of overdoses, primarily occurring in recreational and polydrug use settings rather than medical contexts.

Treatment for ketamine addiction involves a combination of medical treatments and psychological interventions like detox, MAT, behavioral therapy and support groups.

Preventing ketamine addiction starts with education about its risks and effects. Limiting access to the drug, engaging in healthy social activities, and having a solid support network.

What Is Ketamine Addiction?

Ketamine addiction is a chronic substance use disorder characterized by the compulsive use of ketamine despite negative consequences. It is a psychological and physical dependence on ketamine, a dissociative anesthetic drug that alters perception and induces a detached state. The addiction is marked by tolerance (needing more of the drug to achieve the same effects), withdrawal symptoms when stopping use, and continued use despite awareness of physical, psychological, or social problems caused by the drug. Data from the National Survey on Drug Use and Health’s 2015-2019 study show that an estimated 0.13% of adults used ketamine in the past year, with males more likely to use it.

Ketamine is a dissociative anesthetic drug that functions as an NMDA receptor antagonist, originally developed for medical and veterinary use in the 1960s. It is characterized by its ability to produce a trance-like state, sedation, and pain relief while maintaining respiratory function and circulatory reflexes. The compound exists in two forms (S(+) and R(-) enantiomers) and can be administered through various routes including intravenous, intramuscular, oral, and nasal pathways.

What Are The Symptoms Of Ketamine Addiction?

The symptoms of ketamine addiction include severe physical changes like coordination problems and sensory impairments, psychological effects such as intense drug cravings and persistent dissociation, and concerning behavioral patterns including social isolation and neglect of daily responsibilities.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 5th edition), signs that a person is addicted to ketamine include tolerance, a strong craving for ketamine, and abandonment of employment activities because of ketamine.

Ketamine addiction symptoms are categorized into three: physical, psychological, and behavioral symptoms, but these symptoms vary within individuals.

Here are the Ketamine addiction symptoms:

Physical Symptoms of Ketamine Addiction

Here are the physical symptoms of ketamine addiction:

• Increased Tolerance: people with ketamine addiction issues find themselves needing larger amounts of ketamine to achieve the same effects. This need indicates the body’s adaptation to the drug.
• Withdrawal Symptoms: individuals who have a ketamine use disorder experience unpleasant physical effects like sweating, nausea, and tremors when not using ketamine.
• Motor Function Impairment: ketamine addiction is shown by difficulty with coordination and balance, resulting in unsteady movements and accidents. According to Di Lazzaro, V.’s 2003 study, ‘Ketamine increases human motor cortex excitability to transcranial magnetic stimulation’, subanaesthetic doses of ketamine significantly impact motor cortex function, with data showing a progressive reduction in both resting motor threshold (RMT) and active motor threshold (AMT). The research demonstrated that RMT decreased from 49% to 42.6% of maximum stimulator output (P < 0.001), while AMT reduced from 38% to 33% (P < 0.002) at the highest ketamine infusion level (0.04 mg kg-1 min-1).
• Sensory Disturbances: people with ketamine addiction experience blurred vision and slurred speech, which interfere with daily activities.

Psychological Symptoms of Ketamine Addiction

Here are the psychological symptoms of ketamine addiction:

• Intense Cravings: ketamine addiction comes with a compelling urge to use ketamine. Ketamine consumes a person’s thoughts.
• Mood Swings: rapid changes in mood, from euphoria when using to depression when abstaining.
• Memory Loss: Struggling with memory problems, particularly with forming new memories or recalling recent events. According to Morgan, C.’s 2014 study, ‘Long-Term Heavy Ketamine Use is Associated with Spatial Memory Impairment and Altered Hippocampal Activation.’ chronic ketamine use significantly impacts spatial memory and brain function. The research, which examined 11 frequent ketamine users and 15 controls, found that regular ketamine users experienced notable spatial memory deficits. These impairments were linked to reduced activation in the right hippocampus and left parahippocampal gyrus during navigation tasks and decreased activity in the left caudate during memory updating.
• Dissociation: Feeling detached from reality or oneself is a signature sign of ketamine addiction. According to Ballard, E. D.’s 2020 study, ‘The role of dissociation in ketamine’s antidepressant effects,’  asserts that ketamine is strongly linked to dissociation, which is broadly defined as an altered state of consciousness and awareness of the self, environment, and reality.

Behavioral Symptoms of Ketamine addiction

Here are the behavioral symptoms of ketamine addiction:

• Social Withdrawal: Isolating from family and friends to spend more time using or recovering from the effects of ketamine.
• Neglect of Responsibilities: Ignoring or failing to meet personal, professional, or academic obligations due to drug use.
• Continued Use Despite Consequences: Persisting in using ketamine even when it causes physical health issues, mental health problems, or social and legal consequences.
• Secrecy and Deception: an individual with ketamine addiction will go to great lengths to hide drug use, including lying about whereabouts and activities.

These symptoms will help you identify when someone is struggling with ketamine addiction allowing you to get them the professional help they need.

What Are The Causes Of Ketamine Addiction?

The causes of ketamine addiction include genetic predisposition to substance dependency, emotional escape through dissociative effects, and environmental influences like peer pressure and drug availability.

According to the U.S Drugs Enforcement Administration, ketamine is abused because of its dissociative sensations and hallucinogenic effects. People choose to take this drug for various reasons, including genetic predisposition, psychological factors, environmental influences, curiosity, and chronic stress. According to the Journal of Psychopharmacology, roughly 11% of the world population used ketamine in 2018.

The causes of ketamine addiction are given below:

• Genetic Factors: Certain genetic traits increase the chances of an individual being more prone to addiction. People with a family history of substance abuse are at a higher risk of developing addictions themselves. According to Meshkat, S.’s 2021 study, ‘Pharmacogenomics of ketamine: A systematic review. Journal of psychiatric research, 145, 27–34’, three genetic variants significantly impact ketamine response: The Val66Met variant of the BDNF gene leads to reduced antidepressant and anti-suicidal effects, the CYP2B6*6 variant causes more severe dissociative side effects, and the NET allelic variant (rs28386840) increases the risk of cardiovascular complications, particularly hypertension. Certain genetic traits increase the chances of an individual being more prone to addiction.
• Psychological Factors: Many individuals turn to ketamine for its ability to produce euphoric and dissociative effects. They use it as a coping mechanism for stress, trauma, or mental health disorders like depression and anxiety. It is easy to misuse the drug when used this way. 
• Environmental Factors: Accessibility to ketamine, peer pressure, and social circles that encourage drug use significantly increase the risk of addiction. Joseph Palamar, PhD, and colleagues at NYU Grossman School of Medicine analyzed recreational ketamine use from 2006 to 2019 using the National Survey on Drug Use and Health. Their findings indicate an increase in recreational use and availability, peaking at 0.9 percent in late 2019.
• Curiosity and Experimentation: Particularly among young people, the desire to explore and experiment leads to trying substances. There is a high chance that one of these substances is ketamine. This experimentation increases the chances of a pattern of use that becomes an addiction.
• Chronic Stress or Trauma: Individuals facing continuous stress or who have experienced traumatic events tend to turn to substances like ketamine for self-medication. The use of these substances unintentionally sets the stage for addiction.

What Are The Effects Of Ketamine Addiction?

The effects of Ketamine addiction include severe physical complications like urinary tract damage and liver dysfunction, psychological impacts such as persistent depression and anxiety, and significant social consequences including relationship strain and career disruption.

According to a drug fact sheet from the Drug Enforcement Administration, shortly after consuming ketamine, users may notice a rise in heart rate and blood pressure, which typically subsides within the next 10 to 20 minutes. Ketamine also renders users unresponsive to external stimuli. 

The effects of Ketamine addiction are categorized into 3: physical, psychological, and social effects.  These effects affect all aspects of an addicted individual’s life. 

Here are the effects of Ketamine addiction below:

Physical Effects Of Ketamine Addiction

Physical effects of Ketamine addiction include:

• Urinary Tract Damage: Frequent use of ketamine causes significant harm to the bladder and kidneys, resulting in pain, difficulty urinating, and potentially severe urinary tract issues. According to Winstock Adam. R  et al.’s 2012 study ‘The prevalence and natural history of urinary symptoms among recreational ketamine users,’ over 25% of individuals who use ketamine recreationally experience urinary symptoms. These symptoms are directly correlated with both the dose and frequency of ketamine use.
• Liver Dysfunction: Prolonged ketamine abuse is bad for your liver, leading to potential liver damage. According to Wong, G. L.’s 2014 study, ‘Liver injury is common among chronic abusers of ketamine.’, ketamine abuse directly impacts liver health, with 9.8% of 297 chronic ketamine users developing a significant liver injury.
• Neurological Impairments: individuals addicted to ketamine experience problems with memory, cognitive functions, and even persistent hallucinations. 
  According to Chan, K. W.’s 2013 study, ‘Effects of chronic ketamine use on frontal and medial temporal cognition’, regular ketamine users exhibit marked impairments in verbal fluency, cognitive processing speed, and verbal learning abilities, with the severity of deficits strongly correlating with lifetime ketamine exposure. While visual and nonverbal cognitive functions remain relatively preserved, heavy ketamine use is associated with deterioration in both immediate and delayed verbal recall, as well as visual recognition memory. These cognitive impairments persist even when controlling for polydrug use, suggesting ketamine-specific neurotoxic effects predominantly affecting verbal information processing pathways in the frontal and medial temporal regions of the brain.

Psychological Effects of Ketamine Addiction

Psychological effects of ketamine addiction include:

• Depression: Chronic use of ketamine triggers depressive symptoms. These symptoms include prolonged sadness and a loss of interest in enjoyable activities. According to Mathai, D. S.’s 2020 study, ‘The relationship between subjective effects induced by a single dose of ketamine and treatment response in patients with major depressive disorder: A systematic review’ 37.5% of studies demonstrated a correlation between ketamine’s dissociative effects and changes in depression levels, suggesting a potential therapeutic connection that merits further investigation, similar to findings with MDMA and psilocybin treatments.
• Anxiety: ketamine addiction causes increased levels of anxiety, which interfere with daily functioning.
• Dissociation from Reality: Regular intake of ketamine leads to a disconnection from reality. There is a great chance that this disconnection will become persistent and interfere with one’s ability to lead a functional life.

Social Effects of Ketamine Addiction

The social effects of ketamine addiction are:

• Relationship Problems: ketamine addiction strains personal relationships. It causes social isolation and conflicts with family and friends.
• Occupational Issues: ketamine addiction causes an inability to perform at work or school. Ketamine addiction leads to job loss or academic failure. According to Palamar, J.’s 2022 study, ‘Ketamine use in relation to depressive symptoms among high school seniors’, recreational ketamine use showed the strongest correlation with depression among all drugs studied. Students using ketamine had a 55% increased risk of experiencing depression, with those using it 10+ times yearly showing a 70% higher risk. While ketamine has been FDA-approved since 2019 for treating depression in medical settings, this study suggests that recreational ketamine use among teenagers is particularly problematic.
• Financial Difficulties: The cost of sustaining the ketamine drug habit, coupled with reduced earning capacity, frequently leads to financial instability.

What Are The Treatment Strategies Of Ketamine Addiction?

The treatment strategies for Ketamine addiction include comprehensive medical detoxification, structured rehabilitation programs, evidence-based therapeutic interventions, supportive medication management, and personalized aftercare planning.

These treatments address both the dependency and the psychological factors associated with the addiction. 

Here are the Ketamine addiction treatment options:

Detoxification

Detoxification is the primary step in treating ketamine addiction, involving a medically supervised process to safely eliminate ketamine from the body and effectively manage withdrawal symptoms. During detoxification, patients experience symptoms such as worsening depression, suicidal ideation, and psychological distress.

According to Roxas, N.’s 2021 study, ‘A Potential Case of Acute Ketamine Withdrawal: Clinical Implications for the Treatment of Refractory Depression.’, pharmacological interventions are essential for facilitating ketamine detox. Benzodiazepines like lorazepam are used to manage anxiety and agitation by enhancing the calming effects of GABA in the brain. Supportive care is also vital, with patients often monitored in psychiatric emergency departments and receiving psychotherapy to address emotional challenges. Long-term strategies emphasize careful tapering of ketamine to minimize withdrawal symptoms, and clinicians are encouraged to utilize evidence-based treatments like esketamine (Spravato) to mitigate risks associated with off-label use. This comprehensive approach ensures the safety and well-being of individuals during the detoxification process.

Rehabilitation Programs

Rehabilitation programs help ketamine addiction through a structured, multi-faceted treatment approach. Medical professionals provide supervised detoxification while monitoring withdrawal symptoms in a safe environment. The programs deliver targeted therapy through individual counseling, group sessions, and cognitive behavioral therapy to address addiction’s psychological aspects. This comprehensive approach addresses both the physical dependency and underlying causes of ketamine addiction, creating a solid foundation for long-term recovery.

Therapy

Various forms of therapy are necessary for the ketamine addiction treatment process. These therapies include Cognitive-behavioral therapy (CBT), which helps ketamine-addicted individuals identify and change behaviors and thought patterns that lead to drug abuse. Family therapy and support groups also give social support. They help people with substance abuse disorder to understand the impact of addiction on relationships.

Medication

Although there are no specific medications approved to treat ketamine addiction directly, there are some medications that help treat symptoms of withdrawal and co-occurring disorders. These treatable symptoms include depression or anxiety. According to Roberts, E.’s 2024 study, ‘The pharmacological management of ketamine use disorder: A systematic review.’, Ketamine withdrawal management primarily relies on benzodiazepine regimens, particularly diazepam (5mg, 4 times daily with tapering), based on evidence from 6 studies covering 110 participants. While all evidence was rated very low quality, the treatment showed better outcomes when benzodiazepines were combined with other medications like propranolol, naltrexone, or clonidine, with longer treatment needed for patients having higher depression scores and more frequent ketamine use.

Aftercare and Relapse Prevention

Lastly, long-term aftercare plans and relapse prevention strategies are important. These aftercare plans include ongoing therapy, support groups, and lifestyle changes. They help people with ketamine addiction maintain sobriety and manage triggers that lead to relapse.

Ketamine treatment plans are tailored to the individual’s needs to maximize the chances of recovery and maintain long-term sobriety. Acknowledging an addiction is the first step to recovery.

What Are The Withdrawal Symptoms Of Ketamine Addiction?

The withdrawal symptoms of ketamine addiction include:

• Cravings for ketamine: Individuals experience intense cravings for ketamine as their body seeks to regain the substance that it has become dependent on.
• Anxiety: Withdrawal leads to heightened anxiety levels as the brain struggles to adjust to the absence of ketamine, which previously provided a sense of calm.
• Irritability: The lack of ketamine results in increased irritability, as mood regulation becomes disrupted during the withdrawal process.
• Restlessness: Many individuals feel restless and unable to relax, as their body reacts to the absence of the drug it has grown accustomed to.
• Fatigue: Withdrawal leads to fatigue, as the body and mind work overtime to cope with the changes and stress of not having ketamine.
• Difficulty concentrating: Cognitive functions decline, making it hard for individuals to concentrate as their brain adjusts to the absence of the drug.
• Insomnia or changes in sleep patterns: The disruption of normal sleep patterns occurs during withdrawal, leading to insomnia or excessive sleepiness.
• Sweating: Increased sweating occurs as the body goes through withdrawal, reflecting the physical stress of the process.
• Tremors: Physical tremors manifest as the nervous system reacts to the absence of ketamine, indicating withdrawal’s impact on motor control.
• Nausea or vomiting: Gastrointestinal distress, including nausea or vomiting, arises as the body reacts negatively to the sudden lack of the drug.
• Changes in appetite: Withdrawal leads to fluctuations in appetite, with some individuals experiencing increased hunger while others lose their desire to eat.
• Muscle aches and pains: Physical discomfort, such as muscle aches and pains, occurs as the body adjusts to the absence of ketamine and its effects on pain perception.
• Hallucinations or perceptual disturbances: Some individuals experience hallucinations or altered perceptions as their brain chemistry shifts during withdrawal.
• Depersonalization or derealization: Feelings of depersonalization or derealization arise, causing individuals to feel disconnected from themselves or their surroundings.
• Mood swings: Withdrawal leads to significant mood swings, as emotional regulation becomes unstable in the absence of ketamine.

What Are the Types Of Ketamine?

The 2 types of Ketamine are injectable solution and powder or crystalline form.

1. Injectable Solution: Ketamine is commonly used as an injectable solution for medical procedures, anesthesia induction, and sedation in both human and veterinary medicine.
2. Powder or Crystalline Form: Ketamine powder or crystalline form is typically used illicitly for recreation and is snorted, swallowed, or injected. Illicitly manufactured ketamine also appears in pill or capsule form.

Is Ketamine Illegal?

Yes, ketamine is illegal for recreational use or possession without a prescription in the United States. Ketamine is classified as a Schedule III controlled substance, allowing legal use only under medical supervision with a valid prescription. Medical professionals administer or prescribe ketamine in clinical settings. Possession of ketamine without proper medical authorization results in criminal charges ranging from misdemeanors to felonies, depending on the quantity.

What Are The Legal Uses Of Ketamine?

Ketamine is legally used as an anesthetic in both human and veterinary medicine due to its ability to induce loss of consciousness and pain relief.

Is Ketamine Chemically Addictive? 

Ketamine is chemically addictive, affecting both the body and mind through its chemical structure 2-(2-chlorophenyl)-2-(methylamino)cyclohexanone. As a Schedule III controlled substance, it creates low to moderate physical dependence and high psychological dependence, especially when used recreationally. The chemical addiction potential stems from how ketamine interacts with brain neurotransmitters, specifically as an NMDA receptor antagonist, leading to tolerance and dependency over time.

How Do People Abuse Ketamine?

People abuse ketamine primarily in dance clubs, raves, and party scenes by snorting its powder form or injecting it to experience dissociative and psychedelic effects. According to Huang, M.’s 2020 study, ‘Ketamine Abuse: Past and Present.’, dissociative and psychedelic properties have made it a common choice for recreational drug users, with some also using it as an alternative treatment for resistant depression.

How Does Ketamine Affect The Brain?

Ketamine acts on the brain’s neurotransmitters, particularly glutamate, leading to altered mood, perception, and thought processes. It creates feelings of detachment from self and environment. A drug fact sheet provided by the DEA states that ketamine distorts perceptions of sight and sound and makes the user feel disconnected and not in control. According to Strous, J.’s 2022 study, ‘Brain Changes Associated With Long-Term Ketamine Abuse’, prolonged ketamine use leads to reduced gray matter volume, decreased white matter integrity, and lower functional connectivity between thalamic and cortical regions of the brain. These neuroanatomical changes help explain why long-term ketamine users experience cognitive impairments, particularly in memory and executive functioning. With an average daily consumption of 2.4g over 2-9.7 years, these structural brain changes represent serious neurological consequences of ketamine abuse.

Can Ketamine Cause Permanent Damage?

Yes, prolonged use of ketamine causes permanent damage to the bladder. This damage is known as ketamine cystitis. It also causes long-term cognitive impairments, including memory loss and difficulty concentrating.

Where To Find Treatment For Ketamine Addiction?

To find treatment for ketamine addiction, seek rehabilitation centers, addiction treatment facilities, or medical professionals specializing in addiction recovery. These resources provide therapy, counseling, and medical support tailored to ketamine dependency. Support groups also offer valuable assistance in recovery.

How Does The Societal Perception Of Ketamine Use Differ From That Of Opioid Use, And How Does This Impact Treatment And Prevention Strategies?

The societal perception of ketamine use differs from that of opioid use, which impacts treatment and prevention strategies. Ketamine is seen as a “club drug” associated with recreational use in nightlife settings, leading to a perception that its use is less dangerous or more socially acceptable. On the other hand, opioid use is widely recognized as a severe public health crisis with a high potential for addiction and overdose. Differing perceptions influence how individuals seek help and the types of effective prevention campaigns. Tailoring prevention and treatment strategies to address these perceptions improves effectiveness by resonating with target audiences and reducing the stigma associated with seeking help.

What Are The Street Names For Ketamine?

Here are some of the most common street names for ketamine:

• Special K
• Kit Kat
• Cat Valium
• Jet
• Vitamin K
• K
• Green K
• Honey Oil
• Super Acid
• Purple

Where And How Is Ketamine Typically Manufactured And Produced?

Ketamine is typically manufactured in clandestine laboratories and is produced in various forms, including powder or liquid. In regulated environments, ketamine synthesis uses raw materials like cyclohexanone, hydroxylamine hydrochloride, and methylamine, following steps of condensation, reduction, and purification to produce pure ketamine hydrochloride. Classified as a Schedule III controlled substance in the United States, ketamine is prescribed for medical use, including as an anesthetic and for potential depression treatment.

In contrast, illegal labs operate without oversight, leading to significant health risks due to poor quality control and hazardous materials. This illicit production not only jeopardizes user safety but also contributes to drug abuse and addiction, with the black market offering products of uncertain quality and safety.

What Does Ketamine Look Like?

Ketamine looks like either a clear liquid or a white/off-white powder. It’s typically packaged in small glass vials, plastic bags, capsules, or aluminum foil folds.

How Does The Mechanism Of Action Of Ketamine Influence Its Potential For Addiction Compared To Ambien?

The mechanism of action of ketamine influences its addiction potential differently than Ambien through distinct neurotransmitter pathways. Ketamine’s primary action as an NMDA receptor antagonist produces dissociative and hallucinogenic effects, making it highly addictive through its ability to create psychological escape. In contrast, Ambien (zolpidem) influences addiction through its GABA-enhancing mechanism, which primarily creates physical dependence through its sleep-inducing effects. While ketamine’s addiction potential stems from its dissociative mechanism of action, Ambien’s addictive properties arise from its sedative mechanism targeting sleep pathways.