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Ketamine abuse can lead to serious long-term problems. Chronic, long-term ketamine use is associated with tolerance and psychological dependence. Ketamine is physically damaging and can cause a variety of health problems. There is also a risk of overdose, particularly when ketamine is taken in combination with alcohol or other drugs. Professional substance abuse treatment can help users overcome cravings and learn to enjoy themselves without the need for psychoactive drugs. Having a long-term plan for preventing relapse will help support a lifetime of recovery.
Ketamine is a dissociative drug that is used medically as an anesthetic in both humans and animals. Ketamine is especially suited for use in these settings because it makes patients feel somewhat detached from their pain and the medical treatment they are receiving. Recreationally, people use it because it distorts perceptions and has some hallucinogenic properties. Ketamine can cause an out-of-body experience that lends itself to the hypnotic dance music often played at raves and nightclubs.
Ketamine can be very sedating, sometimes making users almost completely immobile. The drug promotes feelings of calmness and physical relaxation. There are reports of ketamine being used as a “date rape drug” in sexual assaults because of its potential to render someone physically unable to resist. It can also cause complete blackouts, at which point users will have little to no memory of events that took place while they were under the drug’s influence.1
Illicit ketamine is typically encountered as a clear liquid or a white powder.1 Depending on the source and type, ketamine can come in a small vial, plastic bag, gel capsule, or folded into paper or tinfoil. For recreational use, ketamine is most often snorted through the nose in its powdered form.1
Powdered ketamine can also be mixed with marijuana or tobacco and smoked. Liquid ketamine can be swallowed directly, mixed into a drink (especially alcoholic drinks), or injected into a vein or muscle.
Street names for ketamine include:1
Ketamine has been used as an anesthetic in the U.S. since the 1970s. In 1999, ketamine and its derivatives became a Schedule III non-narcotic substance under the federal Controlled Substances Act. Ketamine is typically diverted from veterinary clinics and illegally distributed for recreational use. There have also been reports of illicit laboratories (particularly in China and southeast Asia) manufacturing the drug for sale online.2
The effects of ketamine on the brain and body are similar to some other dissociative and hallucinogenic drugs, such as phencyclidine (PCP). During a ketamine high, users have a distorted sense of perception that can alter sights and sounds. The strength and duration of the effects varies depending on the dose. Small doses produce euphoric sensations that last about an hour.3 Higher doses can lead to an intense, hallucinatory experience that users refer to as “K-land” or a “K-hole.”3
A K-hole is often described as a near-death experience that can be spiritual in nature. It is desirable to many users but may be associated with adverse physical effects such as respiratory depression, muscle twitches, dizziness, slurred speech, and vomiting. Other ketamine effects can include:3
During a ketamine high, users have a distorted sense of perception that can alter sights and sounds.
In addition to its short-term effects, ketamine abuse can potentially lead to injury and other, more lasting health complications.
One major concern associated with ketamine is physical injury due to the user’s lack of awareness of their physical environment. This risk can include falls, sexual assault, hypothermia from environmental exposure, drowning, jumping from high places, and especially car accidents.2
From 1996 to 2000, 9% of all fatal drug- or alcohol-related traffic collisions in Hong Kong involved ketamine.2 During 2007, a single trauma center in Hong Kong reported that 4.5% of drivers involved in car crashes tested positive for ketamine.2
Although it is possible, ketamine use rarely causes death from overdose unless it is mixed with other drugs or alcohol.2 Ketamine is popular with poly-drug users—people who take several different drugs at the same time—and it is often mixed with alcohol, methamphetamine, MDMA (ecstasy, Molly), and cocaine. Mixing multiple substances increases the user’s risk of drug poisoning and overdose.2
Over time, chronic ketamine use can have several physical and psychological consequences. Abdominal pain, gastric pain, and urological disorders, including bladder pain and blood in the urine, are the most commonly reported.2 Initial studies have found that up to one third of long-term ketamine users may be affected by such problems, but more research is needed to understand the correlation.2
Long-term ketamine use is also associated with a range of mental health symptoms. Studies have found that frequent users may experience:2
Over time, chronic ketamine use can have several physical and psychological consequences.
Ketamine abuse is associated with both tolerance and dependence, although the evidence points to a more psychological, rather than physical, dependence development.2 Though users may not feel pronounced physical withdrawal symptoms when they stop taking ketamine, they may experience uncontrollable cravings, prioritize their drug use over other activities, and continue using despite harmful consequences.2
Frequent ketamine users develop a tolerance to the drug, meaning they need to take larger doses in order to achieve the desired effects—a cycle that increases the user’s risk of developing a ketamine dependence.2
Another characteristic behavior seen in people with ketamine dependence is their tendency to binge on the drug—continuing to use it repeatedly until they run out.2,3 Binge use is also seen with other drugs that offer short-lived highs, such as crack and methamphetamine. In laboratory studies, animals continued to self-administer ketamine for as long as it was freely available.2 This suggests that ketamine use causes people to lose control and makes it difficult for them to resist impulses.
As with any other substance, ketamine abuse can lead to serious personal and professional consequences. The user may fall behind at school, be unable to perform at work, neglect duties at home, or suffer from legal or financial difficulties related to their drug use or activity while under the influence of drugs.
Ketamine is often termed a “club drug,” which is a broad designation used to refer to recreational drugs used by teens and young adults at bars, clubs, music festivals, and other party atmospheres. Other club drugs include GHB, MDMA (Molly/ecstasy), and Rohypnol.4 These drugs all have intoxicating effects that can produce pleasurable feelings of euphoria. GHB and Rohypnol are sedating drugs that depress certain central nervous system functions. These drugs have long been associated with date rape due to their ability to incapacitate the user, rendering them helpless to sexual advances.4 People who use club drugs frequently “black out” and do not remember what happened while they were high.
Besides exposing users to the risk of sexual assault or physical harm from other accidents while under the influence, club drugs are risky because their chemical composition and potency are often inconsistent. Synthetic drugs are made in clandestine laboratories with no regulatory oversight, so what is sold on the street as Molly (or “pure” MDMA) may actually contain any number of other substances. Drug dealers will also mix, or “cut,” expensive drugs with cheaper substances in order to stretch their supply. When users are unaware of what substances are in the drugs they’re taking, it increases their risk of overdose and potential complications from mixing multiple drugs and/or alcohol.
In 2011, there were approximately 2.5 million emergency room visits related to illicit drugs.5 MDMA was involved in 22,498 cases, hallucinogens were involved in more than 12,000 cases, GHB was involved in 2,406 cases, and ketamine was involved in 1,550 cases.5
People who use club drugs frequently “black out” and do not remember what happened while they were high.
The party atmosphere in which many club drugs are taken carries its own unique risks. With large groups of people using drugs and alcohol, the response to a medical emergency may be delayed by others’ inability to recognize trouble or hesitance to call authorities for fear of getting in legal trouble for their own drug use. Without an immediate response to seek emergency treatment, the risk of overdose increases.
Other health dangers associated with the party scene include combining drugs and alcohol with all-night physical exertion. Hours of dancing can cause elevated body temperature, high blood pressure, fast heart rate, and dehydration—all of which are potential side effects of drug and alcohol use. The synergistic effect of these factors can lead to dangerous health emergencies.
Risky sexual behavior is another significant danger, not only because of the risk of sexual assault, but also the risk of sexually transmitted diseases from unprotected consensual sex, which increases the user’s risk of contracting sexually transmitted diseases like HIV and hepatitis.
For some people, treatment for ketamine abuse will take place in a detox and rehab center. Others may find that outpatient support from a doctor or psychiatrist is sufficient in helping them beat their cravings to use the drug.
Detoxification through drug abstinence is the first step in rehab treatment. Ketamine is not associated with any severely unpleasant or dangerous physical withdrawal symptoms, so there is not a specific medical protocol for ketamine detox as there is for other substances such as opioids or alcohol. Because long-term ketamine users may have developed significant psychological dependence, behavioral therapy in rehab will be essential to recovery.
Addiction treatment professionals will use a comprehensive approach to ketamine treatment. There is no single therapy method that is best for everyone, and each has its strengths. The basic components of any addiction treatment plan include first getting the patient medically stable and drug-free. The second step involves counseling and therapy in various forms. And the third step involves a long-term aftercare treatment plan.
Several different types of therapy are used in addiction treatment. The most common therapeutic approach is cognitive behavioral therapy. This is a form of talk therapy that helps patients identify negative thought patterns and drug triggers. Patients work in individual counseling or group counseling to learn how to change these thought patterns and make healthier choices. Addressing the root cause of drug abuse is critical to a successful recovery.
Many people who abuse ketamine also use other drugs. The treatment for polysubstance abuse will depend on the specific drugs of abuse. For example, ketamine users who also abuse opioids, benzodiazepines, or alcohol may require the medical supervision of an inpatient detox facility in order to manage potentially dangerous withdrawal symptoms associated with these drugs.
Options for seeking ketamine treatment include:
There is variation among rehab programs, and many offer specialized amenities or accommodations to better support their patients. This can include dedicated programs for people of the LGBTQ community, veterans, teens, or faith-based programs for people who want a religious component to their recovery. There are also luxury facilities that offer hotel-like accommodations like pristine locations, swimming pools, private rooms, and spa services. Some centers offer alternative therapies such as holistic treatment, meditation, yoga, acupuncture, massage, and other non-medical treatments like herbal supplements.
Ultimately, your personal preference and situation will determine the rehab model that works best for you. Consider which factors are most important to you and research facilities to determine the setting that will give you the best chance at successful recovery.
Ketamine abuse can be devastating for users and their families, but successfully completing treatment can lead to long-term recovery. Many people are able to maintain a lifetime of sobriety with the proper support. Before leaving rehab, you’ll work with counselors to develop an aftercare plan that will outline long-term ways to prevent relapse. Ongoing support is available through group sessions and regular check-ups with your therapist.
If you or someone you love is struggling to quite using ketamine, reach out and get the help you need.
What would you do with that money if treatment was affordable? Find out if your insurance covers treatment now!