Ketamine Addiction: Effects, Withdrawal & Treatment

Ketamine is a chemical compound that is used as a dissociative drug with anesthetic, analgesic, and psychedelic properties. It is designated a Schedule III controlled substance by the U.S. Drug Enforcement Administration (DEA).^1,2  

Ketamine operates primarily by blocking N-methyl-D-aspartate (NMDA) receptors in the brain. These receptors play a crucial role in transmitting signals related to learning, memory, and emotions. By inhibiting NMDA receptors, ketamine induces a dissociative state, separating the mind from sensory input and creating a sense of detachment from reality.^5,7

Esketamine, a ketamine derivative sold under the brand name Spravato®, has been approved by the U.S. Food and Drug Administration (FDA) for people with depression that is resistant to other drugs and treatments. There is also illicitly manufactured ketamine, sold as a liquid or off-white powder, which goes by such common street names as K, Special K, Super K, or Vitamin K.¹ 

Powdered ketamine is cut into lines and snorted or smoked. Liquid ketamine is injected into the veins or mixed into drinks. Ketamine is often found by itself but it can also be found combined with MDMA, amphetamine, methamphetamine, or cocaine.²

Ketamine distorts the user’s perceptions of sight and sound. The ketamine user may feel euphoria or like they are dreaming or floating outside of their body. At higher doses, a person may experience extreme detachment from both their body and reality. This is often referred to as being in a “k-hole.” A ketamine trip is similar to that of LSD or PCP, though its hallucinatory effects are shorter in duration, lasting approximately 30 to 60 minutes as opposed to several hours.^1,2  

The onset of ketamine’s effects is rapid, often occurring within a few minutes of taking the drug, though taking ketamine orally results in a slower onset of effects. Some common effects of ketamine abuse include: ^1,2   

• Increased heart rate 
• Increased blood pressure 
• Dilated pupils 
• Involuntary rapid eye movement 
• Blurred vision 
• Drowsiness 
• Salivation and tearing 
• Muscle stiffness 
• Nausea 
• Hallucinations 
• Unconsciousness 
• Headache

Common long-term effects of ketamine abuse include:^1,2 

• Gastrointestinal problems, including abdominal pain (“k-cramps”) 
• Uropathy (urinary system damage) 
• Anxiety 
• Depression 
• Memory problems

More research is needed to determine exactly how addictive ketamine might be, since the precise mechanism of ketamine’s addictive effects is unclear. However, the rapid brain uptake and fast emergence of its euphoric effects are believed to enhance the drug’s potential for abuse.⁷ Ketamine’s potential for abuse may lead to moderate physical dependence as well as high psychological dependence.² In light of ketamine’s rising popularity in recent years, the prevalence of ketamine abuse—and dependency—is expected to increase.⁵ 

Current research suggests that regular ketamine use is associated with certain symptoms of addiction, including continued use despite knowing that it is causing problems, physically dangerous use, using more ketamine than intended, spending too much time obtaining or using ketamine, and tolerance, which is when more of a drug is needed to achieve the same effects.¹

Can You Withdrawal from Ketamine?

While more research into ketamine’s potential for dependency and addiction is required to know precisely which withdrawal symptoms ketamine users commonly experience after they stop using it, current studies suggest ketamine withdrawal symptoms are typically psychological in nature, with depression being relatively common. This is likely due to ketamine having a rapid antidepressant effect, so withdrawal from ketamine may induce depression.⁸

Ketamine addiction is treated in various settings, all of which are designed to help the patient develop life skills and avoid returning to their use of substances with the help of counseling and therapy. These treatment settings include: 

• Inpatient treatment requires the patient to temporarily reside in a rehab facility to receive comprehensive, individualized therapy and support. Also known as residential treatment, inpatient treatment helps patients manage their ketamine addiction over the long term and develop life skills to enable them to live healthier, more productive lives.
  

• Partial Hospitalization Programs (PHP) represent a “step down” from inpatient treatment by offering addiction treatment without the residential stay. During PHP, patients attend a program for several hours a day for three to five days per week. PHP programs help people manage their long-term withdrawal symptoms while developing important life and coping skills. 

• Intensive Outpatient (IOP) offers multiple therapy sessions per week, including individual counseling and group therapy. These are designed to address various aspects of recovery from addiction. IOP programs are appropriate for those who require more support than standard outpatient programs but less intensive treatment than what is offered under inpatient or PHP.  

• Standard Outpatient (OP) programs offer flexible treatment options, which enable patients to live in their own homes and address everyday work, school, or family duties while receiving treatment. Treatment can take place via recurring office, virtual, or telehealth visits for counseling, medication support, or both. OP is a viable standalone treatment option for those with mild or moderate substance use disorders or for those who have already completed a more intensive level of care and still need support. 

Many addiction treatment programs offer dual diagnosis treatment, a therapeutic approach that simultaneously addresses the substance use disorder along with any co-occurring mental health disorders such as depression, anxiety, bipolar, or post-traumatic stress disorder (PTSD). 

Finding the right ketamine treatment program depends on the patient’s health history, the substance or substances to which they are addicted, and the length of their addiction. Empowered Recovery Center in Atlanta can provide such personalized treatment plans.