Ketamine Dependence and Recovery
 

Ketamine Dependence and Treatment

How Addictive is Ketamine, and Where Can You Get Treatment?

Introduction to Ketamine

Recently, ketamine has become a recognizable name in mental health, showing promise for the treatment of depression in clinical studies.1 The hallucinogenic drug has been around since the 1970s and misused for almost as long.2 Hallucinogens skew the perception of time, senses, and even reality, resulting in strange or harmful behavior.3 Researchers report few cases of ketamine dependence, but they do occur with prolonged, repeated use.4

How is Ketamine Used?

Worldwide, the use of ketamine has surged over the last few years.5 With increased use comes the risk of misuse and dependency. According to the most recent Surgeon General’s Report on Drugs, 3 million Americans have used ketamine at least once, including 1.3% of high school seniors in 2020.6, 7 The drug is popular for recreational use due to reports of hallucinations, feeling high, and out-of-body experiences.4 This mental state, also known as the “K-hole,” can last up to 75 minutes.4 Other ketamine effects include:

  • Amnesia
  • Pain relief
  • Immobility
  • Feeling relaxed.³

Originally, ketamine was used as an injected surgical anesthetic for humans and animals under the brand names Ketalar and Ketaset.8 It wasn’t until 1999 that ketamine became a controlled substance.2 Now, it’s classified as a Schedule III drug, which, according to the DEA, has “a moderate to low potential for physical and psychological dependence.”9 Other examples of Schedule III drugs include Tylenol with codeine, anabolic steroids, and testosterone.9

Ketamine for Depression

The use of ketamine for depression and addiction came much later. In 2019, the FDA approved a ketamine nasal spray (Spravato) and infusion for treatment-resistant depression.2, 10 As a treatment for depression, ketamine can only be given with medical supervision.8 Anyone who receives a dose is monitored for at least two hours afterward. The drug stays at the medical facility.1 use of the ketamine nasal spray has a risk of temporary sedation or dissociation, which can be stressful in some cases.1 Clinical trials have shown that using ketamine for depression can reduce suicidal thoughts and actions and other depressive symptoms.10

Ketamine for Addiction

Several studies show promise for the use of ketamine for addiction treatment. More research is needed, but early reports indicate that the drug can reduce cravings and use of cocaine, alcohol, and heroin.11


 

How is Ketamine Abused?

Most of the ketamine sold illicitly is stolen from veterinary clinics¹⁰ or trafficked from Mexico. 12, 2 Rather than being sold on the streets, ketamine is usually distributed through friends and acquaintances.2 The liquid form is injected or reduced to crystals, which are ground into a powder and snorted, smoked, or added to drinks.8. Powdered ketamine is often added to tobacco or marijuana cigarettes or mixed with MDMA (ecstasy), cocaine, and meth.2 Alarmingly, ketamine’s odorless and tasteless properties¹⁰ have made it a notorious choice for date rapists.8

Street Names

Street names for ketamine include:

  • Vitamin K
  • Super K
  • Special K
  • Kit Kat
  • Cat Tranquilizer
  • Purple
  • Special La Coke³
  • Lady K²
  • Jet.⁴

 

Is Ketamine Dangerous?

According to the DEA, ketamine has the potential for abuse that could lead to mild physical dependence or strong psychological dependence.2 There aren’t any known withdrawal symptoms, but there are risks associated with ketamine use.8 It’s also not clear whether it’s safe to use over prolonged periods.13

Serious ketamine effects include:13, 14, 15, 15

  • Inflammation of the bladder and urethra
  • Liver disease
  • Kidney problems
  • Feeling out of control
  • The sensation of a near-death experience
  • Sedation, including salivation, muscle stiffness, and dilated pupils
  • Contraction of an infectious disease from sharing needles
  • Overdose, which can result in slow breathing and unconsciousness
  • Hallucinogen Persisting Perception Disorder (HPPD) weeks after taking the drug, despite a 45 minute half life
  • Enhanced side effects when administered with alcohol

Moderate side effects include:

  • Confusion²
  • Problems with attention and memory
  • Temporary hypertension
  • Nausea
  • Stomach pain

 

Treatment for Ketamine Dependency

Physical or psychological dependence on ketamine is rare but can happen.4 The FDA hasn’t approved any medications to treat addiction to dissociative drugs like ketamine. It’s unclear whether behavioral therapies effectively treat addiction to dissociative drugs; however, psychological dependence can point to underlying factors like anxiety or depression.8 Inpatient treatment centers, outpatient programs, therapies (such as cognitive behavioral therapy), and support groups are viable options for addressing ketamine dependency and any associated mental health issues.


Resources

  1. https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression-available-only-certified
  2. https://www.dea.gov/sites/default/files/2020-06/Ketamine-2020_1.pdf
  3. https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/director
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6020109/
  5. https://www.sciencedirect.com/science/article/abs/pii/S0166432819316663
  6. https://www.ncbi.nlm.nih.gov/books/NBK424847/table/appd.t6/
  7. https://www.drugabuse.gov/drug-topics/trends-statistics/monitoring-future/monitoring-future-study-trends-in-prevalence-various-drugs
  8. https://www.drugabuse.gov/drug-topics/commonly-used-drugs-charts#ketamine
  9. https://www.dea.gov/drug-scheduling
  10. https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673
  11. https://pubmed.ncbi.nlm.nih.gov/29339294/
  12. https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-dissociative-drugs
  13. https://pubchem.ncbi.nlm.nih.gov/compound/Ketamine
  14. https://www.drugabuse.gov/publications/research-reports/hallucinogens-dissociative-drugs/what-are-effects-common-dissociative-drugs-brain-body
  15. https://www.ncbi.nlm.nih.gov/books/NBK470357/
  16. https://www.nimh.nih.gov/about/director/messages/2019/new-hope-for-treatment-resistant-depression-guessing-right-on-ketamine.shtml