What to Know About Ketamine Use

Ketamine is a dissociative anesthetic that was developed in the early 1960s and used in human and veterinary medicine. The drug is primarily used for anesthesia.

In the 1950s, phencyclidine (PCP) was developed as an intravenous general anesthetic, but because of its severe side effects, ketamine was developed to replace it. MXE (methoxetamine) is also a similar drug made from arylcyclohexylamines.

Overview

Ketamine is a Schedule III drug, which means it is approved for use as an anesthetic in hospital and other medical settings. It is safe and effective when used in a controlled medical setting, but it also has the potential for misuse and addiction.

Also Known As: Various street names for ketamine include K, Special K, Vitamin K, super acid, super c, bump, cat Valium, green, honey oil, special la coke, and jet.

Drug Class: Ketamine is an NMDA receptor antagonist. It has anesthetic, dissociative, and hallucinogenic effects.

Common Side Effects: Ketamine can have side effects including elevated blood pressure, tremors, hallucinations, confusion, and agitation.

What Does Ketamine Do?

In medical settings, ketamine is given intravenously to induce and maintain anesthesia. When used recreationally, it can be ingested by mouth in pill or capsule form. In liquid form, it can be injected into a vein, consumed in beverages, or added to smokable materials. Some people also inject the drug intramuscularly.

The effects of ketamine are similar to PCP, but not as severe and with a shorter duration. People who use ketamine describe the high as a pleasant sensation of floating or a dissociative state of being separated from their bodies. The drug can produce hallucinogenic-like effects, lasting a short period of time, from one to two hours.

Others describe this experience as being so deep inside the mind that reality seems distant. This state of total dissociation is called the "k-hole."

What the Experts Say

There is little research into the long-term effects of ketamine misuse, but research has shown that chronic use of the drug can produce impairments in memory and reduced psychological wellbeing.

Studies have found that ketamine use can lead to urinary tract problems. People who used ketamine reported an increased urge to urinate, blood in their urine, and pain on urination.

Ketamine can increase the effects of other sedatives like benzodiazepines, barbiturates, and opiates, which can lead to death.​

As a street drug, ketamine has become popular as a "club drug," used by teens and young adults at dance clubs and events known as raves. Because it is odorless and tasteless and can be added to beverages without being detected, there are also reports of it being used as a date-rape drug. In addition to rendering victims immobile, it can also induce amnesia making it difficult to recall events that took place while under the influence.

Psychiatric Uses

Ketamine has been shown to have antidepressant effects in patients with mood disorders, so it is has been sometimes used intravenously off-label to help treat major depressive disorder and bipolar disorder.

In 2019 the FDA approved an intranasal form of ketamine for use in treatment resistant depression. There is still much to learn on the safety and long-term effects of the psychiatric use of ketamine.

Common Side Effects

Some of the common short-term side effects that people experience include:

• Visual disturbances
• Confusion and disorientation
• Drowsiness
• Increased heart rate
• Elevated blood pressure
• Nausea and vomiting
• Euphoria
• Sedation

Depending on the dosage, some can experience these more severe side effects of ketamine:

• Severe allergic reaction
• Hypotension and heart rhythm abnormalities
• Difficulty talking
• Abnormal movements
• Slowed or depressed breathing

Signs of Use

Some of the signs that someone might be using ketamine include:

• Changes in sleep habits
• Irritability
• Mood changes
• Hallucinations
• Difficulty speaking
• Memory problems
• Disorientation
• Presence of drug paraphernalia

Typically, the outward symptoms of ketamine overdose are the psychotropic effects, including dreams, illusions, and hallucinations—similar to LSD and PCP use. Benzodiazepines might be given to reduce agitation. This requires caution, however, as in cases of ketamine overdose, ketamine was typically not the only drug ingested. Over-sedation and drug interactions are a concern.

Tolerance, Dependence, and Withdrawal

The use of ketamine can result in tolerance, dependence, and symptoms of withdrawal. When tolerance occurs, people require larger or more frequent doses of the drug to achieve the same effects they felt initially. Dependence occurs when a person needs to continue taking a drug in order to avoid the negative effects of withdrawal. 

How Long Does Ketamine Stay in Your System?

Ketamine has a half-life of approximately three hours , which means that it takes approximately 14 to 18 hours for the drug to be eliminated from a person's system. The exact range of time, however, depends on a variety of factors including how much of the drug was used as well as the individual's body mass, hydration levels, and metabolism.

Addiction

The National Institute on Drug Abuse reported in 2019 that a bit less than 0.1% of people in 12th grade had used ketamine in the past year.

Addiction to ketamine can cause chemical changes in the brain's reward system that make it very difficult to stop taking the drug. Because ketamine creates feelings of detachment, people often experience major disruptions in multiple life areas once they have developed an addiction.

Signs of addiction can include neglecting work and family responsibilities and spending large amounts of money on the drug. The high from ketamine is short-lived and tolerance tends to build quite quickly, meaning people who use it need to increase the amount they use in order to get the same results.

Withdrawal

Once people have become tolerant, dependent, or addicted to ketamine, they are likely to experience symptoms of withdrawal when they stop taking it. These symptoms can range in severity from mild to more serious. 

Symptoms of withdrawal can include:

• Depression
• Anxiety
• Rapid heartbeat
• Fatigue
• Lack of appetite
• Insomnia
• Nightmares
• Restlessness
• Tremors
• Chills or sweats
• Anger

Because ketamine withdrawal symptoms can sometimes be serious, it can be helpful to go through the detox and withdrawal process under the supervision of trained addictions recovery professionals.

How to Get Help

While ketamine use and addiction is serious, there are effective treatment options available. Treatment options may include cognitive-behavioral therapy (CBT), individual therapy, group therapy, family therapy, motivational enhancement therapy, or other approaches.

While there are no specific medications approved for the treatment of addiction to ketamine, interventions may include the use of medications to treat co-occurring psychiatric conditions.