What to Know About Ketamine Use

Ketamine
Psychonaught/Wikimedia Commons

Ketamine is a dissociative anesthetic 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 as a dissociative anesthetic to replace PCP.

Ketamine is a class 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 abuse 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.

How to Recognize Ketamine

Ketamine usually appears as a clear liquid or a white or off-white powder. However, it can be sold illegally in pill or capsule form. It is tasteless and odorless.

What Does Ketamine Do?

In medical settings, ketamine is given intravenously to induce and maintain anesthesia. When used as a drug of abuse, 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.

Some ketamine users describe a feeling of complete sensory detachment, which they associate with a near-death experience. 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 use, but research has shown that chronic use of the drug can produce verbal, short-term memory, and visual memory loss. Some research indicates that these effects on the brain are irreversible.

One British study found that ketamine use can lead to urinary tract problems. Users reported an increased urge to urinate, blood in their urine, leakage of urine, and pain on urination.

For voluntary users of the drug ketamine, the dangers—other than long-term cognitive effects—lie with the interaction with other drugs the user may be taking, including alcohol. Ketamine can increase the effects of other sedatives like benzodiazepines, barbiturates, and opiates, which can cause 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, it has been 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.

Off-Label Uses

Ketamine has been shown to have antidepressant effects in patients with mood disorders, so it is sometimes used off-label to help treat major depressive disorder and bipolar disorder. While its use for this purpose has become more widespread, there remains relatively little data on the safety and long-term effects. For this reason, a consensus statement by the American Psychiatric Association's Council of Research Task Force recommended that the data limitations and potential risks should be carefully considered before using ketamine off-label to treat mood disorders or other psychiatric conditions.

Research has also found that ketamine can reduce symptoms of post-traumatic stress disorder (PTSD). 

Ketamine has not been approved by the FDA for the treatment of depression or other mood disorders, although clinical trials on its use for these purposes are ongoing.

Common Side Effects

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

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

Severe Side Effects

Depending on the dosage, some users 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

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.

While ketamine may be cleared from the body within a day or two, it may be detectable in urine tests for up to 14 days and in hair follicle tests for up to 90 days.

Addiction

The 2006 National Survey on Drug Use and Health reported that 0.1 percent of people over the age of 12 had used ketamine. An estimated 2.3 million people in the U.S. have tried it at least once in their lifetime.

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. It can also be difficult for those using the drug to gauge how much of the drug they will need, which can lead to overdose.

Overdose

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

If you believe that someone has overdosed on ketamine or another substance, contact emergency services immediately.

Withdrawal

Once people have become tolerant, dependent, or addicted to ketamine, they are likely to experience symptoms of withdrawal if 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 can be serious, there are effective treatment options available. Treatment options may include cognitive-behavioral therapy, individual therapy, group therapy, family therapy, motivational enhancement therapy, or other approaches.

Treatment may occur on an inpatient, outpatient, or residential basis.

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.

If you have a problem with ketamine use, talk to your doctor or contact SAMHSA's national helpline at 1-800-662-4357. You can also use their online treatment locator to find mental health services in your area.

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