Addiction Drug Use Hallucinogens K-Hole and the Effects of Ketamine By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. Learn about our editorial process Updated on June 20, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Table of Contents View All Table of Contents Definition Symptoms Ketamine Effects Why People Take Ketamine Signs of Overdose How to Get Help A "k-hole" is how it feels when you take a high enough dose of ketamine that both your environmental awareness and bodily control become very impaired. When someone has "fallen into a k-hole" (the slang term for this ketamine effect), they are temporarily unable to interact with others or the world around them. Ketamine is a dissociative drug, which means that it can make users feel detached from reality and themselves. It was originally used as an anesthetic, but has also been found effective for treating major depression and bipolar disorder—under medical supervsion. Learn what a k-hole is and what it feels like to be in one, or k-hole symptoms. This article also discusses other ketamine effects, as well as signs of a ketamine overdose and how to get help. Verywell / JR Bee What Is a K-Hole? A k-hole is when high doses of ketamine lead to intense feelings of dissociation. This can cause feelings of being disconnected from or unable to control one's own body, also sometimes affecting the ability to speak and move around easily. One way to think about a k-hole is as a state between intoxication and coma. Some people refer to a k-hole as an out-of-body or near-death experience. As the consciousness of the real world diminishes, alterations in the senses during a k-hole may lead to illusions and hallucinations. While usually temporary, some people have shown ongoing dissociative and psychotic symptoms with long-term ketamine misuse. 2:06 Click Play to Learn More About K-Holes This video has been medically reviewed by John C. Umhau, MD, MPH, CPE. K-Hole Symptoms A k-hole can be frightening and induce strong feelings of powerlessness. This may be especially intense if your ability to speak is affected. When in a k-hole, it can be frustrating if someone is trying to communicate with you and you can't respond. To others, someone in a k-hole may simply look immobile and intoxicated, although their eyes may move around. This is an effect known as nystagmus. Other k-hole symptoms include marked confusion, unexplainable experiences, floating sensations, and mind/body dissociation. Ketamine Effects One of the risks of falling into a k-hole is difficulty coming out of the dissociative state. Some people continue to feel disconnected from the world around them (and from their life), and may even develop ongoing symptoms of psychosis. Ketamine can have effects on the brain, heart, and more. Short-term side effects of taking ketamine can include: Dilated pupilsElevated blood pressureIncreased heart rateIncreased salivation and tear secretionsInvoluntary rapid eye movementMuscle stiffeningNausea Long-term side effects of taking ketamine frequently and/or at high doses include: Bladder problemsCardiac issuesCognitive effectsSeizures What Is Ketamine Addiction? Why People Take Ketamine It can be hard to understand why someone would voluntarily take a drug with k-hole effects. But when taken in lower doses, ketamine can produce feelings of euphoria, making the person taking it feel "at one with the universe." This ketamine effect is sometimes referred to as being in "k-land." It can be particularly attractive to people who have difficulty coping with life and social situations, or those who are troubled by a distressing past. Another motivation for taking ketamine is peer pressure. People may want to try this drug because their friends are doing it. Others do not willingly take ketamine but have it slipped into a drink as a date rape drug. Some people, such as those who use drugs to cope with depression, seek out feelings of disconnection and dissociation. In these cases, people feel that ketamine can help them control their uncomfortable feelings; a k-hole is a kind of oblivion that gives them a temporary escape from the world. Ketamine and Depression A review of several studies found that ketamine is a fast-acting antidepressant, often reaching maximum efficacy at 24 hours. This can appeal to people with depressive symptoms, especially when many antidepressants take weeks to months before any changes are noticed. Research has shown that people who use ketamine more heavily tend to be more depressed than occasional users. It's not clear whether the depression is caused by ketamine use and its impacts on people's lives, or if people who are already depressed are more vulnerable to ketamine misuse as a form of self-medication. Treating depression with ketamine should only be done under the supervision of a trained healthcare professional and with a valid prescription. If you have been trying to escape negative feelings through taking drugs like ketamine, consider talking to your healthcare provider about other ways of treating depression. Signs of Ketamine Overdose Taking too much ketamine can cause an overdose. Signs of a ketamine overdose include dangerously slow breathing and loss of consciousness. If an overdose is suspected, get immediate medical attention. How to Get Help There are many effective and much safer ways of treating depression than seeking out a k-hole. If you have been through significant trauma, such as physical, sexual, or emotional abuse, or if you are struggling with feelings of guilt or emptiness, there are various therapies that can help you. A mental health professional can help find the best treatment options for you. This might include psychotherapy, medications, or both. These treatments can help you feel better without having to experience a k-hole or other negative ketamine effects. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 11 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Gao M, Rejaei D, Liu H. Ketamine use in current clinical practice. Acta Pharmacologica Sinica. 2016;37:865-872. doi:10.1038/aps.2016.5 Strous J, Weeland C, van der Draai F, et al. Brain changes associated with long-term ketamine abuse, a systematic review. Front Neuroanat. 2022;16:795231. doi:10.3389/fnana.2022.795231 Zanos P, Moaddel R, Morris PJ, et al. Ketamine and ketamine metabolite pharmacology: Insights into therapeutic mechanisms. Pharmacol Rev. 2018;70(3):621-660. doi:10.1124/pr.117.015198 Zuccoli ML, Muscella A, Fucile C, et al. Paliperidone for the treatment of ketamine-induced psychosis: a case report. Int J Psychiatry Med. 2014;48(2):103-8. doi:10.2190/PM.48.2.c Drug Enforcement Administration. Drug fact sheet: ketamine. Bell RF, Kalso EA. Ketamine for pain management. Pain Rep. 2018;3(5):e674. doi:10.1097/PR9.0000000000000674 Pahlamar JJ, Rutherford C, Keyes KM. Trends in ketamine use, exposures, and seizures in the United States up to 2019. Am J Public Health. 2021;111(11):2046-2049. doi:10.2105/AJPH.2021.306486 Ho R, Zhang M. Ketamine as a rapid antidepressant: the debate and implications. BJPsych Advances. 2016;22(4):222-233. doi:10.1192/apt.bp.114.014274 Yehia AM, Farag MA, Tantawy MA. A novel trimodal system on a paper-based microfluidic device for on-site detection of the date rape drug "ketamine". Analytica Chimica Acta. 2020;1104:95-104. doi:10.1016/j.aca.2020.01.002 Corriger A, Pickering G. Ketamine and depression: a narrative review. Drug Des Devel Ther. 2019;13:3051-3067. doi:10.2147/DDDT.S221437 Fan N, Xu K, Ning Y, et al. Profiling the psychotic, depressive and anxiety symptoms in chronic ketamine users. Psychiatry Res. 2016;237:311-5. doi:10.1016/j.psychres.2016.01.023 By Elizabeth Hartney, BSc, MSc, MA, PhD Elizabeth Hartney, BSc, MSc, MA, PhD is a psychologist, professor, and Director of the Centre for Health Leadership and Research at Royal Roads University, Canada. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? 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