Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
Ketamine has a complicated reputation. It is a legitimate anesthetic used in hospitals and veterinary medicine, and a related medication has been approved for certain people with hard-to-treat depression. At the same time, ketamine is misused for its dissociative effects, and regular misuse can take a serious toll on the body and mind.
This article explains how ketamine works, what misuse looks like, the health risks involved, the signs that use has become a problem and how treatment can help. If you are using ketamine that was not prescribed for you, or using prescribed ketamine in ways other than directed, this information is for you.
What Ketamine Is
Ketamine is a dissociative anesthetic. It changes how the brain processes signals related to perception, pain and memory, which can create a sense of detachment from the body and surroundings. The Drug Enforcement Administration classifies it as a controlled substance because it has medical value but also a potential for misuse and dependence.
In medical settings, ketamine is given by trained clinicians with monitoring. Esketamine, a closely related medication delivered as a nasal spray, is approved by the U.S. Food and Drug Administration for certain adults with treatment-resistant depression and is administered under medical supervision in certified settings. The FDA has also cautioned about the risks of compounded ketamine products used at home without close monitoring. Supervised medical use is very different from recreational use or self-directed dosing.
How Ketamine Is Misused
Illicit ketamine often appears as a white powder that is snorted, or as a liquid. It may be used at parties, clubs or festivals, or alone as a way to escape stress or emotional pain. Some people misuse prescribed or telehealth-provided ketamine by taking more than directed or using it more often.
At higher amounts, people may experience a deep dissociative state sometimes called a “K-hole,” in which they feel cut off from their body and surroundings and may be unable to move or communicate normally.
Health Risks of Ketamine Misuse
The risks of ketamine misuse range from immediate dangers to longer-term damage.
Short-term risks
- Confusion, disorientation and impaired judgment
- Loss of coordination, which raises the risk of falls, injuries and accidents
- Nausea and vomiting, which can be dangerous in a person who is heavily sedated
- Raised heart rate and blood pressure
- Frightening hallucinations, panic or agitation
- Vulnerability to harm because the person cannot respond normally to their surroundings
Longer-term risks
- Bladder and urinary tract damage. Frequent ketamine use has been linked to painful bladder inflammation, urgent and frequent urination, and in some cases lasting damage.
- Memory and thinking problems. Regular use can affect short-term memory, attention and concentration.
- Mood changes. Some people experience worsening depression, anxiety or feelings of unreality between uses.
- Abdominal pain. Some people who use ketamine heavily report severe stomach cramping.
- Tolerance and dependence. Over time, people may need more to feel the same effect and may struggle to stop.
Dangerous combinations
Mixing ketamine with alcohol, benzodiazepines, opioids or other sedating substances increases the risk of dangerously slowed breathing, choking and loss of consciousness. Illicit powders may also be contaminated with other drugs, including fentanyl.
Call 911 if someone is unresponsive, breathing slowly or irregularly, vomiting while barely conscious, having a seizure or complaining of chest pain.
Is There Ketamine Withdrawal?
Ketamine withdrawal is not as well defined as withdrawal from alcohol or opioids. Some people who stop after regular use report fatigue, low mood, anxiety, irritability, poor sleep and strong cravings. These symptoms can make it hard to stay stopped without support.
If you also use alcohol or benzodiazepines, be especially careful. Withdrawal from alcohol and benzodiazepines can be life-threatening, and these substances should not be stopped abruptly without medical guidance.
Signs Ketamine Use Has Become a Problem
- Using more often or in larger amounts than planned
- Using alone to cope with stress, sadness or trauma
- Bladder pain or needing to urinate much more often
- Memory lapses or trouble focusing at work or school
- Pulling away from friends, family or activities you used to enjoy
- Feeling unable to stop even when you want to
How Treatment Can Help
There are no medications approved specifically to treat ketamine use disorder, but therapy and medical support can help people stop and stay stopped. Many people who misuse ketamine are also struggling with depression, anxiety or trauma, and addressing those conditions is central to lasting recovery.
At Promises Dallas-Fort Worth, our drug addiction treatment programs help adults understand what ketamine was doing for them and build healthier ways to cope. Individual therapy offers space to work through the emotions and experiences underneath the use. When depression or another mental health condition is part of the picture, our dual diagnosis treatment and depression treatment address both together, with psychiatric evaluation and medication management when appropriate.
Frequently Asked Questions
If ketamine is used for depression, how can it be harmful?
Medical use involves specific formulations, careful screening and monitoring by trained professionals. Recreational or unsupervised use lacks those safeguards and carries serious risks.
Can ketamine damage the bladder permanently?
Frequent use can cause significant bladder problems, and in some cases the damage may be lasting. Stopping use and getting medical care early improves the chances of healing.
Is ketamine addictive?
Ketamine can lead to tolerance, cravings and compulsive use. Some people develop a substance use disorder that benefits from treatment.
Reach Out for Confidential Support
If ketamine has become a way to escape, you deserve care that helps you face what you are escaping from. Our admissions team is available 24/7. If you are having thoughts of suicide, call or text 988 to reach the 988 Suicide and Crisis Lifeline.
Verify your benefits for free and in confidence through our insurance options page, call (469) 546-9303, or contact us online.