Ketamine addiction: signs, effects, and treatments

Ketamine addiction is the compulsive use of this drug despite the problems it causes. People with addiction take ketamine regularly, not just in clubs. Ketamine is a dissociative anesthetic. It was first developed to act as anesthesia during medical procedures. Today, the anesthetic use of ketamine is only present in veterinary medicine. Ketamine is also used for the treatment of depression and schizophrenia. It is a powerful substance that changes one’s perception of reality and causes trance-like effects and hallucinations.

Signs of ketamine addiction are gradually increasing ketamine consumption, unsuccessful attempts to stop taking ketamine, and experiencing withdrawal symptoms and strong cravings. People spend a lot of time and money on ketamine to the point they lose interest in everything else. This can lead to problems in relationships, poor work performance, and other issues.

The effects of ketamine can be short-term and long-term. Short-term effects range from a feeling of calmness to agitation, anxiety, unpleasant hallucinations, disorientation, and nausea. On the other hand, long-term effects include organ damage, severe abdominal pain, bladder and urinary tract dysfunction, overdose, dependence, respiratory distress, and others.

What is Ketamine addiction?

Ketamine addiction is a type of physical addiction indicated by a repeated or persistent use of ketamine despite the problems and complications it causes. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) included ketamine use disorder under the heading of phencyclidine-like substances.

Ketamine is a dissociative anesthetic with hallucinogenic effects. Back in the 1960s, ketamine was used as anesthesia in medical procedures, a paper from Frontiers in Human Neuroscience reports. The compound has also been used for the treatment of psychotic symptoms in schizophrenia, the treatment of addiction, and the management of depression.

It may seem ironic that a substance used to aid addiction treatment can be misused. But, people misuse ketamine because it produces effects that are similar to phencyclidine (PCP). Ketamine induces trance-like effects, which is why it belongs to a group of club drugs i.e., substances that people take to enhance their experience at parties. 

Since it can produce an out-of-body experience, ketamine can cause visual and auditory perception changes or hallucinations. The drug can impair a person’s judgment, senses, and motor functions for up to 24 hours after use.

Ketamine can be found in liquid form and as a white powder. Liquid ketamine is often stolen from veterinary offices because it is still used as an anesthetic by vets. People usually inject ketamine, but some also snort or orally consume white powder.

What are the signs of Ketamine addiction?

The most common signs of ketamine addiction are listed below:

• Building tolerance i.e., the need for increasing ketamine dosage to experience the same effects
• Experiencing withdrawal symptoms when attempting to stop
• Unsuccessful attempts to stop taking ketamine
• Using ketamine regularly, not just at parties from time to time
• Mixing ketamine with other addictive substances
• Spending a lot of time and money on buying, taking, and recovering from ketamine
• Continuing with ketamine use despite relationship problems, poor performance at work/school, and financial or legal difficulties
• Lack of interest in activities once enjoyed
• Repeated use of ketamine in dangerous or risky situations such as while driving
• Lying to friends and family about the extent of ketamine use

It is important to note that signs of ketamine addiction may vary from one person to another. They depend on the amount of ketamine a person uses and how frequently they take it. 

What are the side effects of Ketamine?

Side effects of ketamine can be short- and long-term, they are demonstrated in the table below.

How is Ketamine addiction being diagnosed?

Ketamine addiction is diagnosed similarly to other types of substance use disorders. The healthcare provider performs a physical exam, orders lab tests, and evaluates a patient’s medical history. The main purpose of a physical exam is to rule out the physical causes behind symptoms. 

The healthcare provider refers a patient to a psychiatrist who performs a psychiatric evaluation. During this process, a patient answers questions about their symptoms, moods, and behaviors. A psychiatrist may also talk with family or close friends of a patient to get a better insight into their behavior and mood patterns. They will want to make sure the symptoms a patient experiences aren’t due to other problems, such as schizophrenia since it can also cause hallucinations and delusions. 

Based on the information provided, especially when patients report ketamine use, a healthcare professional can determine whether ketamine use disorder is the problem. They will also check DSM-5 to see whether a patient meets the diagnostic criteria for this type of addiction.

Generally speaking, a patient needs to meet at least two criteria within 12 months. These include taking the drug in larger amounts and having a persistent desire or craving for ketamine. Other criteria include spending a lot of time using or buying the drug, lack of interest, withdrawal symptoms when attempting to stop, and others.

What are the Ketamine addiction statistics?

Ketamine addiction statistics are scarce. A study published by the American Journal of Public Health showed less than 1% of people in the United States use ketamine. 

That being said, the recreational use of ketamine has increased over the last few years. The rise in the recreational use of ketamine started in 2019, which is exactly when the Food and Drug Administration (FDA) approved the use of a nasal spray version of the drug for treatment-resistant depression.

The same report showed poisonings with ketamine were at their highest in 2000 and 2001. After this period, poisonings declined and increased again in 2014. That year, there were 1.1 poisonings per 1,000,000 people.

Other statistics about ketamine use and addiction are older. For example, numbers show that in 2014 around 1.5% of 12^th graders had been using this drug. Back in 2013, about 41,000 people between the ages of 12 and 17 reported using ketamine at some point in their lives. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 540,000 people between 18 and 25 years of age use ketamine at some point.

What are the Ketamine withdrawal symptoms?

Ketamine withdrawal symptoms are physical and psychological reactions to the cessation of drug use. The body and brain get used to the presence of ketamine in the system, so when a person stops using it withdrawal symptoms occur as they adapt. 

The duration of ketamine withdrawal is from 72 hours to a few weeks. It depends on frequency and quantity of use i.e. severity of the addiction. A person’s tolerance level and whether they’re using other drugs also play a role in the duration of ketamine withdrawal. They usually settle after two or three days. 

Withdrawal from ketamine is uncomfortable but generally not life-threatening. The most common ketamine withdrawal symptoms are listed below:

• Cravings for ketamine
• Mood swings
• Anxiety and/or depression
• Sweating 
• Elevated body temperature 
• Agitation
• Nausea
• Confusion
• Fatigue
• Hearing loss
• Rage
• Decreased motor skills
• Psychosis including hallucinations and delusions
• Insomnia
• Shakes
• Cognitive impairment
• Reduction in cardiac and respiratory functions

What are the treatments available for Ketamine addiction?

Treatments available for ketamine addiction are listed below:

• Detox: the first stage of the treatment process. Detoxification refers to the cessation of drug use. That is when withdrawal symptoms ensue. Detox should be performed with medical supervision in order to ensure safety. Patients often receive medications that reduce cravings and decrease the intensity of withdrawal symptoms.
• Inpatient program: also known as a residential program, it is suitable for people with moderate to severe ketamine addiction. The inpatient program involves living in a rehab center for a specific period, such as 30, 60, or 90 days. During the program, patients receive different forms of therapy, including individual therapy, family therapy, and group therapy. Different types of behavioral therapy are available, but the most effective approach is cognitive-behavioral therapy (CBT). The main goal of therapy is to help patients uncover irrational and negative thoughts that lead to negative feelings and risky behaviors. Once a patient identifies these thought patterns, they start replacing them with more positive and realistic alternatives. Therapy also helps people with ketamine addiction adopt coping and other skills that help them recover and prevent relapse. Besides CBT, other behavioral therapies for ketamine addiction include dialectical behavior therapy (DBT) for mindful awareness and stress management and acceptance and commitment therapy (ACT) that emphasizes commitment and behavior change.
• Outpatient program: suitable for people with mild to moderate addiction. During an outpatient program, a patient doesn’t sleep in a rehab center. They just attend therapy sessions while maintaining their employment or returning home afterwards. The outpatient program also consists of therapy in an individual or group setting. People who have completed inpatient treatment may also start with an outpatient program to support their recovery.