The Basics of Ketamine Rehabilitation

This guide was written to provide an overview of the ketamine rehabilitation process as well as to offer helpful resources for persons recovering from ketamine addiction.

People abusing hallucinogens should first receive a psychological evaluation. Then, detoxification is the first step in the rehabilitation and treatment process. Ketamine detoxification can be difficult due to unpredictable psychotic behaviors and intense cravings that may occur during withdrawal. Professional monitoring by medical staff is crucial for a safer withdrawal and detox process. As of 2018, the Food and Drug Administration (FDA) had not approved any medications to treat addiction to ketamine or other dissociative drugs, but specific withdrawal symptoms are sometimes treated with proven medications.

Like other substance abuse treatments, behavioral therapies may help you recognize the reasons why you abuse ketamine and help you find better ways to relieve stress and/or have fun. Common therapy options used in addiction counseling include cognitive behavioral therapy and dialectical behavioral therapy, which help you learn how to address thinking patterns that impact your behaviors and teach you other ways to cope without using drugs. Recovery-based support groups also play an integral role after completing treatment.

the four steps of rehab process

What Makes Ketamine Rehabilitation Difficult?

Due to a low to moderate potential for physical and psychological dependence, ketamine is classified as a Schedule III controlled substance, making it illegal to possess it without a prescription. Although punitive legal measures vary by state, federal penalties are severe. For a first offense of possession of any Schedule III drug, you may face a fine of up to $250,000 and/or up to five years in prison. Subsequent possession offenses and charges for possession with the intent to distribute, distribution, and manufacturing all carry even stiffer penalties.

Although estimates of global usage are limited, many countries report hallucinogen use to the United Nations Office on Drugs and Crime (UNODC). Most countries don’t break down hallucinogen use into specific types of drugs, but of those that did in 2019, ketamine use was mainly reported in South-East Asia. This included increased usage in Cambodia, Indonesia, and Thailand. Australia also reported a slight increase in use following a period of relative stability, and England and Wales reported a significant increase of ketamine use between 2016/17 and 2017/18 with a jump from 1.2% to 3.1% among people ages 16 to 24.

The Unique Struggle of Ketamine Addicts
Ketamine…
  • use can cause flashbacks for several weeks after taking a dose.
  • addiction causes intense cravings.
  • causes highly unpredictable psychotic behaviors that can present during withdrawal and detoxification.
  • detoxification is best done cold turkey, which can make the detox process extremely difficult.

Ketamine/Hallucinogen Rehabilitation Statistics

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates in 2018 that:

  • 3,622,000 people 12 years of age and older — 1.3% of the population — used ketamine.
  • 273,000 people 12 years of age and older — 0.1% — were in need of treatment for a hallucinogen use disorder.
  • 288,000 people 12 years of age and older — 7.7% — in need of treatment enrolled in a rehabilitation program for hallucinogen abuse.

Hallucinogen Treatment Admissions by Gender

73.4% Male
26.6% Female

Demographics of Individuals Seeking Treatment for Hallucinogen Addiction

According to a 2017 SAMHSA report that charts admissions to and discharges from publicly funded substance use treatment facilities, men are considerably more likely to seek treatment for hallucinogen abuse, such as ketamine. The gender breakdown of treatment admissions for hallucinogens was 73.4% male and 26.6% female. While hallucinogen addiction occurs in all age groups, the most common age group admitted to a treatment facility for hallucinogen use was individuals aged 25 to 29, with 30 being the average age of all individuals from all age groups seeking rehabilitation.

Hallucinogen Treatment Admissions Percentages by Age Group, 2017
Age at the Time of Treatment Admission Percentage of Hallucinogen Treatment Admissions (which may have included ketamine)
12-17 8.7%
18-24 25.7%
25-34 36.9%
35-44 18.8%
45-54 7.2%
55-64 2.6%
65+ .2%

Ketamine Detoxification & Withdrawal Process

Detoxification is the process of eliminating a specific substance from your body, which starts as soon as you stop taking the substance and ends when no trace of the substance is left in your bloodstream. Because it’s best to stop using ketamine cold turkey, detox can be extremely difficult to endure and includes intense cravings and psychological discomfort.

The initial comedown/detox from ketamine should begin within 24 hours, which generally is the maximum length of time it takes for the total elimination of the drug from your bloodstream. Although withdrawal symptoms vary, early symptoms often include fatigue, chills, sweating, tremors, irregular heartbeat, and loss of appetite. Withdrawal usually lasts four to six days with psychological withdrawal symptoms being the most dangerous. These can include intense depression that may increase suicide risk, flashbacks, hallucinations, and psychosis. Although withdrawal symptoms are usually not as severe as they are for many other drugs, overall dissatisfaction with life and strong cravings to continue using the drug make detox difficult.

Withdrawal Symptoms

Body Mind
Short-Term Symptoms Aches and pains
Chills
Clumsiness
Drowsiness
Headache
Heart palpitations
Impaired senses
Lack of coordination
Fatigue
Loss of appetite
Restlessness
Sweating
Tremors
Confusion
Disorientation
Impaired judgment
Irritability
Long-Term Symptoms Cognitive Issues
Cravings
Insomnia
Anxiety
Depression
Generalized dissatisfaction with life
Hallucinations
Flashbacks
Memory loss
Nightmares

Psychotic behaviors are unpredictable during ketamine withdrawal

It can be difficult to detox from ketamine because of extremely unpredictable psychotic behaviors you may experience during the withdrawal process. Ketamine-induced psychotic behaviors can include schizophrenic-like behavior, which can occur while under the influence or during withdrawal.

Ketamine use can cause hallucinations and flashbacks that can continue during withdrawal

Ketamine is considered a hallucinogenic, and even casual use may cause you to experience hallucinations, which may be intensified with heavier use and include distorted sounds and colors, hearing sounds or voices that aren’t there, or seeing things that aren’t real. These hallucinations may not stop right away when you quit using ketamine, and flashbacks may occur for several weeks after using ketamine last.

Ketamine withdrawal can lead to severe depression and suicidal thoughts

Intense craving and depression are the two most common problems reported by chronic users, which continue throughout withdrawal. Severe depression and a general feeling of unease and dissatisfaction with life could spark suicidal thoughts.

Ketamine Detoxification Medications

There’s limited research on the management of ketamine withdrawal, and the FDA has yet to approve any medications for the treatment of ketamine addiction. However, some rehab programs may attempt to relieve specific symptoms with proven medications. An antidepressant may be prescribed to counter depression, or a glutamate release inhibitor may help with depression and cravings. If you display extreme anxiety or agitation, you may be given benzodiazepines to control these symptoms. Supportive care, especially intravenous fluids, is another vital part of the recovery process.

For more information about withdrawal, read our guide on Ketamine Addiction.

Treatment for Ketamine Addiction

Many types of behavioral therapies may be helpful in treating ketamine addiction, including those that help you recognize the reasons for your ketamine abuse and address new ways of relieving stress. Popular therapy choices include cognitive behavioral therapy and dialectical behavior therapy to help you change your feelings and thoughts about hallucinogen use and find new ways to cope. Motivational interviewing has also helped some people stop using ketamine.

Currently, there aren’t any established treatments for ketamine addiction or any FDA-approved drugs for treating ketamine addiction. However, rehab programs may offer various medications proven to alleviate specific symptoms as medication assistance during withdrawal. These medications may make detox more comfortable, but they’re ceased after the symptom it treats disappears.

Rehabilitation Settings

Within either an inpatient or outpatient setting, treatments such as detoxification services, behavioral therapies, and medication-assisted treatments are offered for varying lengths of time.

Inpatient treatment involves living full time (including overnight) at a treatment facility for a set time period. Outpatient treatment involves scheduled appointments at a facility in which you are free to come and go. Within each category, there are several distinctions.

Ketamine Treatment Programs
Setting Type of Treatment Description Duration Time Commitment
Inpatient Short-Term Residential Intensive treatment, sometimes in a hospital setting. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:

24

Days Per Week:

7

Long-Term Residential Intensive treatment in a non-hospital setting, most often a therapeutic community with other patients. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-12 months Hours Per Day:

24

Days Per Week:

7

Partial Hospitalization Intensive treatment in a hospital setting. Patients do not stay overnight. Considered inpatient due to the hospital setting. Extensive services are provided and require a near full-time commitment every week. Medication-assisted treatment is available to those who qualify. 14-30 days Hours Per Day:

6-8

Days Per Week:

5

Outpatient Intensive Day Treatment Extensive services of an inpatient program but patients return home each day following treatment. After completion, patients often transition to less intensive counseling. Therapies offered are extensive. Medication-assisted treatment is available to those who qualify. 3-4 months Hours Per Day:

2-4

Days Per Week:

3

Counseling Both individual counseling and group counseling focus on short-term behavioral goals to develop coping strategies. Therapies offered are moderate. Medication-assisted treatment is not available. As long as desired Hours Per Day:

1-2

Days Per Week:

1-3

Support Groups Self-help groups center on maintaining abstinence after another form of treatment. Typically meet one day a week for 1-2 hours. As long as desired Hours Per Day:

1-2

Days Per Week:

1

Behavioral and Medication-Assisted Therapies

Behavioral therapy for substance addiction seeks to identify and manage addictive behaviors that lead to abuse and prevent relapse. Behavioral therapy is based on the concept that all behavior is learned, and thus, unhealthy behavior can be changed through learning coping skills and increasing awareness of negative thoughts and beliefs that contribute to substance abuse.

For some substances, such as opioids, medication-assisted treatment can help ease withdrawal symptoms, reverse changes caused by addiction, relieve cravings, block euphoric effects, and help sustain recovery. Because there aren’t any FDA-approved medications for ketamine addiction, the primary purpose of medication-assisted treatment for this substance is to treat individual symptoms of withdrawal with medications known to help alleviate these symptoms. Treatment may include an antidepressant, antipsychotic, anticonvulsant, and/or antianxiety medication.

Behavioral Therapies for Ketamine Addiction
Type of Therapy Definition
Cognitive Behavioral Therapy

Further reading:

Cognitive-behavioral therapy is structured psychotherapy that helps you recognize and stop negative behaviors and thought processes that cause you to abuse ketamine and teaches you coping strategies to prevent relapse.
Dialectical Behavior Therapy

Further reading:

Dialectical behavior therapy can be especially helpful for dealing with depression after quitting ketamine and helps you develop skills to better regulate your emotions, tolerate distress, and interact effectively with others.
Motivational Interviewing

Further Reading:

Motivational interviewing helps you address and resolve your ambivalence about stopping ketamine use while enhancing your motivation to quit and make healthy lifestyle changes.

Medication-Assisted Treatment for Ketamine Addiction

Type of Medication for Treatment Definition
Medications for Specific Symptoms

Further reading:

Various medications have been used during ketamine withdrawal to treat specific symptoms. In the past, these have included glutamate release inhibitors to reduce depression and cravings, benzodiazepines to relieve agitation and anxiety, antipsychotics for more volatile patients, and naltrexone to reduce cravings.

How to Find Help

Finding a Rehabilitation Center for Ketamine Addiction

While it may be less common for ketamine addiction to occur, it’s still a distinct possibility for chronic and/or long-term users, and more people are seeking rehabilitation and treatment each year. Due to limited information about the best treatment methods and an increased need for it, more research may soon be forthcoming.

When used by medical professionals, ketamine is a safe, effective anesthetic and pain reliever, among other things. However, when it’s abused and you’ve become addicted, it’s important to find a rehabilitation center that specializes in ketamine rehabilitation and treatment. Choose an addiction expert with a customized individual approach and solid continuing care services following your discharge.

Our Directory

Our directory of rehab programs includes a comprehensive list of available treatment centers and programs as provided by the Substance Abuse and Mental Health Services Administration (SAMHSA). In the directory, you will find tools to filter the programs by setting, price, and location.