Ketamine Addiction, Abuse, and Symptoms

How ketamine affects the brain

Although ketamine has a currently accepted medical use, there’s potential for abuse, which can lead to low or moderate physical dependence and/or high psychological dependence. Exactly how it affects the human brain isn’t completely clear, but neuroimaging studies have revealed functional and/or structural abnormalities in the brains of chronic users. Psychiatric disorders, including depression, cognitive impairment, and psychosis, are prevalent among chronic users, and irreparable brain damage could result from extreme use.

Behavioral signs of ketamine usage and abuse

Prolonged ketamine abuse can affect a person’s emotional state, personality, and behavioral patterns. Some noticeable changes can include increased irritability, restlessness, anxiety, and mood swings with a decrease in sociability. Even casual use can cause hallucinations, and excessive use can intensify hallucinations and lead to psychotic episodes. These episodes may lead to schizophrenic-like behaviors and tendencies, including hearing sounds or voices that aren’t really there, preoccupation with unimportant sounds, unusual thought content, disorganized speech, and emotional withdrawal.

Continued use of ketamine often leads to tolerance and addiction. Once a person is addicted, they may continue using the substance despite apparent negative effects on their health, relationships, and careers. Ketamine addiction could lead to impaired judgment and risky behaviors, including committing crimes to get more of the drug and satisfy extremely strong cravings. A person addicted to ketamine often lacks control over their drug use and spends all their time trying to acquire the drug, ignoring their other responsibilities and obligations. As the person’s addiction worsens, they may display a total lack of motivation and enjoyment of life with prolonged isolation and increasing depression.

How ketamine affects the body

Physical effects on the body are often dependent on the dose. Even at lower doses, ketamine can impair your motor functions and cause disorientation, hallucinations, numbness, uncontrollable eye movements, drowsiness, changes in perceptions of color and/or sounds, slurred speech, and nausea. High doses of ketamine can also cause these symptoms, plus severe respiratory depression, increased or decreased heartbeat, dizziness, muscle weakness, muscle twitches and stiffness, impaired vision, amnesia, immobility, agitation, aggression, and flashbacks. Other adverse effects include difficulty thinking or learning, upset stomach and vomiting, and dissociation from your body and identity. Heavy use can lead to serious gastrointestinal issues, debilitating lower urinary tract issues, liver and kidney dysfunction, respiratory problems, depression, and death from overdose in extreme cases.

Early physical effects of ketamine

Within minutes of taking ketamine, you may experience increased blood pressure and heart rate, which gradually decreases after about 10 to 20 minutes. You may become mellow and unresponsive to stimuli, feel a dissociation with your body, have an altered perception of sounds and/or color, and experience numbness, dilated pupils, rapid eye movements, stiffening of muscles, involuntary muscle movements, tearing eyes, drooling, and nausea. Hallucinations often occur and last about an hour or less, but difficulties with coordination and impairment of your judgement and physical senses may last up to 24 hours after taking the drug. High doses of ketamine may produce even more intense effects commonly referred to as falling into the K hole in which users are unable to communicate or move with memory loss a common occurrence.

Severe and long-term physical effects of ketamine

When used in a controlled medical setting and individualized to the patient, ketamine can be beneficial, but when it’s misused, it can cause long-term psychological and physical health problems. Repeated use of ketamine, especially in large doses, can lead to memory loss, depression, stomach pain and ulcers, respiratory problems, seizures, psychosis, and gastrointestinal issues. Flashbacks have been reported for several weeks after using ketamine.

Frequent use also may eventually cause ketamine-induced ulcerative cystitis and contracted bladder, dubbed ketamine bladder syndrome. This is a severe, extremely painful condition that requires ongoing treatment. Urinating becomes painful, and incontinence, or difficulty holding in urine, is common. Bladder issues may also lead to renal (kidney) damage, which makes your body dependent on dialysis. Similar effects have been seen in the bile ducts causing chronic liver injury.

Long-term ketamine users may develop a craving for the drug, leading to dependence and addiction. The risk for overdose is high for recreational users, especially as they develop a tolerance and begin increasing their dosage. Problems with memory loss may also cause users to forget how much they’ve taken, so they take more than they should. Combining ketamine with alcohol and other substances that increase the sedative effects can also lead to a fatal overdose.

As noted by Credentialed Alcoholism and Substance Abuse Counselor Jeremy Barnett, “Ketamine is not a very commonly abused substance, and, as such, is lacking much needed research and attention. There is no known medication to aid in cravings, which makes treatment that much more challenging. Long-term ketamine use can cause significant health issues, such as problems with the bladder and other internal organs. Ketamine is often used in party settings, as users may experience dissociative and hallucinatory effects. Many intense ketamine highs can results in a “K Hole,” leading to a strong sense of unreality, and, in certain settings, increasing potential risk of falling victim to predatory sexual behavior.”

Global hallucinogenic usage is hard to define but seems to be on the rise

While there weren’t any global estimates on the use of hallucinogens in the 2019 United Nations Office on Drugs and Crime World Drug Report, many countries report their use without specifying the type of hallucinogens used. However, when ketamine was specified, its use was mainly reported in South-East Asia with increased use in Cambodia, Indonesia, and Thailand. In Australia, the reported non-medical use of ketamine was 0.4% in 2016, which demonstrated an increase following a period of relative stability. England and Wales saw a significant increase of past-year hallucinogen use, with a considerable increase of ketamine use between 2016/17 and 2017/18. This leap was primarily due to an increase from 1.2% to 3.1% among adolescents and young adults between the ages of 16 to 24 and represented the highest estimated use of ketamine since this country began measuring its use in 2006-07.

Hallucinogen usage in the United States remains high among all age groups

According to the 2018 National Survey on Drug Use and Health, an estimated 5.6 million people in the United States ages 12 or older used hallucinogens in the past year, representing 2% of the population. Several drugs are grouped in the hallucinogen category, including LSD, PCP, peyote, psilocybin mushrooms, MDMA (ecstasy), ketamine, DMT, and salvia divinorum.

In 2018, 1.1 million new users of hallucinogens were reported. Approximately 376,000 adolescents ages 12 to 17 used hallucinogens that year, representing 1.5% of adolescents. About 6.9% of young adults between 18 and 25 used hallucinogens over the past year, representing 2.3 million people in this age group. An estimated 1.3% of adults age 26 or older used hallucinogens in 2018, representing 2.9 million people in this age group, which also represented an increase over percentages reported in 2015 through 2017.