Is ketamine a party or date rape drug? Is it a miracle drug to treat depression or substance use? Is it a drug to put people and animals under during surgery or to control pain? The answer is yes to its many uses. Ketamine is used as a recreational drug as well as for medical purposes. As a recreational substance, it can cause a person to feel disconnected from reality — like they are in a dreamlike state. In the medical world, it is used as a short-acting medication to sedate a person or animal. It has also been used off-label to treat chronic pain linked to cancer or migraines.
In recent years, it has gained popularity as a potential mental health treatment, particularly for severe depression. It may also be useful for treating substance use disorders. However, its benefits, dosage and long-term effects are still under
investigation, and it may be risky to use without medical supervision.
What is ketamine?
Ketamine is manufactured as a liquid that can be injected into the body, inhaled through the nose or taken through a tablet. It’s a form of hallucinogen which means that it can cause a person to feel detached from reality – it’s like living in a movie or a dream.
It is used as a general anesthetic[1] during medical procedures to make a patient unconscious. For example, it can be used in emergency departments when fixing broken bones or painful wounds. In low doses, it can be used by doctors to treat severe pain. It is also used in veterinary clinics for animals.
Also known as special K, super K and vitamin k, among other slang terms, in illicit use, ketamine is swallowed or evaporated to form a snortable powder. It is odorless and tasteless, so it can be added to beverages without being detected, and it can cause memory loss. Because it has been used to commit sexual assaults due to its ability to sedate unsuspecting victims, ketamine is also considered to be a “date rape” drug.
Why do people use ketamine?
While ketamine use is generally rare among individuals in the United States, it has increased in recent years.[2]
People who use ketamine illegally are usually doing so for its mind-altering effects. Ketamine in lower doses can act as a stimulant. In higher doses, it can cause dream-like states and hallucinations, and often complete feelings of being disconnected from reality. People who use it report sensations ranging from a pleasant feeling of floating to being completely separated from their bodies.
Similar to LSD and PCP, ketamine’s effects have made it a “club drug,” used by individuals going to events like raves.
Signs of ketamine use include:
- Altered behavior; can be more mellow or have more energy
- Irritable or agitated
- Depression
- Slurred speech
- Rapid eye movements
- Difficulty sleeping
- Significant mood changes
- Nausea and vomiting
- Skin redness or flushing
Not everyone will react to ketamine in the same way. Differences in body type, age, the strength of the ketamine being taken and one’s own ability to handle the drug can mean that individual experiences are wildly different from one another.
What are the negative effects of ketamine?
Some ketamine experiences involve a terrifying feeling of almost complete sensory detachment that is likened to a near-death experience. These experiences, similar to a “bad trip” on LSD, are called the “K-hole.” This can make someone feel completely frozen and immobile, and sometimes causes psychosis.
Low doses of ketamine may result in problems with attention, learning ability, and memory. Recent research has found that regular ketamine use can lead to severe urinary tract infections.[2] In high doses, ketamine can cause delirium or extreme confusion, memory loss, problems with physical movement, high blood pressure, and depression. There is also the possibility of breathing problems that can be fatal.
Flashbacks have been reported several weeks after ketamine is used. Ongoing use may also cause restlessness, depression, thinking difficulties, loss of consciousness and memory loss. Psychosis (e.g., seeing and hearing things that aren’t real or extreme fear) can also last after someone stops ketamine use.
Additionally, it is possible to overdose on ketamine, particularly if it is mixed with other substances.[3] Using ketamine along other hallucinogens like magic mushrooms or LSD can significantly increase the effects of both, which can put an individual at danger of serious accidents. Ketamine combined with opioids or alcohol can cause an individual to pass out, vomit or even fatally overdose. Ketamine-related poisonings have also increased in recent years.
It is also important to note that standard drug tests are unlikely to detect ketamine in the body. One of the safest ways to ingest ketamine is through a nasal spray, which helps an individual control how much they are taking.
Does ketamine treatment work for depression?
Recent research[3] has found that ketamine therapy can help to relieve severe depression other treatments have not helped. This is often called “treatment-resistant depression.” Although there are different definitions of treatment-resistant depression, it generally means that antidepressant(s) or other common therapies have not worked to reduce symptoms.
In 2019, the FDA approved a ketamine nasal spray. It is called esketamine[4] and is sold under the brand name of Spravato. It is recommended to treat major depression, suicidal thinking and treatment-resistant depression for adults over the age of 18. It is only available by prescription and must be taken at a certified doctor’s office or clinic. Because of the risks associated with the medication, patients must be monitored by their healthcare provider for at least two hours after receiving a dose.
Many studies have shown that ketamine therapy can effectively treat depression.[5] The benefits can be felt very quickly, sometimes within 40 minutes, though this depends on the way it is administered (through an IV, the nose, etc.). The effects generally do not last very long, peaking at a few hours and generally impacting a patient for a few days to a week, which also depends on how it is administered. As a result, it is not yet known if this treatment is effective in the long term, or if it can only provide temporary relief from depression symptoms. On-going maintenance treatment may be needed, depending on the patient.
Small research studies[6] show that it may be safe and effective for treating depression in adolescents between the ages of 12 and 17. However, more research is needed to determine if this can help young people. Spravato is not approved for children.
Ketamine therapy for depression does not work for everyone. Stephen Petrow[7] , a contributing writer for the Washington Post, shared his experiences with ketamine after years of treatment with antidepressants and talk therapy. “In the days that followed I still didn’t feel like myself. Detached. Untethered. Scared. In a world of my own. Several friends noticed this difference in me, with one asking me directly if I was at risk of self-harm.”