Studies suggest that ketamine use is safe when used in clinical care for people of a wide age range1 . Most negative side effects occur after consuming too much ketamine, during unhealthy personal use patterns, or combining it with alcohol. Ketamine can be addictive and can cause permanent bladder damage if misused. It should be noted, however, that a lethal dose of ketamine is difficult to reach.
Law enforcement seizures of black market ketamine are up sharply in the U.S. Ketamine purchased on the black market can be misrepresented as a counterfeit substance or mixed with potentially deadly adulterants, such as fentanyl.
Ketamine Risks
Things to Know
- Negative side effects from ketamine generally occur after overconsumption or combining it with alcohol
- Ketamine can be addictive
- If misused, ketamine can cause permanent damage to the bladder and urinary tract
- Black market ketamine can be mixed with deadly compounds
Ketamine Overdose
“K-hole” refers to a ketamine high that leads to a heightened state of dissociation, often making people feel out of body. Overdosing on ketamine is different. It may produce dissociation, but it will also produce significant symptoms, including uncontrolled eye movement, pupil dilation, excessive salivation, tachycardia, palpitations, chest pain, abdominal pain, tenderness, paranoia, dysphoria, restlessness, confusion, slurred speech, dizziness, ataxia, lockjaw, and muscle stiffness. However, these symptoms typically abate within 15 minutes to several hours without lasting effects. A lethal dose of ketamine is estimated at about 4.2 grams, or 4,200 milligrams for a 154-pound human2 .
Ketamine Heart Risks
Some reports suggest that ketamine can create instability in heart and blood vessel function3 . This may include a temporary increase in blood pressure and heart rate or a decrease in blood pressure and heart rate4 . Abnormal heart rhythms may also occur5 .
Respiratory Depression
Respiratory depression can also occur when someone takes or is administered too much ketamine, if it is combined with alcohol, or if the rate of administration is rapid6 . Ketamine can also cause confusion or agitation7https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877453/[/foonote] in some people due to its anesthetic, dissociative effects.
Nausea and Vomiting
Ketamine may cause nausea and vomiting8 and feelings of motion sickness in some patients. Mixing ketamine and alcohol can also lead to severe nausea and vomiting and is not recommended.
Bladder and Urinary Tract Issues
The frequent and nonclinical consumption of ketamine can lead to potentially permanent bladder and urinary tract issues9 . Frequent, long-term usage of ketamine has been correlated with10 lower urinary tract symptoms and bladder dysfunction.
Is Ketamine Addictive?
According to a 2019 analysis, the abuse liability for ketamine appears minimal when administered in a clinical setting. The review analyzed private practice outcome data from 235 patients who received ketamine treatment for mental health conditions ranging from MDD to developmental trauma, PTSD, anxiety, and related disorders, and stated: “[D]espite the stigma of recreational use and concerns regarding addiction, ketamine used in KAP [ketamine-assisted therapy] practice does not produce any physical dependence. Importantly, we have not had patients seek ketamine outside of our clinical practices or encountered any other indication of addictive behavior”11 .