Is Ketamine Addictive? Therapy Use vs. Dependence

Disclaimer: This article is for general informational purposes only. It is not expert medical advice, diagnosis, or treatment, and it does not replace formal treatment by a licensed clinician. If you are having a crisis or thoughts of suicide, call or text 9-8-8 (U.S.). If you are experiencing a medical emergency, call 9-1-1 (U.S.).

If you or someone you love is considering or taking ketamine for depression, or is worried about how much ketamine they are using, you might want to know is ketamine addictive.

The answer is that it can be. The risk depends on how often and heavily ketamine is used. A person receiving carefully supervised treatment is very different from a person using it regularly on their own. In this article, we will explain the difference, explore what ketamine addiction looks like, and what your next step can be.

Is Ketamine Addictive?

Ketamine can be potentially addictive. A substance is generally considered addictive when it leads to uncontrolled use despite negative impacts on your health and well-being. Ketamine is a controlled Schedule III substance in the U.S.; it has medical uses for sedation and anesthesia.

The next question is how addictive is ketamine. It is often placed below opioids, methamphetamine, and cocaine, and above some other substances like cannabis. The risk is lowest when ketamine is prescribed and supervised by a licensed clinician.

What Is Ketamine Addiction?

Ketamine addiction is a substance use disorder in which a person compulsively uses ketamine despite its negative consequences on their physical and mental health. Common symptoms of substance use disorders (including ketamine addiction), as per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), are:

• Strong cravings and urges
• Using more than planned, or for longer than planned
• Spending a lot of time getting, using, or recovering from ketamine
• Repeated, unsuccessful attempts to cut back
• Ongoing use despite physical or emotional consequences
• Prioritizing ketamine use over career and family
• Development of tolerance and withdrawal symptoms – needing a higher dose or more frequent sessions for the same effect (tolerance) is often the first sign that use is drifting toward dependence

If anybody is experiencing ketamine withdrawal symptoms, like sweating, tremors, elevated body temperature, or heart palpitations, seek medical attention right away.

What Are the Reasons for Ketamine Abuse?

Ketamine is a dissociative anesthetic with some hallucinogenic properties. It can create a sense of detachment from the body – offering a getaway from pain and suffering within you. It also impacts the brain’s reward system and can produce euphoria. For someone living with anxiety, depression, trauma, or chronic pain, that escape can feel like relief, but this relief is very temporary. Unfortunately, it is this short-lived relief that kicks off a pattern of use.

Clinicians use the term ketamine abuse for using ketamine for other reasons other than medical ones, such as using more than prescribed, using without a prescription, using someone else’s prescription, or using to cope with emotional distress.

Many of those who struggle this way also have an untreated mental health condition underneath, which is why treating both with therapy, medication management, skills training, peer community, relapse prevention, and continued care is crucial.

Is Ketamine Physically Addictive?

Ketamine is not as addictive as alcohol or heroin, but the body does adapt. Ketamine is more often described as psychologically addictive, meaning the use stems from cravings, habit, and emotional dependence. Even so, those who use it often can develop physical effects, including tolerance and unpleasant withdrawal symptoms when they stop.

Is Ketamine Addictive When Used for Depression?

When ketamine is given under medical supervision, at prescribed doses and intervals, the risk of abuse is much lower than what comes with recreational use. Only one type of esketamine nasal spray (Spravato) is U.S. Food and Drug Administration (FDA)-approved for treatment-resistant depression – meaning treatment for depression that has not responded to other first-line treatment options. However, this only happens in safe and supervised settings. It must be given in a certified clinic with at least two hours of monitoring. Ketamine itself is not FDA-approved for any psychiatric condition; IV ketamine infusions for depression are used off-label.

But even so, is ketamine therapy addictive? It can be for some, particularly those who have a personal or family history of substance use, who use ketamine between sessions, or who begin to rely on it to feel okay. If this seems familiar to you, speaking to your mental health treatment provider to adjust your care to your evolving needs is the first step toward change.

How to Tell the Difference Between Therapeutic Ketamine Use and Dependence?

Can Ketamine Be Prescribed in Telehealth Programs and Taken at Home?

Ketamine lozenges or tablets prescribed online are not the same as certified/supervised clinical treatment. The FDA issued a warning regarding at-home compounded ketamine leading to misuse, psychiatric effects, slowed breathing, and bladder problems especially when the treatment provider is not physically present to monitor you. As consumption happens at home, ketamine tolerance and ketamine dependence can develop.

If you become worried about your ketamine use, you can speak with your treatment provider so that they can suggest the next steps for you.

How Do Ketamine Withdrawal Symptoms and Timeline Look Like?

If someone has been using ketamine regularly, stopping can be uncomfortable. Common ketamine withdrawal symptoms are:

• Strong cravings
• Anxiety and restlessness
• Low mood or depression
• Trouble sleeping
• Fatigue
• Sweating or tremors in some

Ketamine addiction withdrawal is often more emotional than physical. Evidence on the exact ketamine withdrawal timeline is limited. Patterns vary by person, amount, and duration of use. Clinicians commonly describe it this way:

• First Few Days: Cravings, anxiety, and sleep troubles peak
• First Two Weeks: Cravings, mood changes, and fatigue may linger, but the other symptoms ease
• Few Weeks to Months: Cravings and low mood can come and go, especially under stress

Ketamine withdrawal is not typically life-threatening the way alcohol withdrawal can be. But anxiety and low mood can give rise to suicidal thoughts or ideation. If someone is experiencing suicidal thoughts or ideation, call or text 9-8-8 (U.S.) right away.

Ketamine Addiction Treatment

Ketamine can be addictive, but the encouraging news is also that ketamine addiction treatment can be effective. There is no FDA-approved medication specifically for ketamine abuse, so treatment focuses on behavioral therapies and whole person healing that treats the mind, body, and spirit.

• Behavioral Therapies: Motivational interviewing, cognitive behavioral therapy, contingency management, and 12-Step facilitation therapies.
• Underlying Mental Health Conditions: Dual diagnosis of ketamine use and mental health disorder(s) is treated together.
• Holistic Healing Practices: Nutrition, sleep, exercise, mindfulness, and other practices that focus on the whole you – mind, body, and spirit.
• Family and Peer Communities: Family therapy and peer community meetings, such as 12-Step and non-12-Step meetings, can be of immense use.
• Ongoing Care: Ongoing therapy, lifestyle modifications, and relapse prevention for a lasting recovery.

At Skyline Recovery Center, ketamine addiction recovery treatment is provided through structured outpatient programs, such as partial hospitalization (PHP) and intensive outpatient (IOP) programs. Our programs are tailored to your needs and goals and offer structure along with flexibility – you do not have to put your life on hold to receive the care you need and deserve.

If you need medical attention for other ketamine-related side effects, such as respiratory depression, liver injury, or ketamine bladder (a painful and potentially irreversible condition caused by ketamine damaging the lining of the urinary tract), we coordinate your care with respective providers so that you receive well-rounded care for your physical and mental health concerns.

If You Are Using Ketamine for Medical Reasons:

If a licensed clinician prescribes ketamine for depression, post-traumatic stress disorder (PTSD), or chronic pain, you do not have to choose between your care and your recovery. We begin by listening to how ketamine has helped you and what has changed in your use.

With your consent, we coordinate with your prescriber to review dose, frequency, and any use outside your treatment plan. If ketamine tolerance or dependence has developed, we treat it alongside the condition that led you to ketamine, so your healing does not depend entirely on ketamine.

Taking the Next Step In Your Ketamine Addiction Recovery Journey

If ketamine use has begun to feel out of your control, you do not have to sort it out by yourself. At Skyline Recovery, our team meets with you in confidential, supportive settings to recommend the right level of care and personalized treatment programs that meet you where you are.

Reach out to us to understand your options with someone who will listen to you – we are here for you, whenever you are ready.