What Is Ketamine? Recreational Use, Dangers, and Therapy Explained

A Larger Illicit Supply

Seizure data suggest the illicit supply has also grown. The number of ketamine seizures by U.S. law enforcement increased 349% from 2017 through 2022, and more than 98% of the ketamine seized was in powder form. The same JAMA Psychiatry authors note that only a small amount of ketamine may be diverted from medical settings. Most of the increase in recreational use appears to be supplied by illicit trafficking. Illicit ketamine is also generally much cheaper than prescribed ketamine or esketamine.

Who Is Using Ketamine

From 2021 to 2022, adults ages 26 to 34 were 66% more likely to have used ketamine in the past year than adults ages 18 to 25. Adults with college degrees were more than twice as likely to have used it as those with a high school education or less. People who used ecstasy (MDMA), GHB, or cocaine were also more likely to use ketamine.

The link between depression and ketamine use has weakened. From 2015 to 2019, adults with depression were 80% more likely to have used ketamine in the past year. From 2021 to 2022, however, ketamine use increased only among adults without depression.

Social and Cultural Factors

Some people take ketamine at clubs “so that they can socialize without feeling anxious or without feeling insecure about themselves.” In addition, its effects are shorter-lasting than those of many similar drugs, and more people now see alcohol as harmful. These are observations from NPR reporting, not findings from clinical research.

Growing popularity does not mean ketamine is safe to use without medical supervision. Ketamine is generally considered a safe anesthetic in medical settings, but misuse can lead to serious harm. Illicit ketamine may be adulterated with substances such as fentanyl, and young, otherwise healthy people have died after combining ketamine with alcohol.

Ketamine Recreational Use: Effects and the “K-Hole”

Recreational ketamine use involves taking ketamine without a legitimate prescription or outside a prescribed treatment plan, often leading to euphoria, dissociation, and altered perceptions of time and space. Users may experience hallucinations, a sense of detachment from their bodies, and profound sedation.

At high enough doses, a person may enter what users call a “k-hole.” Although the experience can vary from person to person, some general characteristics exist. Users disconnect from reality, as if watching themselves experience the world. Intense visual and auditory hallucinations accompany this dissociation, ranging from abstract colors to two-dimensional planes to dreamlike landscapes that defy all physical laws.

People may also lose motor control and their sense of taste, temperature, and general body awareness. Finally, emotions can vary wildly, from euphoria to intense fear and anxiety. Some people have emphasized euphoria; others have called it a “near-death experience” and a complete loss of self.

Dangers of Ketamine: Addiction, Bladder Damage, and Overdose

The main dangers of ketamine include addiction, memory and thinking problems, bladder damage, contaminated street supplies, and overdose, especially when ketamine is mixed with alcohol or other drugs. One significant concern is the risk of addiction. Ketamine can be habit-forming and lead to dependence. Prolonged, excessive use can cause tolerance, meaning users need higher doses to achieve the desired effects. Stopping suddenly after heavy, long-term use may cause withdrawal symptoms.

Other risks of ketamine use include cognitive impairments, memory problems, and bladder toxicity. Chronic use can damage the bladder and urinary tract (sometimes called ketamine bladder syndrome), leading to symptoms such as frequent urination, pain, and difficulty emptying the bladder. Ketamine bought from illicit sources may also vary in purity and strength. Adulteration with other substances is risky, increasing the potential for unexpected and harmful effects.

Finally, there is the risk of overdose, which is uncommon when ketamine is taken alone but rises with cross-drug use. In party and social settings, ketamine is often taken with other substances. High doses can result in severe respiratory depression, loss of consciousness, and even death. The risk is especially high when people combine ketamine with alcohol or opioids.

Ketamine Therapy: How Supervised Treatment Works

Ketamine therapy is the medically supervised use of ketamine to treat certain mental health conditions. Research on its therapeutic potential has focused mostly on depression that has not improved with other treatments. Ketamine infusion therapy, which is sometimes paired with talk therapy in an approach called ketamine-assisted psychotherapy, has emerged as a novel treatment option for treatment-resistant depression and other mental health conditions. Because ketamine itself is not FDA-approved for psychiatric use, these infusions are given off-label.

During a ketamine infusion session, a controlled dose of ketamine is administered intravenously in a clinic or hospital setting under the supervision of medical professionals. Treatment typically involves multiple sessions over a few weeks, each lasting about 40 minutes. Some patients notice improvement within about a day, much faster than with traditional antidepressants, but results vary from person to person.

Esketamine is also available as an FDA-approved nasal spray that patients self-administer under the supervision of a healthcare professional. In January 2025, the FDA also approved esketamine as a standalone treatment for adults with treatment-resistant depression, so it can now be used with or without an oral antidepressant. After administration, the individual is typically monitored for at least two hours to ensure safety and watch for any immediate side effects or adverse reactions. Treatment usually starts with twice-weekly doses, then gradually becomes less frequent.

Every medical use of ketamine described above takes place under close supervision by medical professionals. Self-medicating is risky because people cannot reliably control the dose or purity or safely monitor their own reactions. The FDA warned that using compounded ketamine at home without monitoring may put patients at risk of serious side effects.

Alternatives to Ketamine Therapy for Depression

Research on ketamine for depression is still evolving, especially on long-term safety and how long benefits last. Established alternatives include traditional antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs). These medications, though slower-acting compared to ketamine, have been extensively studied and are effective for many individuals with depression and anxiety disorders. Another option is transcranial magnetic stimulation (TMS), an FDA-cleared, drug-free treatment that uses magnetic pulses to stimulate brain regions involved in mood. It is often considered when depression has not improved with medication.

Furthermore, various psychotherapeutic approaches, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and interpersonal therapy (IPT), are effective for many people with mental health conditions. These evidence-based therapies address underlying causes and teach coping mechanisms that can support long-term recovery and well-being.

Frequently Asked Questions About Ketamine

What is ketamine used for?

Ketamine is FDA-approved as an anesthetic for medical procedures. Clinicians may also prescribe it off-label for treatment-resistant depression. A related drug, esketamine (Spravato), is FDA-approved for that condition.

Is ketamine addictive?

Yes, ketamine can be habit-forming. Repeated use can lead to tolerance and dependence, and some people keep using it even when it harms their health, work, or relationships.

Is ketamine therapy the same as recreational use?

No. Ketamine therapy uses measured, pharmaceutical-grade doses in a clinical setting, with monitoring during and after each session. Recreational use involves unknown doses and purity with no medical oversight, which increases the dangers of ketamine.

Can you overdose on ketamine?

Yes. According to the DEA, a ketamine overdose can cause unconsciousness and dangerously slowed breathing. The risk is higher when ketamine is combined with alcohol, opioids, or other substances.

Get Help for Ketamine Addiction at GateHouse Treatment

Although we understand that sometimes drugs may provide momentary relief, their continued and unsupervised use can lead to addiction and serious health problems. If your ketamine use feels out of control, or you’re worried about someone you love, help is available.

At GateHouse Treatment, we offer a variety of levels of care to get your life back on track. We offer outpatient, intensive outpatient, partial hospitalization, psychotherapy, medication-assisted treatment, family therapy, and more to support holistic wellness and sobriety.

You don’t have to carry this burden alone. Call us at (855) 448-3588 for a free consultation. Reach out on our website to regain control of your life.