What is Ketamine? Side Effects, Uses, Risks, and More

Lately, ketamine has been capturing news headlines nationwide, both for its rapidly expanding medical use and its rise as a recreational substance. In the U.S., past‑year use among adults shot up about 40% from 2021 to 2022, continuing a sharp upward trend that public health officials have been observing since 2015.[1]

The U.S. isn’t the only country seeing an increase in ketamine use lately, though. In the UK, ketamine use increased by 85% from 2023 to 2024.[2]

Between the FDA approving Johnson & Johnson’s esketamine nasal spray, Spravato, and public figures like Elon Musk speaking out on their ketamine use, ketamine is no longer just an anesthetic or a fringe club drug. It’s one of the more popular mood-and-mind-altering substances people use today.

Despite its popularity, ketamine comes with the potential for serious risks. It can also be addictive.

In this article, we’ll explore what ketamine is, why people use ketamine, and the dangers associated with it.

What is Ketamine?

Ketamine is a dissociative anesthetic drug that was originally developed in the 1960s. It was used (and still is) in medical and veterinary settings to induce anesthesia and cause sedation.[3]

Ketamine doesn’t just make patients go unconscious like traditional anesthetics do. It also causes a dissociative state, where individuals often report feeling detached from their body or environment. This characteristic has made ketamine appealing for recreational use.

Today, ketamine is listed as a Schedule III controlled substance in the United States, meaning it is available by prescription but is closely monitored.

In addition to its approved medical uses, ketamine has gained attention for its off-label use in treating certain mental health disorders, particularly when other treatments have failed to provide relief. However, there are serious risks involved, especially when ketamine is misused or used recreationally.

Common Side Effects of Ketamine

When administered in a clinical setting, ketamine is generally considered safe and well-tolerated. The effects it produces can depend greatly on the dose that is administered during the session. However, it does come with a variety of side effects, especially at higher doses.

Common side effects of ketamine include:

Dissociation and hallucinations
Increased heart rate and blood pressure
Nausea and vomiting
Drowsiness or dizziness
Dilated pupils
Involuntary rapid eye movements
Bladder issues

Ketamine’s Therapeutic Potential: Uses for Depression, PTSD, and More

Over the past two decades, numerous studies have highlighted ketamine’s rapid-acting antidepressant effects. People who are prescribed it often report relief within hours of administration.

Ketamine may be used therapeutically to treat:

Treatment-resistant depression – Ketamine is particularly promising for individuals with treatment-resistant depression, or those who haven’t responded to conventional antidepressants. Sometimes a single infusion can provide rapid relief, though repeated treatments may be necessary for sustained benefit.[4]
Post-traumatic stress disorder (PTSD) – Early research suggests ketamine may also help individuals suffering from PTSD by reducing the severity and frequency of intrusive thoughts and flashbacks.
Anxiety disorders and suicidal ideation – Some evidence points to ketamine’s ability to reduce severe anxiety and suicidal thoughts, making it a valuable emergency intervention in psychiatric crises.[5]

It’s important to note that ketamine treatment for mental health is usually delivered in specialized clinics under close supervision. This includes careful dosing protocols, psychological support, and follow-up care, all of which are essential components of safe and effective therapy.[6]

Why Do People Misuse Ketamine? Understanding the Appeal

Despite its medical benefits, ketamine is also misused recreationally. Known on the street as “Special K,” it is often used for its hallucinogenic and euphoric effects.

People who misuse ketamine report experiencing a dreamlike or “out-of-body” state, sometimes referred to as a “K-hole.” A K-hole describes a dissociative episode marked by intense hallucinations and a sense of detachment from reality. The drug can also induce feelings of floating, time distortion, and other altered states of consciousness that many users find enjoyable or enlightening.

Ketamine is popular in club and rave cultures, where users may combine it with other substances for a more intense experience.

While ketamine can be appealing to some, the recreational use of it is illegal, and comes with numerous health and safety risks.

Potential Risks of Ketamine Misuse

Recreational or chronic misuse of ketamine poses several significant risks. These can be physical, psychological, and social in nature.

Physical risks include:

Accidental injury
Liver or kidney problems
Bladder and urinary tract damage
Physical dependence

Psychological risks include:[7]

Cognitive impairment
Worsening mental health problems
Poor decision-making
Memory loss
Tolerance and dependence

There are legal and social risks of using ketamine recreationally, too. The possession or distribution of ketamine without a prescription is illegal in many countries, including the U.S., and can lead to criminal charges. And, like many other mood-and-mind-altering substances, ketamine misuse can strain relationships, impact job performance, and reduce a person’s overall quality of life.

What to Do if You or Someone You Love is Using Ketamine

If you or someone you care about is using ketamine, it’s important to respond with empathy, not judgment. Substance use can be complex, and approaching the topic with understanding can make a significant difference in their willingness to seek help.

Start by having a calm, respectful conversation. Express concern without blame, and focus on how the person is feeling rather than solely on their behavior. It’s okay to ask questions and listen without trying to “fix” everything immediately.

If ketamine use is interfering with daily life, mental health, relationships, or safety, consider reaching out to a healthcare provider or mental health professional. Addiction specialists and therapists trained in substance use can provide guidance and support tailored to individual needs.

Support groups—both in-person and online—can also be valuable for individuals and their loved ones. Recovery is not one-size-fits-all, but there is help available. For local treatment and recovery options, visit https://apcbham.org/find-help/adult-substance-use/.

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