Is Ketamine Physically or Psychologically Addictive?

Ketamine misuse is a growing problem throughout the UK, with government figures showing that usage is on the increase, especially among younger people. Data from the Crime Survey for England and Wales showed more than a fourfold increase, from 0.9%  of 16-24-year olds using the drug in 2006-07, compared to 3.8% in 2022-23. There was also an increase in the proportion of adults entering treatment for ketamine problems in 2023-24, from 1.6% in 2022-23 to 2.3% last year.

But what are the dangers of this drug, and is ketamine physically or psychologically addictive?

What Is Ketamine?

Ketamine was developed in the 1960s and became commercially available in the 1970s when it was used as a rapidly acting, nonbarbiturate general anaesthetic. The drug has been used at various times as a battlefield and veterinary anaesthetic – you might have heard ketamine referred to as a ‘horse tranquiliser’.

Ketamine is still commonly used in veterinary medicine and is also used in human medicine – although not as frequently as some other painkillers. When it is used, it tends to be in trauma situations for severe, acute pain, although it may also be used to treat severe pain from cancer and some other types of chronic pain.4 Some studies suggest that it may have the potential for treating depression, but it is not currently licenced for this in the UK.

Ketamine is also commonly used as a recreational drug, often referred to as ‘Special K’ or ‘Ket’, for its dissociative and numbing effects. It is classified as a Class B drug under the Misuse of Drugs Act 1971 in the UK, making possession illegal without a prescription.

Is Ketamine Physically or Psychologically Addictive?

While studies into ketamine are still ongoing, it appears that it does not generally cause physical dependency along with severe physical withdrawal symptoms, as can be the case with drugs such as opioids and alcohol. Psychological addiction is far more common with ketamine use due to the mental cravings it creates. These may often be linked to a desire to ‘escape reality’ or deal with emotional distress. Users may experience psychological withdrawal symptoms if they try to stop or reduce their use of the drug.

There is also evidence that users can develop a tolerance over time, meaning more of the drug is needed to get the same effect.

The Psychological Addiction to Ketamine

Ketamine affects the brain’s reward system, producing feelings of euphoria. The drug’s dissociative properties can cause feelings of detachment, and some people also experience altered perceptions, including hallucinations. Many people seek out these effects and this can lead to compulsive use and psychological dependence on ketamine, especially in individuals using the drug as a coping mechanism for stress, trauma or anxiety.

Addiction is a complex condition. The National Institute on Drug Abuse says addiction is “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences”, adding that it involves “functional changes to brain circuits involved in reward, stress, and self-control”.

Ketamine certainly appears to fit these criteria. Some signs of psychological ketamine addiction could include:

• Obsessive thoughts about ketamine
• Cravings when not using the drug
• Prioritising drug use over responsibilities
• Continuing to use it despite negative consequences
• Using ketamine to self-medicate or escape problems

Can Physical Dependence Develop?

When considering ketamine physical vs psychological addiction, it should be noted that ketamine does not typically cause physical withdrawal symptoms like opioids or alcohol. Ketamine withdrawal symptoms tend to be psychological, but they can be severe and include mood swings, agitation, depression and acute anxiety. Some people might also experience physical side effects such as sweating, shaking and nausea.

Ketamine use also brings numerous physical risks, including the potential to overdose and damage to the bladder and kidneys.

The Long-Term Risks of Ketamine Addiction

The long-term effects of ketamine abuse include both mental health impacts and physical damage. Ketamine abuse – particularly heavy and/or prolonged usage – has been linked to changes in brain structure and function, as well as serious mental health conditions, including anxiety and even psychosis.

Some relatively common mental and cognitive side effects associated with ketamine include:

• Anxiety
• Paranoia
• Memory loss
• Cognitive impairment
• Shortened attention span
• Mood swings

Ketamine use can also cause physical damage, particularly to the bladder and urinary tract. It is estimated that as many as 26–30% of ketamine users experience at least one bladder symptom and the condition commonly known as ‘ketamine bladder’ can be severe and long-lasting. Ketamine bladder can lead to difficulty urinating, incontinence, pain and inflammation.

There is also some evidence that ketamine use can damage the cardiovascular system by increasing blood pressure and heart rate.9

Ketamine use can also have shorter-term risks. It can cause a lack of awareness and coordination that can increase the risk of accidents and put the user in dangerous situations. There have been cases where ketamine has been used to facilitate sexual assault or ‘date rape’, for example.10

It is possible to overdose on ketamine. This can lead to a range of symptoms, including seizures and slowed breathing. Overdose can be particularly dangerous when ketamine is mixed with other drugs, and there have been reports of fatalities.11

Another risk is an extreme sense of dissociation commonly known as a ‘K-hole’. This causes a sense of being ‘disconnected’ from the body. The effects are usually temporary but can be very distressing, and some people may suffer lasting psychological damage.

Treatment Options for Ketamine Addiction

Ketamine addiction treatment UK options may include:

• Detox Programmes – Medical supervision to manage psychological withdrawal and cravings
• Therapy and Counselling – Evidence-backed techniques such as Cognitive Behavioural Therapy (CBT) to address psychological dependence
• Holistic Therapies – Mindfulness and stress-relief practices to support emotional recovery
• Support Groups – Peer support networks to maintain recovery

Comprehensive rehab programmes can combine all these factors and more into holistic treatment programmes that address every aspect of addiction, including the root causes of substance misuse. Step One’s personalised treatment plans include inpatient rehab, outpatient care and aftercare support.

If you are struggling with ketamine misuse and dependency, get in touch with Step One today for confidential advice and assessments or to get the ball rolling on treatment and recovery.