Ketamine’s paradox: Life-changing therapy for some, devastating addiction for others

Ketamine’s rising popularity has created a paradox. While it’s hailed by some doctors as a breakthrough psychiatric treatment, it’s also driving a surge in addiction and harming people’s health. To better understand people’s experience of ketamine and how it might be best used in medical treatment, we surveyed hundreds of people who self-identify as struggling with ketamine addiction.

Ketamine is gaining recognition as a promising, rapid-acting intervention for mental health conditions for many. Phase three clinical trials are now underway for its use with people with alcohol problems. A ketamine-based nasal spray, Spravato, has also been approved as a standalone therapy for treatment-resistant depression,

But for others, particularly recreational users in their 20s, ketamine use can lead to more harm than healing.

Once seen as a fringe party drug, ketamine – also known as “K” – has now entered the mainstream, gaining popularity as a nightlife narcotic and reports of widespread use in Hollywood. But with its rise have come warnings: several high-profile deaths, including actor Matthew Perry and drag artist The Vivienne, have sparked public concern.

Medical ketamine is a regulated drug used in hospitals and clinics under professional supervision. Illegal ketamine, often used recreationally, is unregulated, may be contaminated and carries higher risks of overdose, addiction and health complications due to unknown purity and unsafe use.

To better understand the experience of ketamine addiction and to help inform improved treatments, our research team at the University of Exeter and University College London surveyed 274 people with self-identified ketamine addiction from Europe, North America and Australia**. We believe the results offer the most in-depth data of its kind to date.

While ketamine is chemically distinct from opioids, some users described its emotional and social toll as equally devastating. One participant described it as “the heroin of a generation”.

This stark characterisation underscores the growing number of people seeking treatment – not only for addiction, but also for physical health complications that can follow heavy, prolonged use.

Sixty percent of respondents reported bladder problems – a side effect well known among long-term ketamine users, but rarely discussed outside specialist circles. Many also described intense psychological symptoms such as cravings, low mood, anxiety and irritability.

While these experiences probably reflect heavier users than the average recreational consumer, they highlight the serious harms experienced by those who become dependent.

Alarming statistics

Alarmingly, over a third of our respondents had never sought treatment. Among those who had, only 36% were satisfied with the care they received. One person noted: “I think they need to research drugs or options that fight K bladder, K kidneys and K stomach cramps. Ketamine can make your lifespan much shorter.”

A recurring theme throughout the survey responses was frustration at the lack of awareness – among peers, educators, healthcare providers and even addiction specialists – about ketamine’s risks.

“No one even understands what ketamine is or what it does,” said one participant. They added: “It shouldn’t be our job to explain the science. It should be taught. People need to be educated. There’s so much less information out there compared to drugs like cocaine.”

Most participants had first encountered ketamine in recreational settings. Only four participants first encountered it through prescription, primarily in the United States, where at-home ketamine therapy is becoming more common. In contrast, the UK restricts ketamine use to clinical supervision.

Crucially, the doses reported by participants were far higher than those used in medical settings. Rapid tolerance development and escalating use were common concerns.

New treatment strategies

To support those struggling with ketamine addiction, our findings point to the urgent need for new treatment strategies. These include pharmacological options to address physical complications like “K cramps” (severe abdominal pain often described as excruciating) and improved understanding of how ketamine causes bladder and kidney damage.

Equally vital is improving education – both for the public and for healthcare professionals – about the risks of ketamine use and the realities of addiction. We hope our survey offers a platform for those with experience to be heard and for their voices to shape future research, clinical care and public health messaging.

This survey comes at a crucial time in ketamine’s evolving story. In response to rising recreational use and recent fatalities, the UK government is reportedly considering reclassifying ketamine as a Class A drug. However, when ketamine was reclassified from Class C to Class B in 2014, use among 16–24-year-olds increased by 231%, suggesting that harsher penalties do little to curb demand.

Instead of relying on punitive measures, we must focus on expanding treatment access, reducing stigma and investing in prevention. Our study shows the urgent need for more research into what makes ketamine addictive, how to prevent its physical harms and, most importantly, how to help people recover and reclaim their lives.

This article is republished from The Conversation under a Creative Commons license. Read the original article.