Is Ketamine Addictive?
Updated: Jul 27
Whenever a doctor prescribes a new medication, it is nearly reflexive to wonder whether it might be addictive. After all, we’ve seen the news stories about the opioid crisis, and it’s natural to be wary of medicine that you’ve never tried before.
The answer is simple, but it requires some understanding of the different types of addiction. There are two types of addiction: psychological and physical. Most people are more concerned about physical addiction. Ketamine is not usually physically addicting. If you miss a ketamine therapy session, you will not feel negative physical side effects often associated with withdrawal in addicts.
It’s worth noting that ketamine has been used around the world as one of the safest anesthetics for adults, children, and animals. It has been exhaustively studied for decades and has not been shown to cause addiction the way that opioids do.
However ketamine, like any drug, has the possibility of becoming psychologically addicting. Risk factors for psychological addiction are completely different from physical addiction and have little to do with the medication in question. Continue reading for more information about psychological addiction and how to differentiate it from physical addiction.
Psychological Addiction Vs. Physical Addiction
It’s important to begin by addressing the two types of addiction: psychological and physical. By understanding the difference between the two, you will have a better idea of what it means to say that ketamine can be psychologically addicting at the prescribed dose, but not physically addicting at the dosages a doctor would prescribe.
The pharmacology of drugs can create physical addiction in patients and as a result, some drugs have a higher risk of addiction than others. The chemical makeup of a drug decides how it influences your brain. Some drugs, like Ibuprofen, affects your body by suppressing pain signals and lowering your fever. Other drugs, like cocaine, cause a large amount of dopamine to flood certain parts of your brain, resulting in a high and making you feel elated.
The elevated level of dopamine eventually leads to addiction because your body comes to rely on the large presence of the neurotransmitter, and in turn decreases the number of receptors which the dopamine activates. When you aren’t under the influence of the cocaine or elevated dopamine levels, your brain receptors are “starved” for stimulation and as result you crave more.
Ketamine doesn’t affect your dopamine receptors or involve the reward center of your brain. In fact, it is prescribed by doctors around the world as a sedative and anesthetic during surgical procedures because it is less likely to cause addiction than opioids while still effectively suppressing pain. Recent research has even looked into using ketamine to control flare-ups for patients with chronic pain.
Keep in mind that recreational ketamine can be physically addicting. This is because unregulated, large doses for the purpose of hallucinating acts more dramatically on your body. That is why ketamine is labelled as a Schedule III drug and is not legal to take outside of the purview of a licensed medical professional.
As a recreational drug, ketamine may be known as Special K, Kit Kat, or Vitamin K. One reason why it can lead to physical addiction when you begin at high doses is that humans quickly build up a tolerance to ketamine. If you’re taking it to chase a high, you will soon need to take larger and larger doses to recreate the feelings.
When you take it as part of a prescription, however, you begin at a much lower dose. This is known as a subdissociative dose because it is low enough that most patients do not hallucinate or dissociate. Additionally, your goal in a medical context is to feel the regenerative effects of ketamine after your session as your mind forms new and better pathways. When you aren’t trying to ‘get high’ and your doctor is monitoring your medicinal intake, there is nearly no worry of becoming physically addicted to ketamine.
Psychological addiction is very different from physical addiction, although they both lead to the same drug-seeking behaviors. Physical addiction, as noted above, is when your body becomes dependent on a drug to feel normal. Your body has trouble functioning normally without a baseline amount of the drug in your body and you need an increasingly larger amount of drugs to achieve a high. Physical addiction will lead to withdrawal symptoms when you stop taking it.
Psychological addiction is an imagined dependence on a drug. You may feel like you can’t accomplish basic tasks without consuming more of the drug, even though your body isn’t physically dependent on it. Knowing that a specific drug makes you feel good, or that you will feel poorly without it, can cause a strong psychological addiction.
Psychological addiction can be just as powerful of a condition as physical addiction. Ketamine, like all drugs, is designed to impact your body. Someone could, in theory, become psychologically addicted to any drug.
Even drugs that don’t have any physical dependence can cause mental dependence. However, ISHA’s trained professionals are there to ensure that you take a consistent amount of ketamine on a prescribed schedule and to help you work through any possible ensuing issues.
Ketamine’s Properties at the Subdissociative Dose
Research on ketamine therapy pharmacology has revealed that many of the effects seen in higher doses are mostly absent in lower doses. Experiences regarding dissociation, or the feeling of being completely detached from reality, and hallucinations are extremely rare in subdissociative doses.
Another aspect that separates medically prescribed ketamine from recreational ketamine is the frequency of doses. Recreational ketamine users may self-dose multiple times per day or for many days on end without taking a break. The combination of high doses taken at a high frequency make ketamine have a high risk of physical and psychological addiction.
Under your ISHA’s supervision, you will take a predetermined, consistent amount of ketamine on a controlled schedule with constant monitoring. We will walk you through the process from start to finish and continuing watching you through our telehealth system to ensure that you have as positive of an experience as possible.
Lumanauw DD, Youn S, Horeczko T, Yadav K, Tanen DA. Subdissociative-dose Ketamine Is Effective for Treating Acute Exacerbations of Chronic Pain. Acad Emerg Med. 2019 Sep;26(9):1044-1051. doi: 10.1111/acem.13755. Epub 2019 Apr 29. PMID: 30901130.