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Ketamine Detox Guide: Symptoms, Timeline, and Effects

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Ketamine is becoming increasingly popular to rave goers.
Ketamine is a dissociative anesthetic drug that has some hallucinogenic properties. Much of the illicit supply of ketamine is stolen or illegally obtained from legitimate sources, such as veterinary clinics.14 It is often referred to as a “club drug” since many teens and young adults abuse it in party settings, such as bars, raves, and clubs.14,15

The common street names of ketamine include Jet K, Cat Valium, Special K, and Purple. Ketamine is frequently encountered as a white powder or a clear liquid. It is usually smoked in marijuana or tobacco cigarettes, cut into lines and snorted, injected, or mixed into drinks. Users often take it with other drugs, including cocaine and methamphetamine.14

Short-term Effects of Ketamine Use

Ketamine produces dissociative effects which have the potential to make the user feel disconnected from reality and out of control. It may produce hallucinations, which involve hearing, seeing, or feeling things that are not there. The effects of ketamine last about 30-60 minutes.14

There are several slang terms used to describe the effects of the drug, including:14

  • K-hole: This refers to a near-death or out-of-body experience.
  • K-land: This describes a colorful and mellow experience.
  • God: When ketamine users believe that they have met God or a higher power.
  • Baby food: Users experience bliss and sluggishness.

There are other side effects users may experience, such as:16

  • Belligerence or aggressiveness.
  • Impulsiveness.
  • Volatility.
  • Impaired judgment.
  • Loss of control of body movements.
  • Muscle rigidity.
  • Slurred speech.
  • Uncontrollable eye movements.
  • Increased blood pressure and heart rate.
  • Diminished response to pain.
  • Increased sensitivity to certain sounds.
  • Seizures.
  • Coma.

The reinforcing effects of ketamine, such as feelings of pleasure and dissociation, may compel people to continue using the drug. However, each use of the drug can expose a person to an unpredictable set of frightening and even harmful side effects. Receiving ketamine detox and treatment can help to prevent casual ketamine users from progressing to an addiction, a condition that leads to significant distress and impairment in an individual’s life.

Consequences of Long-term Use

Long-term use of ketamine increases the risk of experiencing detrimental side effects, some of which can be fatal. These include:14, 15,16

  • Flashbacks, even several weeks after last use.
  • Cognitive problems.
  • Depression.
  • Increased risk of overdose, especially when combined with other drugs.
  • Tolerance, or a need for higher doses to achieve the same effect.
  • Addiction, characterized by uncontrollable ketamine use regardless of negative effects.
  • Cravings for ketamine.
  • Increased risk of injury caused by accidents, falls, or fights.
  • Impaired memory, speech, and cognition.
  • Intracranial hemorrhage, or bleeding inside the brain.
  • Rhabdomyolysis, or the breakdown of muscle tissue, which can lead to kidney failure.
  • Increased risk of cardiac arrest, hyperthermia, and respiratory problems.

Even if a long-term ketamine user has developed a problematic pattern of use, it’s never too late to enter a detox or addiction treatment program that can help you on the road to recovery.

Effects and Symptoms of Ketamine Withdrawal

The effects of ketamine vary depending on the method of illicit use. The drug can be injected, smoked, swallowed or snorted. It remains in the system for 11 to 17 hours on average. Consequently, the most intense physical withdrawal symptoms occur shortly following discontinuation of use and can last for several days. A number of factors can influence this, including 3:

  • Age.
  • Dosage.
  • Frequency of administration.
  • Weight.
  • Hepatic function – elimination takes longer when liver function is impaired, which may delay the onset of withdrawal.

Similar to other drug addictions, ketamine’s withdrawal syndrome may prove unpleasant and difficult to bear, however the physical symptoms of withdrawal are rare. 4, 5 In some cases, ketamine withdrawal symptoms are not much different from the symptoms seen to arise from actively abusing the drug, including:

  • Depression.
  • Insomnia.
  • Difficulties with coordination 6.
  • Cognitive impairment.
  • Urinary complications 7.

Some specific groups appear to be at greater risk for negative withdrawal symptoms than others. Existing research suggests that women are more likely to demonstrate cognitive decline and urinary problems than men 8. Patients who experience depression prior to ketamine use are likely to have more serious issues with depression upon cessation of the drug 9.

Detox Timeline and Protocol

The acute withdrawal period for ketamine will often dissipate within a few days. Less severe symptoms can extend for longer periods, however.

No medications have been approved by the FDA for addiction to ketamine. Instead, treatment focuses primarily on the emotional and/or psychological withdrawal symptoms that may appear.

Girl undergoing therapySupervised detoxification can take place in or later transition into a longer residential treatment program. Residential addiction treatment centers typically last for 30, 60 or 90 days. Post-detox treatment will focus on providing both the medical and psychological support necessary to help manage cravings, teach relapse prevention skills, and instill new ways of thinking and behaving that will promote long-term physical and mental health.

Do I Need Ketamine Detox?

The severity of other forms of drug addiction is often characterized, in part, based on the presence and intensity of the associated physical withdrawal symptoms. Physical withdrawal symptoms for ketamine are not common and do not last very long. As such, it is a less reliable gauge for those concerned about the presence or lack of an addiction to ketamine or the need for detox and treatment. In many cases, the lack of a pronounced physical withdrawal syndrome should not be mistaken for there being addiction present.

Cravings and responses to cravings are perhaps a better way to decide whether help is needed. Some illicit users of ketamine report that drug cravings persist for very long periods. They seem to go off the drug relatively easily, but tend to reinitiate use at a later time. Ultimately, should a compulsive pattern of ketamine use be impacting any area of your life – be it your health, your social interaction, or your job – you may indeed benefit from detox and longer-term substance abuse treatment.

Negative Effects of Continuing Ketamine Use
Continuing to use ketamine is harmful in both the short and long term. Side effects include 11:

  • Sedation.
  • Confusion.
  • Delirium.
  • Dizziness.
  • Hypertension.
  • Increased heart rate.
  • Slowed respiration.
  • Nausea and vomiting.
  • Nightmares.

How Does Supervised Detox Help?

Detoxing alone presents a risk. Cravings can be intense, and a supervised program may provide an environment that supports sobriety and an opportunity to access other therapeutic resources that promote long-term well-being.

Users who suffer from depression may experience a significant worsening of their symptoms. A program with supervision assures that any mental health issues or complications that may arise can be addressed appropriately, and necessary treatment can be extended to the patient.

References:

  1. McNulty, J.P., Hahn, K. (2012).  Compounded Oral Ketamine. International Journal of Pharmaceutical Compounding, 16(5):364-368.
  2. Trujillo K, Smith M, Sullivan B., Heller C, et.al. (2011).  The Neurobehavioral Pharmacology of Ketamine: Implications for Drug Abuse, Addiction, and Psychiatric Disorders. Institute for Laboratory Animal Research, 52(3), 366-378.
  3. National Institutes of Health (2009).  Ketamine. Toxnet.
  4. Garg, A., Sinha, P., Kumar, P., and Prakash, O. (2014). Use of naltrexone in ketamine dependence. Addictive Behaviors, 39(8), 1215-1216.
  5. Błachut M, Sołowiów K, Janus A, Ruman J, Cekus A, et. al. (2009). A Case of Ketamine Dependence.  Psychiatria Polska,43(5), 593-599.
  6. Quibell, R., Prommer, E., Mihalyo, M., Twycross, R., and Wilcock, A. (2011) Ketamine. Journal of Pain and Symptom Management, 41(3) 640-649.
  7. Chen, W. Huang, M and Lin, S. (2014). Gender differences in subjective discontinuation symptoms associated with ketamine use. Substance Abuse Treatment, Prevention and Policy, 9: 39.
  8. Chen, W. Huang, M and Lin, S. (2014). Gender differences in subjective discontinuation symptoms associated with ketamine use. Substance Abuse Treatment, Prevention and Policy, 9: 39.
  9. Lin, P., Lane, H. and Lin, C. (2016). Spontaneous Remission of Ketamine Withdrawal–Related Depression. Clinical Neuropharmacology 39(1), 51–52.
  10. Garg, A., Sinha, P., Kumar, P., and Prakash, O. (2014). Use of naltrexone in ketamine dependence. Addictive Behaviors, 39(8), 1215-1216.
  11. Quibell, R., Prommer, E., Mihalyo, M., Twycross, R., and Wilcock, A. (2011) Ketamine. Journal of Pain and Symptom Management, 41(3) 640-649.
  12. National Institute on Drug Abuse (2016). Commonly Abused Drugs Charts.
  13. National Institute on Drug Abuse (2016). Commonly Abused Drugs Charts.
  14. Drug Enforcement Administration. (2017). Drugs of Abuse: A DEA Resource Guide. 68-69.
  15. National Institute on Drug Abuse. (2014). Drug Facts: Club Drugs.
  16. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

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