Ketamine is a dissociative anesthetic. In hospitals and clinics it can be lifesaving: it controls pain, helps with emergency procedures, and—in select patients under close monitoring—may rapidly ease severe depression (esketamine is the FDA-approved nasal form).
Outside medical care, people use ketamine for brief euphoria and detachment. Doses can be unpredictable, especially with street products, and redosing to “keep it going” can lead to binges, accidents, and health problems.
Street names: Special K, K, Ket, Vitamin K, Kit Kat, Super K.
Common ways people use: snorting powder, swallowing caps/tablets, occasionally injecting, or “dusting” a joint or cigarette.
Signs use is becoming a problem
- You use more often or in larger amounts than you planned.
- Strong cravings or thinking about ketamine much of the day.
- Skipping school/work, pulling away from family or friends, or hiding use.
- Memory gaps, “brain fog,” trouble focusing.
- Bladder symptoms: burning, urgency, going every few minutes, or blood in urine.
- You’ve tried to cut back and couldn’t, or you keep using despite harm.
Withdrawal (varies by person): anxiety, restlessness, low mood, poor sleep, sweats, tremor, irritability, and cravings. Some people feel “flat” for days to weeks as the brain resets.
Dangers & health risks
Accidents and injuries
Balance and judgment drop fast. Falls, traffic crashes, drowning, burns, and choking on vomit are common risks. Never drive or swim while high.
Bladder and kidneys (“ketamine cystitis”)
Heavy use can inflame and scar the bladder. Signs: pain, urgency, frequent urination, or blood in urine. Left untreated, kidney problems can follow.
Brain and mood
Frequent use is linked to memory and attention problems, slowed learning, anxiety, depression, irritability, and poor sleep.
Heart and blood pressure
Ketamine can raise heart rate and blood pressure. The risk climbs with stimulants (cocaine, meth, MDMA) or if you already have heart disease or hypertension.
Breathing risks with depressants
Mixing ketamine with alcohol, benzodiazepines, sleep meds, or opioids deepens sedation and can slow breathing to dangerous levels.
Liver and gut
Some heavy users develop liver or bile duct issues (yellowing eyes/skin, dark urine, pale stools, upper-right belly pain). “K-cramps” (severe abdominal pain) often follow binges, especially with dehydration.
Contamination & dose swings
Illicit products vary in strength and may contain other drugs. A “normal” line can hit much harder than expected.
K-hole: what it is and why it’s risky
A K-hole is a deep dissociative state at high doses. People feel detached from their body and time, see intense visuals, and become barely responsive. Some chase it; many find it frightening. During a K-hole you can’t protect yourself—falls, exposure to heat or cold, aspiration (breathing in vomit), robbery, or assault can occur. Using alone or in unsafe places turns a K-hole into a life-threatening situation.
Treatment that works & how to start
Step 1: Medical assessment
A clinician reviews your use pattern, mental health, sleep, bladder or liver symptoms, and other substances. Early goals: stabilize sleep and mood, hydrate, check urine/labs when needed, and refer to urology if bladder pain or bleeding is present.
Step 2: Choose the right level of care
- Inpatient/residential if safety is a concern or home isn’t stable.
- PHP/IOP (day or evening programs) for several sessions a week with strong structure.
- Outpatient for step-down counseling, skills practice, and medication management.
- Sober living to protect early recovery.
Step 3: Proven therapies
- CBT to handle triggers and cravings, and to plan for risky moments.
- Motivational Interviewing to build commitment without shame.
- Contingency Management (rewards for meeting recovery goals).
- Trauma-informed care (EMDR/ART) when trauma is part of the story.
- Family therapy for boundaries, communication, and support that doesn’t enable.
Step 4: Medications (target symptoms)
There’s no FDA-approved “anti-ketamine” medication. Clinicians may treat depression, anxiety, insomnia, or bladder pain with appropriate meds. Managing these issues lowers relapse risk.
Relapse prevention—make it concrete
- Write a short plan: top triggers, early warning signs, people to call, and places to go.
- Build daily structure: regular sleep, meals, movement, therapy, and peer support (SMART Recovery, 12-Step, Refuge Recovery).
- Change your cues: new routes, new routines, remove paraphernalia.
- If you’re receiving medical ketamine/esketamine, follow clinic rules, attend integration therapy, and be honest about cravings or non-medical use so your team can adjust care.
If someone is in crisis now: call 911 for severe agitation, chest pain, very high blood pressure, seizures, collapse, or unresponsiveness. Keep the space calm and quiet, reduce lights/noise, place the person on their side if they’re not fully awake, and stay until help arrives. (Naloxone reverses opioid overdoses; it does not reverse ketamine.)
You’re not alone. Search our treatment directory for programs that understand dissociatives like ketamine—or call our confidential hotline at (866) 578-7471. We’ll help you stabilize, protect your health (including bladder care), and build a recovery plan that fits your life—today.
