Ketamine addiction has become a serious health concern in the UK, There has been a reported rise in non-prescribed ketamine use in recent years.
Ketamine was once seen as a party drug, but the patterns of use are changing. Government data from 2023 to 2024 found that 8.4% of young people in drug treatment in England reported ketamine use, up almost double the amount from two years earlier. That rise reflects a broader shift in who is using ketamine and how common it’s become.
Ketamine addiction develops when use moves from occasional to habitual, and when stopping or cutting down starts to feel difficult or impossible. Addiction to ketamine is a recognised medical condition, with serious physical and psychological consequences, some of which aren’t fully reversible.
Understanding how ketamine addiction develops and what it does to the body and mind can help show whether you or someone you know needs professional help.
Find out more about ketamine addiction treatment
How does ketamine addiction develop?
Ketamine is a fast-acting medicine that blocks special receptors in the brain. Doctors and vets use it as an injection to put animals, and sometimes humans, to sleep for surgery. But ketamine is also known as a dissociative drug that can make you feel detached from your environment or reality.
Ketamine acts primarily by blocking specific receptors in the brain that are involved in mood, memory, and pain. When this happens, the brain’s normal signalling is disrupted which is what produces the dissociative, out-of-body effects.
Research has proposed that ketamine can also lead to increased dopamine release. This is one of the mechanisms thought to make ketamine addictive, because that dopamine release creates a reinforcement loop. The brain registers the experience as rewarding and builds an association between ketamine use and relief or pleasure. As this repeats, the brain begins to expect and seek that dopamine response, and use becomes harder to control.
Tolerance can then develop alongside this. Many people move into patterns of daily or near-daily use, needing more each time to get the same effect. By this point, most people can no longer clearly tell recreational use from dependent use.
Ketamine dependence is primarily psychological. There’s no severe physical withdrawal syndrome like with alcohol or opioids, and this can make ketamine dependence feel less serious than it is. But the psychological pull and the health consequences of sustained use are significant.
“It was my first time coming into rehab […] the people of Castle Craig made me feel at home right away. After a couple of weeks, I stopped smoking as well.”
Is ketamine addictive if it’s used as a medicine?
Esketamine is a closely related compound that’s approved by NICE for use in adults with treatment-resistant major depressive disorder who have not responded to at least two antidepressant treatments.
Some that use ketamine recreationally will have seen news coverage of its use as a licensed medical treatment and may think that means ketamine is safe. But the distinction is that trained clinicians administer esketamine in precise, regulated doses. They monitor patients for adverse effects, including the potential for misuse.
Recreational ketamine use involves uncontrolled doses, unknown purity, and none of the safeguards that make supervised clinical use safer. The pharmacological effects overlap, but the risk profiles are fundamentally different.
Signs of ketamine addiction
The clinical criteria for ketamine addiction can include a pattern of use that causes significant impairment or distress across multiple areas of a person’s life. The signs tend to emerge gradually, and they look different depending on whether you’re noticing them in yourself or in someone else.
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Physical signs of ketamine addiction
- Tolerance is one of the earliest physical signs. It often develops before most people recognise it as a problem.
- Physical discomfort, restlessness, or low mood when not using Ketamine are also common, even without a dramatic withdrawal syndrome.
- Urinary symptoms are a warning sign that sustained use is beginning to affect the body. If you’re experiencing discomfort when passing urine or increased urgency, speak to a doctor.
- Ketamine can also impact coordination and balance during use, and can cause slurred speech that may be mistaken for being drunk.
- People using a lot of ketamine may also show signs of changes in appetite, disrupted sleep, and less attention to their health in general.
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Psychological signs of ketamine addiction
- Cravings, a strong and recurring desire to use, are a central feature of ketamine dependence. So is preoccupation, spending a significant amount of mental energy thinking about using, obtaining ketamine, or recovering from its effects.
- Ketamine can produce dissociation, a sense of detachment from the body and surroundings. The boundary between that dissociative state and ordinary experience can begin to blur.
- Difficulty concentrating or emotional flatness when not using are signs that ketamine has started to affect mood and perception.
- Many people who use a lot of ketamine report using it to manage anxiety, low mood, or difficult feelings. Needing it to cope emotionally is a key sign of psychological dependence.
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Behavioural signs of ketamine addictiion
- Using more ketamine than you meant to, or more often than planned.
- Wanting to cut down or stop, and finding you can’t.
- Pulling back from relationships, hobbies, or things that used to matter.
- Continuing use even when you know it’s causing problems at work, in relationships, or with your health.
- Responsibilities and physical health often get neglected in the same way as ketamine use increases.
- Using ketamine in dangerous situations, such as before driving, during working hours, or while caring for others.
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How ketamine addiction affects your health
The health consequences of sustained ketamine use are serious and, in some cases, not fully reversible. Understanding them is not intended to alarm, but to give a complete and honest picture of what the research shows.
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Ketamine bladder syndrome
Ketamine and its metabolites have been reported to penetrate and damage the tissue lining of the urinary system, leading to cell death. This is the mechanism underlying ketamine bladder syndrome, a condition that’s becoming more common in recreational users.
Bladder damage typically develops in people who are using ketamine daily at nasal doses above 1g. The primary symptoms are:
- Lower abdominal pain
- Pain when passing urine
- An increased urge to go
- In advanced cases, bladder capacity can drop severely
Stopping early offers the best chance of recovery from bladder symptoms. The longer use continues after symptoms appear, the less likely full recovery becomes. Advanced bladder damage may require specialist urology input and, in serious cases, surgical intervention.
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Ketamine addiction and mental health
Ketamine dependence doesn’t always develop on its own – there is a lot of evidence suggesting a strong link between addiction and mental health. Anxiety, depression, and trauma-related conditions can frequently co-occur with ketamine addiction. And, this is a bi-directional relationship; mental health conditions can drive use, and sustained use can worsen mental wellbeing.
Addressing the substance use alone, therefore, can leave the underlying anxiety, depression, or trauma untreated. This then can resurface.
At Castle Craig, your dedicated Consultant Psychiatrist is involved from the point of admission. They assess your mental health alongside the addiction, and treat co-occurring conditions as part of the same programme.
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Cognitive and psychological effects
Regular ketamine use can be associated with:
- Damage to both short-term and long-term memory
- Depression in people who use it frequently.
These effects can be more pronounced in people who use large amounts regularly than in people who use occasionally.
At high daily doses, cognitive impairment has been associated with structural brain changes, including evidence of brain shrinkage and other lesions. These findings come from studies of heavy recreational users, not from patients receiving therapeutic ketamine from a doctor.
Stopping ketamine can partially reverse cognitive effects, particularly in people who stop before long-term structural changes occur. This is one of the clearest clinical arguments for acting sooner rather than later.
Ketamine addiction treatment at Castle Craig
Ketamine detox
Ketamine dependence is primarily psychological rather than physical. Detox and ketamine addiction treatment at Castle Craig focuses on stabilisation and medical assessment, rather than simply just managing the physical withdrawal. On arrival, our clinical team assesses each patient and builds a care plan around their individual needs.
Detox takes place in Kirkurd House, our dedicated admissions unit, with 24-hour nursing and medical cover.
Medication may be prescribed where it is clinically needed. The goal is physical and psychological stability before the therapeutic work begins.
Ketamine rehab and therapy
Ourr approach to ketamine addiction treatment combines individual therapy, group therapy, Cognitive Behavioural Therapy, and 12 Step facilitation. The treatment plan follows each person’s assessment findings, which include the mental health evaluation conducted by our Consultant Psychiatrist.
You don’t have to have made a decision to get in touch. Our team can help you understand what the right next step might look like for you.
Private health insurance covers residential treatment at Castle Craig in many cases. You can speak to our admissions team about costs and the funding options available.
If someone in your life is affected by ketamine addiction
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How to start the conversation
It’s hard to watch someone in your life become addicted to ketamine. You may be uncertain what you’re seeing or if it’s really as big a problem as it looks. Those concerns are understandable, but they don’t mean you should wait to talk to them.
The most useful conversations tend to be specific rather than general.Rather than confronting them about drug use, try describing what you’ve noticed.
Give specific examples about changes you’ve seen or worries you have. That’s more likely to open a dialogue than close one down.
For advice on how to speak to someone in your life about ketamine addiction, never hesitate to get in touch. You don’t need to have a diagnosis or a plan, and they don’t need to know you’re calling.
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How our family programme works
Castle Craig includes a structured family programme as part of residential treatment. Addiction affects everyone connected to the person using, and recovery is more likely to last when the people closest to them are part of it.
We offer family therapy sessions later in treatment, once the patient is ready to engage.
Family members often need support of their own too, separate from what they’re providing to the person in treatment. Family workshops are available online and in person, and are included in the cost of treatment. They give family members the tools and knowledge to understand addiction as a medical condition, and to support recovery without inadvertently enabling continued use.
You can find more information and more educational resources on the Castle Craig addiction resources hub.
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Frequently asked questions about ketamine addiction
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What medications are available to help manage ketamine addiction withdrawal symptoms?
There are currently no medications specifically approved for ketamine use disorder or ketamine withdrawal. Ketamine addiction treatment focuses on stabilisation, psychological support, and addressing the underlying factors that drive use. Our clinical team may be able to prescribe medication that can help you manage withdrawal symptoms or treat co-occurring conditions.
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What are the most effective treatment centres for ketamine addiction in the UK?
The most important things to look for in a residential treatment centre for ketamine addiction are accreditation, the presence of qualified clinical staff, and the ability to assess and treat co-occurring mental health conditions.
Castle Craig is a registered private psychiatric hospital, accredited by CHKS. Our Consultant Psychiatrist conducts a full mental health assessment from the point of admission, and any co-occurring conditions are treated within the same programme.
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Are there local support groups for ketamine dependency?
Narcotics Anonymous (NA) offers peer support for anyone with experience of drug dependence, including ketamine. SMART Recovery is an alternative that takes a more secular, cognitive-behavioural approach. Both are free and available across the UK, in person and online.
Peer support is a meaningful part of many people’s recovery. For people whose ketamine use has reached the level of dependence, it works best alongside clinical treatment.
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Can ketamine bladder damage be reversed after stopping use?
Ketamine causes damage to the tissue lining of the urinary system, through direct cytotoxic effects of ketamine and its metabolites on urothelial cells. This damage is cumulative and progressive with continued use.
Advanced bladder damage may require specialist urology care, particularly where ketamine has significantly reduced bladder capacity. In some cases, it isn’t fully reversible.
If you’re experiencing urinary symptoms and using ketamine, stopping as soon as possible gives the best clinical outcome. You should consult a GP about symptoms, regardless of whether you’re ready to address your ketamine use.