Ketamine Withdrawal Symptoms

Watching yourself or someone you care about become dependent on a drug can leave you wondering what to do. Whether used recreationally or for pain relief, ketamine addiction can happen quickly. Withdrawal can be a daunting prospect, but many successfully regain control of their lives with the right help. Making the decision to come off ketamine is putting your health, relationships and quality of life first. Detox is just the beginning. In this article, we’ll explore the process of Ketamine withdrawal and take a look at the best options for achieving sustained recovery.

Ketamine Detox in a Nutshell

• The high experience when taking ketamine makes it highly addictive. The sedative effects and euphoria provide an escape from life for some.
• Withdrawal symptoms are often indicative of physical or psychological dependence.
• The severity of ketamine withdrawal symptoms is influenced by how much you take, how long you’ve taken it, and how you take it.
• Going through detox and withdrawal without the proper support can be extremely uncomfortable and dangerous.
• Detox alone won’t guarantee sustained recovery.  
• Going through detox without support can be dangerous.  Acute withdrawal symptoms are often severe.    
• Professional support is necessary for understanding and managing the root of the addiction.  
• Addressing existing mental health problems is vital for sustained recovery.
• Ongoing recovery requires a combination of therapeutic approaches. Treatment tailored to the individual is beneficial in achieving long-term abstinence.

What is Ketamine?

Ketamine is an anaesthetic medication used by both the medical and veterinary professions. Although most commonly used as an anaesthetic or sedative, pain specialists often prescribe it as an analgesic (pain-relieving) medication. 

The tranquillisation properties of ketamine make it popular on the recreational drug scene. However, people who have been prescribed the drug for pain relief are just as at risk of becoming addicted as those who use it recreationally, especially if they take it in conjunction with opiates. As a dissociative anaesthetic, many users take ketamine to experience calmness, and euphoria and enter a trance-like state.

Ketamine Withdrawal Symptoms

As tolerance grows, the amount and frequency of use increase, subsequently leading to long-term, chronic abuse for many. When undergoing ketamine withdrawal, the extreme highs are replaced by equally extreme lows, producing some distressing side effects.  Acute withdrawal symptoms can be severe, with some people experiencing depression and even suicidal thoughts. Others may experience hallucinations, rage and even psychosis. The psychological effects often persist long-term.

Physical Symptoms

Although the psychological withdrawal symptoms of ketamine are considered to be more prevalent, physical symptoms can, in themselves, be dangerous. For instance, detoxing from ketamine can cause fluctuations in blood pressure.

Physical withdrawal symptoms include:  

• Insomnia and difficulty sleeping
• Irregular or rapid heartbeat
• Changes in blood pressure
• Respiratory issues, including difficulty breathing
• Nausea and vomiting
• Temporary hearing loss
• Dizziness and fatigue
• Headaches
• Double vision
• Shakes
• Sweating
• Bladder pain

Psychological Symptoms

Although some physical dependence does occur, ketamine addiction, certainly in the long-term, is primarily psychological. Ketamine interferes with mood-altering neurotransmitters such as serotonin, dopamine and norepinephrine. The result is both short-term and long-term changes in brain chemistry. Users feel the effects after 10-15 minutes, with the high lasting 30 minutes to 1 hour. The changes to brain chemistry that occur through ketamine abuse cause the most significant symptoms during withdrawal.  Without the regular hit, the lows experienced often exacerbate pre-existing mental health issues.  

Psychological withdrawal symptoms include:

• Confusion
• Cognitive impairment (difficulty thinking or focusing)
• Agitation
• Psychosis (hallucinations)
• Irritability and anger
• Memory issues and amnesia
• Depression and anxiety
• Intense cravings
• Mood swings
• Suicidal thoughts
• Flashbacks
• Exacerbated existing mental health problems
• Feeling detached
• Feeling of floating

Acute Withdrawal from Ketamine

The onset of withdrawal symptoms at the beginning of detox varies from person to person. Heavy, chronic users are most at risk of acute symptoms. And those who use other substances with ketamine run the risk of increasing the severity of withdrawal symptoms. However, it is difficult to predict which symptoms will occur and in what combination. Although not generally considered directly life-threatening, the level of discomfort experienced can drive users to re-use. They may also experience rage or severe depression. Using out of desperation to ease the intense cravings and discomfort increases the risk of ketamine overdose. For this reason, guided withdrawal is recommended. Severe acute symptoms can include respiratory distress, depression, suicidal ideation, intense cravings and rage.

Ketamine Withdrawal Timeline

As with many drugs, detox and withdrawal is never a linear process. Frequency, level and method of use can go a long way toward predicting the severity of symptoms. Heavier users will usually experience more severe symptoms, with psychological issues such as depression persisting long-term.  

Withdrawal symptoms are at their most intense in the first stage of detox, with many lingering to different degrees for several weeks. Generally speaking, most physical symptoms dissipate within a couple of weeks. This is technically considered to be the detox period. However, the psychological effects of ketamine addiction and withdrawal often require long-term therapeutic support, especially if the user has existing mental health problems. 

Days 1 – 3

Ketamine is quickly metabolised after your last hit, but the effects can last to varying degrees for up to 24 hours. The onset of acute symptoms starts around this time.  Although it varies from person to person, most will experience some physical symptoms, including sweating, increased heart rate and anxiety. Psychological symptoms include agitation, hallucinations, anger and even psychotic episodes. Some of the most common and challenging symptoms at this stage are depression and intense cravings. Symptoms at this point are at their most severe, and the compulsion to take more, coupled with impaired decision-making, can lead to relapse. For this reason, it’s crucial to get support throughout withdrawal.

Days 4 – 14

Many of the early symptoms will persist, but some, particularly the physical ones, will begin to fade towards the end of two weeks.      

Day 15 onwards

It’s common for users to consider the end of the detox period as the end of all necessary treatment. Many symptoms will have subsided at this point. However, changes to brain chemistry in the absence of ketamine may cause ongoing psychological symptoms.  Continuous support and targeted treatment are vital at this stage to address depression, mood swings and cravings to prevent relapse. From this point onwards, a structured treatment programme is vital to help the user enter a new life without the drug and reduce the risk of a relapse. 

Ketamine Detox

The challenges inherent in detoxing from ketamine addiction relate to its psychologically addictive nature. While some physical withdrawal symptoms are common, the danger lies not only in the initial stages of detox but also thereafter.  Changes to neurotransmitters from ketamine abuse and the subsequent effects of removing the substance make the psychological side effects unpredictable and dangerous for some. For this reason, a high level of support during and after detox is essential for successful recovery. Treatment focuses on addressing past, present and future mental health considerations.

Home Detox for Ketamine

For some, the prospect of an inpatient rehab programme can seem too daunting to consider. You may perceive being in a familiar environment surrounded by loved ones as necessary for successfully detoxing.  

While detoxing from ketamine at home is possible, it’s worth recognising that this may present challenges and could be dangerous. The initial symptoms can be severe and unpredictable, possibly requiring medical attention.  

Decision-making may be impaired and cravings intensified. Severe psychological symptoms may occur, needing specific care and emotional support from specially-trained professionals. Depending on the level of ketamine use, “going cold turkey” is usually recommended, but this approach incurs risks that loved ones may not be equipped to deal with.

Medically Supervised Detox for Ketamine

Where possible, a medically supervised detox is the safest way to come off ketamine. The first 24 hours can be overwhelming. The onset of acute withdrawal symptoms is often intense and sometimes dangerous, requiring medical supervision. During this period, you may experience severe depression and cravings, driving you to take more ketamine.  

Castle Craig offers medically supervised detox involves support for both the physical and psychological symptoms associated with the drug leaving your body. Withdrawal symptoms are closely monitored with doctors, nurses and therapists on hand to provide treatment throughout the detox process.  

Medicines That Can Support Ketamine Detox

In most cases, coming off ketamine abruptly or “going cold turkey” is considered the best approach. While there are no medications designed specifically to lessen the effects of ketamine withdrawal, individual symptoms can be helped with medication if required.  For instance, dehydration can be treated with intravenous fluids; anxiety or changes in blood pressure can be treated with the appropriate medication.

Getting Help for Ketamine Addiction

Recognising that you may be dependent on ketamine or have a ketamine addiction and seeking out support is the first step to recovery. It’s common to feel alone and overwhelmed by the journey ahead of you. Thankfully, there are various support options depending on your level of use, circumstances and resources. Talk to your GP, who will be able to advise you on local services and oversee your progress. And while some routes to getting help are more beneficial than others, it’s important to realise that any support is better than none.

It’s worth remembering that the cycle of ketamine abuse doesn’t end with detox.  Understanding the reasons for becoming dependent and being guided in cultivating awareness of future triggers goes a long way to maintaining recovery.

Support Groups

Support groups are a valuable way to navigate the challenges of coming off ketamine.  From the initial stages of contemplating detox to enjoying sustained recovery, talking freely to people who understand what you’re going through can see you through difficult times. Support groups can be a less intimidating first step in seeking treatment for those who may never take action otherwise. Continued support has been proven to prevent relapse throughout the detox and withdrawal journey.

Benefits of joining a support group:

• It’s an opportunity to connect with others after feeling isolated by addiction.
• Hearing about other peoples’ experiences can inspire confidence, generate hope for the future and help to avoid pitfalls.
• You can get a sense of accomplishment and increased self-esteem from empathising with and supporting others.

It should be noted, however, that not all support groups are equal. Some are poorly run, don’t guarantee anonymity, or may just not be the right fit for you. Attending a group as the only source of support won’t ensure a safe detox, successful withdrawal or long-term recovery.

Counselling / Therapy

Detox without a treatment programme that includes ongoing therapy is more likely to result in relapse. This is down to the fact that a habit that requires a detox (or brings withdrawal symptoms when quitting) is indicative of an addiction. If the drug is psychologically addictive, understanding the root of the addiction may help prevent future relapse. A treatment programme which includes therapy aims to treat both primary addiction issues and mental health problems.

Therapy is tailored to the individual and is designed to explore and focus on addressing personal challenges and circumstances that may be contributing to ketamine addiction. Cognitive behavioural therapy (CBT), motivational enhancement therapy (MET), and dialectical behaviour therapy (DBT) are used to examine underlying issues and coping strategies with the goal of achieving sustained recovery.

Benefits of counselling/therapy:

• An opportunity to explore the root cause of addiction and help prevent relapse.
• You’ll develop tools to deal with life challenges throughout recovery.
• It’s a safe environment to discuss issues without judgement.

Outpatient Rehab

Outpatient rehab falls somewhere between home detox and residential rehab. Patients attend part-time or in the evening for a variety of therapy sessions. They must follow a rigid programme designed to maximise treatment efficacy while still living a relatively normal life.  

The treatment is targeted at more intermittent users who perhaps haven’t yet become physically and psychologically addicted, but overall, treatment is less intensive.  This is due to the patient living at home rather than benefiting from the “fully immersed recovery” offered by full-time residential treatment programmes. The success of outpatient rehab lies more in the patients’ commitment, which is more difficult to sustain in day-to-day life. 

Benefits of outpatient rehab:

• It’s a viable option for those who are unable to access residential rehab.
• It provides a safer alternative to going it alone at home.
• The patient can work and deal with responsibilities while getting treatment.
• It’s flexible and works around the patient’s schedule.

Drawbacks include the lack of one-to-one relationships between staff and the patient, plus a more generic treatment plan as opposed to one tailored to the individual. Although outpatient rehab is a preferred alternative to detox without support, the patient may find himself or herself in triggering situations. 

Contact CATCH Recovery for online or in-person outpatient addiction treatment programmes.

Residential Rehab

Inpatient rehab providers such as Castle Craig provide the benchmark for drug detox and rehabilitation from ketamine addiction due to its holistic approach. Patients are assessed and monitored and benefit from the experience of a multidisciplinary team 24 hours a day. Not only does being away from home restrict access to triggers and dealers, but it also removes distractions, responsibilities and settings that may derail detox and recovery. Residential treatment tends to range from 3-5 weeks, depending on the immediate needs of the patient and the tailored treatment plan. Successful residential rehab aims to tackle detox and withdrawal, cravings, the temptation to use and relapse prevention.

Benefits of residential rehab:

• Evidence-based therapies are available to address the underlying causes of addiction.
• Patients are monitored for severe withdrawal symptoms and treated accordingly.
• A safe environment means, being free of distractions, triggers, or access to the supply of ketamine.
• The patient can be completely focused on recovery.
• Treatment is geared towards sustained recovery beyond the detox process.

Where Can a Person Get Support in Relation to Ketamine Addiction?

Here are some answers to other common questions related to ketamine withdrawal and addiction recovery.

Support for recreational drug and alcohol problems – Mind

You may have wanted to come off ketamine for a while but feel scared at the challenges you face. Here, we will discuss how to manage and reduce symptoms, and how best to cope with any long-term side effects.