Is Mixing Ketamine With Alcohol Dangerous?

There is a fine line with ketamine between a dose that causes an extreme “high” and a dose that leads to an overdose. When alcohol is brought into the equation, it’s even more unpredictable. The majority of hospital visits, overdoses and deaths related to ketamine also involve alcohol.

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This article is for you if:

  • You are worried that you or someone you know might be addicted to using ketamine and alcohol together.
  • You or someone you know are in trouble right now, having taken a combination of alcohol and ketamine.
  • You are concerned about yourself or someone else drinking while taking legitimately prescribed ketamine. 

Mixing Ketamine With Alcohol: Key Facts

  • It is extremely dangerous to mix alcohol and ketamine even in small amounts.
  • Long-term risks of ketamine and alcohol addiction include life-changing liver, kidney, or bladder damage; heart conditions; and psychiatric and cognitive problems. 
  • Anyone who tries mixing alcohol with ketamine and enjoys the experience is at risk of becoming addicted. 
  • Understanding the stages of addiction can help you to reassess your relationship with ketamine and alcohol, and get help if you need it.
  • If you or someone you know has taken a cocktail of ketamine and alcohol it is important to get medical support as soon as possible. 
  • Treating alcohol and ketamine addiction is more complicated than treating addiction to a single substance. Residential rehab is the safest and most effective treatment option. 

Mixing Ketamine & Alcohol — Side Effects & Risks

It’s not only dangerous to use ketamine and alcohol together, it’s potentially deadly. It doesn’t matter if you’re a first-time user, is taking prescribed ketamine, or have become an addict, both the short-term and long-term side effects can be life-changing or even fatal. 

Effects & Dangers of Combining Ketamine & Alcohol

When used independently, both ketamine and alcohol impair judgement and motor skills; when used in combination, these effects are heightened. Taking even small quantities of ketamine with alcohol can cause the user to become over-intoxicated, which increases the risks. And to complicate things further, the user may be unaware of how much the substances are affecting them. 

Signs that someone has mixed alcohol and ketamine include:

  • Appeared very drunk – slurred speech, difficulty walking, poor coordination
  • Impaired judgement and decision-making
  • Drowsiness or sedation
  • Agitation and/or irrational behaviour
  • Slowed breathing and heart rate
  • Confusion and memory loss
  • Involuntary eye movements
  • Irregular heartbeat
  • Abdominal pain

More severe and potentially life-threatening side effects to look out for include:

  • Difficulty breathing
  • Paralysis
  • Vomiting
  • Pale, clammy skin
  • Paranoia and/or depression
  • Seizures
  • Collapse
  • Coma

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Long Term Risks

There are significant long-term risks associated with regularly using ketamine and alcohol in combination. They include:

  • Liver, bladder, kidney, and heart problems may be irreversible
  • Psychiatric issues or cognitive impairment
  • Increased risk of certain cancers
  • Serious injury as a result of impaired motor function, poor decision-making, paralysis, or collapse while under the influence.

How Does Ketamine & Alcohol Affect the Body?

When taken in pill or powder form, ketamine affects the body quickly.  Snorting the drug has a quicker onset – between 5-15 minutes while taking it in pill form produces effects from 5-30 minutes. The effects of alcohol occur around 10 minutes after ingestion.  Combining both together or in quick succession creates an intense reaction in the brain and the body.  

The immediate side effects of combining ketamine and alcohol include:

  • Increase in blood pressure
  • Increased heart rate
  • Increased body temperature
  • Muscle rigidity causes an inability to move or paralysis
  • Seizure
  • Nausea and vomiting

For chronic users, the consequences are far-reaching. Getting help is crucial in preventing long-term health issues caused by alcohol and ketamine addiction.  

Long Term Effects on the Body

The long-term impact that a person will experience as a result of ketamine and alcohol addiction is very individual, but here is an overview of some of the most likely problems. 

Liver Damage

Chronic abuse often causes fatty liver disease, scarring and in extreme cases, cirrhosis.  Ketamine is also broken down by the liver, placing an extra burden on the already compromised organ and increasing the chances of long-term damage.

Ketamine Bladder Syndrome and Urinary Tract Damage

Bladder damage is a common side effect among ketamine users. The drug causes inflammation of the bowel lining, a condition known as Ketamine bladder syndrome. If left untreated, this can cause irreversible scarring known as fibrosis in the lining of the bladder.  There is no cure, and the bladder must often be surgically removed.

Kidney Damage and Disease

The liver is responsible for metabolising alcohol first. For this reason, ketamine can remain in the system for longer, putting more pressure on other organs, including the kidneys.  Alcohol in itself places a heavy burden on the kidneys, resulting in kidney disease and even failure in chronic or binge drinkers. 

Cardiac Issues and Risk of Stroke

The acute effects of ketamine use often cause cardiac symptoms, such as increased or slowed heart rate, a rise in blood pressure and chest pain. Alcohol has similar effects. The long-term result of frequent use of both substances is consistently raised blood pressure, irregular heartbeat and weakened heart muscle, all of which increase the risk of a cardiac event or a stroke.

Psychiatric and Cognitive Issues

Both ketamine and alcohol affect the brain in significant ways. The short-term effect on the brain’s reward system by interfering with dopamine and serotonin is what many users seek when mixing ketamine and alcohol. However, spikes and troughs in mood caused by changes in brain chemistry can cause or worsen existing mental health problems.  Ketamine addiction can result in the atrophy of integral areas of the brain.  Alcohol’s deleterious effect on the brain is often gradual but no less devastating, often resulting in something called “Wet Brain”, a deficiency of Vitamin B1 resulting in neurological problems and psychosis.  Seizures, stroke and impairment are also real risks.


The systemic effects of both substances in combination mean that no part of the body is immune. The body’s ability to detoxify isn’t designed to deal with the onslaught of external toxins. chronic alcohol and ketamine abuse can lead tonutritional deficiencies and a compromised immune system, laying the body open to a variety of cancers.

Ketamine Addiction, a Slippery Slope?

So, it’s clear that a cocktail of ketamine and alcohol can result in hospitalisation or even death, but what about addiction? As a club scene drugs, first-time users who enjoy the effects of ketamine with alcohol may go on to use the two substances together regularly. They may be unaware of the risks or have an “it won’t happen to me” mentality. Anyone prescribed ketamine for pain relief may accidentally discover heightened inebriation after a glass or two of alcohol. It doesn’t take much for experimentation or accidental discovery to become habitual use, and for habitual use to become an addiction. 

But what exactly is addiction, and how does it happen? 

The Stages of Addiction 

According to the NHS, addiction is defined as not having control over doing, taking, or using something to the point where it could be harmful to you. The American Society of Addiction Medicine, takes its definition further, describing addiction as a chronic disease that affects the brain’s reward, pleasure, memory, and motivation. Whichever definition you subscribe to, addiction doesn’t happen overnight. The process develops over a series of stages.

  1. Initial use/experimentation – This is the first time a person tries a substance. That initial exposure can come about for a wide range of reasons, including curiosity, peer pressure, being prescribed medication, or experimenting with self-medication. relieve physical or mental discomfort. Alternatively, a person may be prescribed a drug for a medication condition. If that first use is pleasurable or provides some sort of high or relief, the user has the drive to experience that feeling again. This leads to the second stage of addiction. 
  2. Continued use/abuse – The person continues using the substance regularly to get the effects that first made it attractive to them. Using becomes a regular activity and a normalised part of their lifestyle. The user might be using more of the drug or mixing it with other substances to achieve a ‘better’ high. 
  3. Tolerance – When a person uses a substance frequently, it causes chemical changes in the brain, and the body needs the drug to function normally. In order to achieve a high, the user has to take the drug more frequently or in larger doses. They may try harder drugs or start injecting in an effort to reach a quicker, more intense high.
  4. Dependance – The individual is now physically and psychologically dependent on the substance. It becomes their only source of pleasure, despite having a negative impact on their life. 
  5. Addiction – The person has lost control of their use. Their health, finances, and relationships are all affected by their addiction yet they are in denial of this fact

Common symptoms of dependence include:

  • Risky use – e.g. at work or when driving
  • Spending more time trying to source the substance; taking risks to source it
  • Increased cravings for the substance
  • Withdrawal symptoms when unable to obtain the substance
  • Relationship or family problems
  • Loss of interest in hobbies, interests, and socialising
  • Poor performance at work

Diverting the Course of Addiction

Cutting through the path of addiction requires the user to first become aware that they are moving towards dependence and addiction, and be motivated to address the underlying cause(s). They can then take steps to curb their growing dependence. For example:

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  • Cultivate awareness of triggers to using such as:
    • Social circles and relationships
    • Physical or emotional pain or distress
    • Activities, locations, and times of day associated with their drug use
  • If they are prescribed ketamine for pain relief, talk to their GP about alternative pain management support
  • Reduce access to the substance(s)
  • Get help to change circumstances that put them at risk of addiction
  • Get appropriate help for pre-existing mental health problems or to get a diagnosis
  • Develop new ways of coping with/avoiding situations that put them at risk of using
  • Build a strong social support network.

What Should You Do If You Have Taken Ketamine & Alcohol 

The unpredictability of how the combination of ketamine and alcohol will affect each individual makes it difficult to know what level is dangerous. Add to that the fact that combining both can result in sudden and extreme levels of intoxication that may impair judgment.  

The best course of action is not to mix ketamine and alcohol. However, in the event that you or someone else has used these two drugs together you can take the steps below.

If you or someone else has mixed a small amount of alcohol with ketamine:

  • Stop using the substances immediately/ask the user to stop using
  • Make sure you/the user is not alone
  • Monitor for any symptoms
  • Call for help – if symptoms are mild, call NHS 111 for advice; if symptoms are severe, call 999 for an ambulance.

If taking ketamine and alcohol has become a regular habit for you or someone else:

  • Speak to your GP and consider contacting a support group or rehabilitation clinic for advice. If you are concerned about someone else’s substance use, encourage them to take these steps. 
  • Do not go ”cold turkey” without consulting a medical professional. Depending on the frequency of use both alcohol and ketamine withdrawal symptoms can be dangerous.  If you’re concerned about symptoms you or someone else is experiencing, call NHS 111 or 999 in an emergency.

If you or someone else has been mixing ketamine and alcohol regularly for an extended period of time:  

  • Speak to your GP, who will be able to refer you to local support services, including rehabilitation clinics that specialise in medically-supervised detox and long-term treatment. If you are concerned about someone else’s substance use, encourage them to take these steps. 
  • If you or someone else is experiencing potential withdrawal symptoms, call NHS 111 or 999 in an emergency and ask for an ambulance.

What Is The Safest Way to Treat Alcohol & Ketamine Dependence?

Treating dual alcohol and ketamine addiction requires a multimodal approach to aid successful recovery. There are different treatment options available to suit individual circumstances.  


If you’re worried about someone who’s showing signs of alcohol and ketamine addiction, a professional-led intervention can be a helpful tool. Lines of communication are opened between the user and loved ones, helping the user to challenge denial and access treatment. Intervention can be useful at any stage of addiction, but in the end, it’s only beneficial if the user decides to get help.  

Support Groups

Peer support groups allow users to meet and speak openly with others in the same situation. The aim is for the user to benefit from others’ experiences in a safe environment without feeling judged. Support groups are helpful throughout the recovery journey in providing support and encouragement at every step.


Therapy and counselling are vital in getting to the core of the addiction and addressing pre-existing issues that may have influenced the user in taking the substances in the first place.  Therapy is beneficial once the user has sought help to detox and is looking towards sustained recovery.


Outpatient programmes can be useful for those who aren’t in the grip of addiction.  However, residential rehab is considered the benchmark treatment for people with an addiction to two or more substances. 

A residential treatment programme provides a safe and supportive environment in which to address the complex nature of alcohol and ketamine addiction. The addict will receive a thorough assessment, undergo a medically-supervised detox and work through a  tailored holistic treatment plan desiged to give them the highest chance for successful long-term recovery.

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