Ketamine Withdrawal

By
Shlomo Hoffman
Medically Reviewed by
Dr. Jefferey A. Berman MD, DFASAM
Last Updated
July 19, 2022

Part of the complete guide to understanding addiction

Table of Contents
  1. Ketamine Withdrawal
  2. What Happens With Ketamine Withdrawal
  3. Withdrawal Symptoms of Ketamine
  4. Factors That Effect Withdrawal
  5. How Long Withdrawal Lasts
  6. Withdrawal Timeline
  7. The intensity of Withdrawal Symptoms
  8. Withdrawal Effects of Ketamine
  9. Why You Shouldn’t Detox At Home
  10. Can you Die from Ketamine Withdrawal?
  11. Ketamine Withdrawal Treatment
  12. Ketamine Detox Programs
  13. Sources

Ketamine Withdrawal

Ketamine is a dissociative drug often misused for its hallucinogenic properties. It is popular in nightclubs and bars for its sedative effects. Most illicit use of ketamine is sourced from legitimate sources, such as veterinary clinics or smuggled into the USA. Ketamine abuse is relatively low in comparison to other countries, although 58 countries reported its misuse to the World Health Organization. It is usually mixed with other drugs including cocaine, MDMA, amphetamine, or methamphetamine. If a user has repeatedly taken ketamine the body will grow tolerant of it. To continue to feel the effects of ketamine and maintain balance the user will now need to take more and more of the substance. Once the body is dependent on ketamine stopping the drug can cause withdrawal symptoms that can be uncomfortable for a user. Withdrawal must be treated correctly to prevent relapse so that users don’t cycle through many periods of withdrawal and dependence, which can cause permanent damage to the brain and nervous system.

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What Happens With Ketamine Withdrawal

The first step to treating a ketamine addiction is to detox the body from the substance. While detoxifying, withdrawal symptoms are common which can be distressing for the user. Symptoms can be physical and psychological and will vary in their intensity. They are often opposite to the effects experienced while using the drug.

Learn more about drug detox

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Withdrawal Symptoms of Ketamine

Once the body has become psychologically dependent on ketamine a range of symptoms will ensue. Most of the withdrawal symptoms of ketamine are psychological, not physical.

Common symptoms are.

Physical Symptoms

  • Confusion
  • Coordination loss
  • Delirium
  • Hallucinations
  • Inability to focus
  • Irregular heart rate or blood pressure
  • Rapid breathing
  • Sleep disturbances
  • Speech impairments

Behavioral Symptoms

  • Aggressive or violent tendencies
  • Psychosis
  • Schizophrenic-like behaviors
  • Suicidal ideations

Emotional Symptoms

  • Anxiety
  • Depression
  • Paranoia

Symptoms can range in intensity and be challenging to manage.

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Factors That Effect Withdrawal

The severity of withdrawal is also determined by factors that affect withdrawal such as.

  • Age
  • Dosage
  • Frequency of use
  • Weight
  • Liver Function
  • Prior Psychological Conditions

Some specific groups of people can be more susceptible to difficult withdrawal symptoms. Users who suffered from depression prior seem to have serious complications with symptoms of depression. As well, research has found women to be at higher risk for cognitive decline and urinary problems than men due to ketamine use.

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How Long Withdrawal Lasts

Withdrawal symptoms can last from 72 hours to several weeks. It generally takes between 2-4 days for ketamine to leave the body. Once it does, withdrawal symptoms will set in. Once ketamine has left the body symptoms will worsen for a day or two. After there are expected to be no physical symptoms, but psychological cravings can be experienced for many months after quitting.

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Withdrawal Timeline

  • Days 1-3, symptoms will begin approximately 24 hours from the last dose. This can include shakes, fatigue insomnia, rage, depression, hallucinations, delusion, tremors, double vision, nausea, rapid breathing, and hearing loss.
  • Days 4-14, withdrawal symptoms can persist for 2 weeks before tapering off.
  • Days 15+, withdrawal symptoms should be stable but psychological symptoms can persist. Nerve cell damage may be present in the brain which causes permanent psychological issues.

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The intensity of Withdrawal Symptoms

The level of intensity of withdrawal will depend on how the withdrawal symptoms are managed, the extent of dependence as well as individual factors. If the withdrawal is overseen by a professional and managed, then the likelihood of severe symptoms is lessened.

  • Minor Withdrawal, a person experiencing mild withdrawal symptoms will have sleep disturbances, rapid breathing, inability to focus, and minor anxiety. Minor withdrawal describes a person who is also only symptomatic for two weeks.
  • Mid-Level Withdrawal, this will include symptoms of confusion, coordination loss, speech impairments, and depression. People who do not have a history of prior drug abuse and are not chronic ketamine users generally will experience this level of withdrawal.
  • Sever Withdrawal, serious symptoms can occur if someone has been a chronic ketamine user. These include symptoms of paranoia, delirium, irregular heart rate or blood pressure, aggressive or violent tendencies, psychosis, schizophrenic-like behaviors, and suicidal ideations. These symptoms require 24/7 oversight and medication to manage.

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Withdrawal Effects of Ketamine

Ketamine can be mistaken as non-addictive because the withdrawal does not affect the body physically as much as many other drugs. However, the psychological effects of ketamine can be as difficult to overcome as physical effects. It is common for there to be co-addictions present which can complicate the withdrawal process. There is also a lot of uncertainty regarding ketamine withdrawal since the symptoms and effects depend on many factors.

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Why You Shouldn’t Detox At Home

Detoxing from ketamine alone can be risky even without major physical side effects. The psychological effects and cravings can be very challenging, causing a relapse if not properly treated. It can also cause a person to lash out which can be dangerous if they are around others. The chances of remaining sober are greatly increased through professional treatment.

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Can you Die from Ketamine Withdrawal?

It is unlikely to suffer a fatal physical event while detoxing from ketamine. However, there is a risk of suicide due to the severe depression that some users feel while detoxing. Another risk is that ketamine acts as a sedative and changes the heart rate, therefore when stopped the heart rate can fluctuate. This can potentially be highly dangerous.

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Ketamine Withdrawal Treatment

The most common treatments for withdrawal are counseling and support. Medical management can help as well. Medication is used in some cases to help with withdrawal symptoms., however, there are no FDA-approved medications for withdrawal.

There are two main goals of treatment.

  1. Treat detox symptoms and ensure the user is safe and healthy.
    This can include ensuring the patient doesn’t dehydrate or treating psychological symptoms with medication.
  2. Resist cravings to use again.

Cravings typically peak about 2-4 days after use so having support to help resist cravings is important for maintaining sobriety.

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Ketamine Detox Programs

It is possible to detox from ketamine on your own however having outside support and help is beneficial. It can prevent future relapse as well. For ketamine, “social” detox is possible which is built upon the support and an environment without triggers.

There are medical detox options as well such as.

  • Hospitals
  • Detox Facilities
  • Inpatient rehab programs
  • Outpatient programs

There are many resources available to help a user overcome their addiction and change the course of their life. With the right treatment, a patient can be on the road to sobriety and regain their freedom of life. Reach out to Avenues Recovery today and get your new life of sobriety started.

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Sources

Ketamine Toxicity – StatPearls – NCBI Bookshelf (nih.gov)
Ketamine Addiction
Ketamine | C13H16ClNO – PubChem (nih.gov) 
What Are the Effects of Common Dissociative Drugs on the Brain and Body? | National Institute on Drug Abuse (NIDA)
Drug Fact Sheet: Ketamine (dea.gov)

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