Axial diffusivity is thought to be a measure of axonal density and radial diffusivity is thought to be related to the degree of myelination (Liao et al., 2010). In 16 ketamine users averaging 2.4 grams/day for 7.3 years, a lower level of axial diffusivity was found compared to 16 polydrug controls, especially in the frontal part of the right hemisphere (Edward Roberts et al., 2014). Axial diffusivity was significantly lower in eight white matter clusters in the right hemisphere in the ketamine group compared to the control group, the three largest being located in the frontal cortex (Edward Roberts et al., 2014). Jovaiša et al. (23) conducted a randomized controlled trial in which participants were given either saline placebo infusion or 0.5 mg/kg/h of IV ketamine prior to rapid opiate antagonist induction under general anesthesia.

With its fast action and relatively low toxicity, the drug soon supplanted phencyclidine (or PCP) as a popular emergency anesthetic. But, like PCP, ketamine also spread through the illicit underground, where it remains a popular drug, especially in the UK and increasingly in the US where seizures of the drug have increased 349% in the past five years. Ketamine has been prized by recreational users for its “dissociative” quality, which distorts sound and vision, and ability to facilitate typically pleasing, out-of-body experiences.

Anesthesia

For cannabis and stimulant use disorders, there are no FDA-approved treatments (8). With limited treatment options, a myriad of non-FDA approved medications (e.g., gabapentin, clonidine, bupropion) are tried as standalone pharmacotherapies and in conjunction with behavioral interventions. There is a wealth of evidence indicating the value of ketamine in treating severe pain, including conditions such as trauma, fractures, abdominal and flank pain, low back pain, and extremity pain. When used for pain management, sub-dissociative dosing, otherwise known as low-dose ketamine (LDK), is used, either alone or as an adjunct to other pain relief medications. It is safe and effective to use in combination with injectable nonsteroidal pain medications as well as opioids. It has gained greater acceptance as concern has grown regarding opioid use.

The 2019 World Drug Report by the United Nations Office on Drugs Control [12] classified ketamine under new psychoactive substances (NPS) that could pose a threat to public health and not under the control of international drug conventions. The prevalence of illicit ketamine use varies from region to region with relatively low rates of 1.7% and 0.7% in the United Kingdom and Unites States, respectively [13–14]. However, in some Asian countries, ketamine is one of most used illicit drugs and was the primary NPS seized in 2019 https://ecosoberhouse.com/ in East-Asia [15–16]. Due to the illicit nature of the drug, precise numbers of people using ketamine may be higher than reported. The euphoric effects experienced at high doses known as the “K-hole” includes feelings of detachment from one’s physical environment and losing sense of time, space, balance, and verbal skills, creating an “out-of-body experience”. The lower price point of ketamine as a substitute for more expensive and less accessible drugs such as cocaine also might explain its growing popularity [18].

Ketamine Abuse and Addiction

This is an index of network centrality, showing the importance of a voxel in a functional network. In 41 chronic ketamine users with a mean use of 2 grams/day for 3.4 years compared to 44 drug-free controls, lower ReHo in the right anterior cingulate cortex and higher ReHo in the left precentral frontal gyrus were found (Liao et al., 2012). The higher ReHo in the left precentral frontal gyrus was negatively correlated with estimated total lifetime ketamine consumption and ketamine craving ketamine addiction (Liao et al., 2012). This may suggest that ReHo is initially increased more by ketamine use but that this increase eventually decreases with more prolonged and intensive use, which may alter functional organization in frontal networks. In the same sample, the authors compared smoking chronic ketamine users with non-ketamine smokers and with non-ketamine, non-smokers by performing fMRI. They found a higher activation in the anterior cingulate cortex (ACC) in response to ketamine cues.

• Rehabilitation centers can help with different treatment options, detox programs, and other necessary assistance for overcoming dependency.
• Read on to explore the effects of ketamine, signs of ketamine use disorder, and insights on how to get help if you or someone you know is struggling with ketamine use.
• However, its use as a treatment for psychiatric disorders has been limited due to its reinforcing effects and high potential for diversion and misuse.
• Especially in the presence of altered mental status, CNS infections such as meningitis and encephalitis, and CNS malignancies also merit consideration.
• Because children metabolize ketamine faster than adults, higher dosing is required than in the adult population.

No medications have been FDA-approved to treat ketamine addiction, but doctors may prescribe other medications to help treat co-occurring mental health conditions. Hospitalization may sometimes be required to manage serious withdrawal symptoms. Treatment for ketamine addiction often involves some type of psychotherapy, such as cognitive-behavioral therapy (CBT), motivational enhancement therapy, family therapy, or group therapy. Patients with fibromyalgia may now seek treatment at the IV Solution & Ketamine Centers of Chicago, IL. The center specializes in using IV solutions to address a variety of ailments, and it is Chicago’s first private facility to offer clinically proven intravenous ketamine therapies for the treatment of depression, chronic pain, fibromyalgia and more. People with bipolar disorder are also more susceptible to addictive behaviors and depression when using drugs, Hamilton said.

Dual action of ketamine confines addiction liability

It is not clear whether people who are addicted to ketamine experience any symptoms of withdrawal when they stop taking the drug. In a 2020 article, researchers reported some exciting results from a trial in forty people with alcohol use disorder. All participants received motivational enhancement therapy, but half were randomized to a single IV ketamine session, and the others to midazolam. Ketamine is a powerful dissociative drug that can have severe side effects, both short and long-term. It can lead to addiction and withdrawal symptoms if you use it frequently.