In a revealing new study published in Addiction, researchers shed unprecedented light on ketamine use disorder (KUD), a growing public health concern often overlooked amid the drug’s therapeutic hype. The study led by Rebecca E. Harding and colleagues from University College London and the University of Exeter, paints a stark portrait of the physical, psychological, and systemic challenges faced by ketamine users worldwide.
Drawing from an international sample of 274 individuals aged 18 to 67, the study reveals that chronic ketamine use is associated with a variety of debilitating symptoms. These include bladder dysfunction and nasal damage, both affecting around 60% of participants, and intense abdominal pains known as "K-cramps" reported by 56%. Alarmingly, while the majority experienced severe symptoms, more than half did not seek any form of treatment, citing barriers such as stigma, lack of tailored services, and inadequate medical understanding of KUD.
The research also highlights the emergence of a withdrawal syndrome tied to ketamine cessation, with cravings (71%), low mood (62%), anxiety (59%), and irritability (45%) being the most common symptoms. Participants described an abstinence experience resembling that of opioid withdrawal, a significant finding that challenges earlier assumptions about ketamine’s relatively benign addictive profile.
Treatment experiences were generally unsatisfactory. Only 36% of treatment-seeking individuals reported being content with the care received. Most services were described as ill-equipped to address ketamine-specific issues, and many patients encountered healthcare providers who underestimated the drug's addictive potential. Particularly striking was the sentiment that ketamine’s growing clinical use as a rapid-acting antidepressant has contributed to public underestimation of its dangers.
Among those who did pursue recovery, support groups and inpatient rehabilitation were reported as the most effective approaches, though many participants found personal strategies such as developing hobbies or quitting independently more helpful than formal treatment programs. The study identifies affordability, privacy, and targeted therapy addressing the unique psychological and physical aspects of KUD as critical features desired in treatment options.
The findings arrive amid a backdrop of surging ketamine use both recreationally and medically. UK government statistics indicate that ketamine use has more than doubled since 2016, particularly among people under 25. Similarly, US data reflect a 1116% increase in ketamine seizures between 2017 and 2022, illustrating its rising presence on the illicit market.
Harding and her team call for urgent reforms, advocating for specialized treatment services, greater public and professional education on the risks of ketamine misuse, and harm reduction initiatives tailored to the drug’s unique risk profile. They emphasize the need for future research to explore pharmacological treatments for KUD and to better understand its psychological sequelae.
The full study is available open access here: https://doi.org/10.1111/add.70073
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