Despite its reputation as a party drug in some circles, ketamine carries a real risk of harm. Recognising possible signs of ketamine use could help some people to access support before serious harm develops.
There is no single physical or behavioural sign that proves ketamine use, but there are some that, taken together, could indicate a pattern of behaviour and substance misuse. Even if you suspect someone is misusing ketamine, though, a calm, non-judgemental response is almost always better than confrontation.
What Is Ketamine?
Ketamine is a dissociative anaesthetic with legitimate human and veterinary medical uses. It was first used as a human anaesthetic in the 1960s. It became strictly controlled, however, due to its potential for misuse and risk of harm. It is still used as an anaesthetic, analgesic agent (painkiller) and can now be prescribed for the management of treatment-resistant depression.
It is also used recreationally for the feelings of detachment, altered perception or euphoria it can produce, but remains a controlled drug in the UK. Following a recent review the Advisory Council on the Misuse of Drugs (ACMD) advised that ketamine should remain a Class B substance but expressed concern about the growing use of high-dose ketamine and the long‑term harms associated with it.
Immediate Signs That Someone May Have Used Ketamine
Some signs that an individual may be under the influence of ketamine can include confusion, disorientation and appearing detached from their surroundings. They may also have slurred speech, poor coordination, difficulty moving and reduced responsiveness. Some people feel nauseous or throw up.
The individual may experience altered perception and hallucinations – which they may mention or indicate with unusual eye movements.
Many of these signs can have other medical or substance-related causes though, and any indicator alone is not enough to demonstrate that a person has taken ketamine.
What Is a K-Hole?
A K-hole is commonly used term to describe a state of intense dissociation that sometimes arises, especially with a larger dose of ketamine. The user may feel completely detached from their own body and the world around them and this can result in an inability to communicate or move and react normally.
Many people find the experience may be frightening or distressing and severe sedation or unresponsiveness should not be dismissed as an expected effect of ketamine.
Physical Signs of Regular Ketamine Use
Regular ketamine use can trigger changes in sleep, appetite, energy and weight. A user might have unexplained injuries linked to impaired coordination or reduced awareness of pain. There may be nasal irritation or frequent nosebleeds depending on how the drug was consumed. Persistent abdominal or pelvic discomfort may be a sign of developing bladder damage – one of the main risks posed by ongoing ketamine use.
Bladder and Urinary Warning Signs
Repeated ketamine use can lead to a condition known as ketamine uropathy which can be painful and seriously impact your quality of life. It can cause severe urinary symptoms including bladder pain, urgency and reduced bladder function. Long-term use can lead to progressive damage in the urinary tract and bladder wall, resulting in chronic pain, frequent urinary tract infections and even irreversible bladder damage that may require major surgery.
Needing to urinate more frequently or urgently, pain or burning when urinating, incontinence and blood in the urine can all be symptoms that may indicate ketamine-induced uropathy. Prompt GP assessment is crucial and you should seek urgent attention for inability to urinate, severe pain or significant blood in the urine.
Abdominal Pain and K-Cramps
Another painful issue associated with frequent ketamine use is a severe abdominal pain sometimes known as K-cramps, which may be accompanied by nausea or vomiting.
Abdominal symptoms may involve the liver or bile ducts and will require prompt medical assessment. You should avoid using more ketamine to mask the pain as the problem and any damage may continue to get worse.
Psychological and Cognitive Signs
Long-term ketamine use has been linked to cognitive issues such as memory problems and difficulty concentrating. It can also trigger mental health symptoms such as anxiety, depression, paranoia and mood changes, and make existing mental health conditions worse.
Some people may experience hallucinations and find the dissociative effects of ketamine distressing – particularly the severe effects known as a K-hole.
Any psychological, cognitive and mental health issues should be assessed in their own right, rather than automatically attributed to ketamine.
Behavioural Signs of Ketamine Use
There are numerous behavioural signs that could indicate a pattern of ketamine use. These could include:
- Secrecy, changes in friendships and withdrawal from usual activities.
- Unexplained spending, missing money or frequent requests for money.
- Declining performance at work, school or university.
- Neglecting responsibilities
It’s worth reiterating though, that none of these offer ‘proof’ of ketamine use and may have other causes. In some cases, simple adolescent changes in behaviour could be mistaken for signs of substance misuse and accusations could be counter-productive and harmful.
Signs of Ketamine Addiction
Dependence can develop gradually and is generally more psychological than physical.
Signs of a growing ketamine addiction could include:
- Using ketamine more frequently or in larger doses
- Increased tolerance – needing more for the same effect
- Cravings
- Unsuccessful attempts to stop or reduce use
- Preoccupation with securing more ketamine
- Continuing use despite negative consequences such as bladder issues, declining mental health, relationship problems or financial impact
How to Approach Someone You Are Concerned About
There is no one ‘right’ way to talk to someone about your concerns but in general it can be useful to choose a private and calm time to talk. It is definitely best to avoid confronting someone while they are severely intoxicated or distressed.
Try to provide specific observations rather than accusations, listen without judgement and if the outcome is that they are using ketamine, ask what support the person would accept. Professional help and advice may be the way forward even when the person is uncertain about treatment.
When Ketamine Use Is an Emergency
You should call 999 if a ketamine user is unconsciousness or experiences seizures, breathing problems or chest pain. Severe confusion, dangerous agitation and inability to wake are also signs that you should seek immediate medical attention.
Place an unconscious but breathing person in the recovery position if possible. Stay with them and follow the emergency call handler’s instructions.
Treatment for Ketamine Use
Treatment for ketamine use may include a number of steps and stages, including a medical assessment, a medically managed detox, psychological therapy and support for any physical complications. Evidence-backed therapeutic techniques such as cognitive behavioural therapy (CBT), motivational work and relapse prevention sessions can all help address psychological aspects of addiction and there may be coordination with urology or mental health services where required.
Get Support for Ketamine Misuse Today
Prompt medical assessment may be required for urinary or abdominal symptoms but individuals and families concerned about ketamine use in the longer term can always contact Cassiobury Court for confidential advice on the next steps to take. If you think you could be struggling with ketamine addiction, get in touch today for more information on the treatment options available to you. Call us on 01923 369 161 today.
