Many ketamine abusers begin taking the drug under the misapprehension – widely shared within the drug-taking community – that it is not an addictive substance. While it’s true that most authorities do not consider ketamine to be physically addictive (although signs of physical dependence have been observed in long-term intravenous users) its abuse can certainly lead to psychological addiction, with a variety of withdrawal symptoms potentially manifesting.
Withdrawal occurs when a user who has developed a tolerance for the drug (in simple terms, when their body and mind have adapted to the presence of ketamine in the system and now consider it “normal”) suddenly stops taking it. The brain is now forced to readjust to the absence of ketamine, and rebalance itself chemically. During this process a number of symptoms may arise, some of them potentially extremely unpleasant. The withdrawal process is likely to be longer and more pronounced for users who have been taking ketamine for a long time and/or in comparatively high quantities. The method of consumption also has an impact: someone who has been injecting ketamine is very likely to suffer worse withdrawal symptoms than someone who has snorted it.
Some common symptoms of ketamine withdrawal include:
It’s important to note that each ketamine user will experience withdrawal in their own way. Some may experience few or even none of the above, and those quite lightly, while others may be subjected to many of them and to a very unpleasant degree. Because of the profound psychological impact of ketamine abuse (providing extreme experiences, often in intense environments such as raves, and in combination with other drugs) it’s also possible that various other symptoms unique to a particular user will arise, beyond those listed above.
As noted above, each experience of ketamine withdrawal is unique. Therefore, it’s impossible to provide an exact timeline applicable to each user going through withdrawal. Nevertheless, a rough schedule of what to expect might look something like the following:
Days 1-4: Depending on the extent and frequency of abuse, withdrawal symptoms may begin to kick in within one or two days of consuming ketamine for the last time, and grow increasingly intense over the next two or three days. Likely symptoms during this period include anxiety, hallucinations, nightmares, insomnia, paranoia and episodes of rapid breathing, while mood swings are likely to be very volatile and cravings increasingly intense.
Days 5-14: After four or five days, the most pronounced and intense symptoms will wear off (often quite rapidly); however, insomnia is likely to persist and depression often kicks in at around this time. Cravings will almost certainly still occur, although they will diminish in frequency and intensity.
Two weeks and onwards: After a fortnight, most withdrawal symptoms will have disappeared (although some – especially depression – may persist in a condition known as post-acute withdrawal syndrome, or PAWS). However, if the ketamine abuse has resulted in permanent neurological damage any symptoms of such damage will be persistent and will require the attention of medical professionals.
Various approaches exist to treating an addiction to ketamine; which one is appropriate for any given addict will depend on a range of factors particular to them. However, in general, a combination of residential rehab (including medically assisted detox) and therapy is considered the most likely to result in long-term success and to minimise the chances of relapse with its attendant dangers.
Rehabilitation – “rehab” – describes the overall process by which a person breaks an addiction and returns to a healthy, drug-free life. However, it’s most commonly used to refer to specific addiction treatment facilities which a patient attends (either as an inpatient or an outpatient) and which provide the framework within which that healing process can take place. Rehabs are typically found in pleasant, tranquil settings within which an addict can relax and focus on their recovery without the distractions and temptations of the outside world. These facilities usually offer a range of therapies, as well as providing first-rate medical attention (especially vital during the detox/withdrawal process) and robust patient confidentiality.
Inpatient treatment is usually provided for between 30 and 90 days depending on the extent of a patient’s addiction; during this time they will be able to go through withdrawal and engage in therapy whilst being kept away from ketamine and any other substances of abuse. Outpatient services are more appropriate for addicts with significant family and/or work responsibilities who cannot commit to spending that much time away from those responsibilities; however, these patients may struggle to stay away from the temptations of the outside world whilst their treatment is ongoing.
Unfortunately, there are currently no medicines available which are able to “cure” a ketamine addiction; while ketamine has been available for many years, research into treatment for ketamine-related disorders is relatively thin on the ground. However, it is possible that doctors treating ketamine addiction will prescribe certain medication to deal with specific withdrawal symptoms (which can anyway seem like the most unpleasant and problematic aspects of breaking the addiction). Symptoms such as anxiety and sleep disorders might be treated with certain benzodiazepines (for example, diazepam); depression might be addressed by any of a broad range of antidepressants now available; and some of the more prominent behavioural symptoms such as aggression and mood swings could be addresses in the short term by a course of antipsychotics.
Some addicts choose to try to tackle their addiction independently at home; whilst this is inadvisable for various reasons, it’s especially crucial to avoid self-medicating as some of the medications used to treat withdrawal symptoms can be very dangerous when not correctly consumed (and may themselves be addictive). Regardless of one’s preferred route to an addiction-free life, anyone in this situation should consult with their GP before attempting to detox: detoxification without the appropriate medical assistance could prove fatal.
Therapy aims at getting to the root cause of an addiction and addressing the reasons behind a person’s substance abuse and addictive behaviour; while detoxification and withdrawal is the “cure” for the immediate drug dependency, it is the therapy which should be considered the longer-term “cure” for the more profound and complex behavioural and psychological aspects of the addiction itself. Numerous therapy models have been developed in recent years to tackle the scourge of drug addiction, and in the case of an addiction of a psychological nature (such as that potentially resulting from ketamine abuse) this aspect of treatment is especially vital. Therapy can be provided either within the confines of a rehab environment or separately, in the outside world, and can prove very useful for a long time after an addiction is considered successfully broken; indeed, therapy is usually considered a vital part of the long-term recovery process.
As with so many aspects of addiction, the way an addict responds to particular therapies and the success obtained therefrom will vary significantly from one case to another. Some of the most prominent models such as cognitive behavioural therapy (CBT) and motivational therapy (MT) have proved extremely successful in treating psychological addictions but they may not benefit everyone, and an addict may have to try out a number of models before settling on an appropriate solution.
Group therapy can be highly beneficial – partly because the addict is able to share experiences, advise and learnings with other ketamine abusers who understand the fundamentals of that specific substance abuse – and support groups such as Narcotics Anonymous are available across the country for people in the later stages of recovery. Peer networks built up through such support groups can also prove indispensable in combatting the temptation to relapse even months or years down the line.