Author: James Anderson

Ketamine Addiction: Definition, Symptoms, Effects, and Treatment

Both the adult and the adolescent groups had higher functional connectivity between the left and right precuneus (Hung et al., 2020a). Lin et al. used resting state fMRI to compare a group of chronic ketamine users, many of which also used other drugs like cannabis or cocaine, to healthy controls (Liu et al., 2016). They found lower functional connectivity of the default mode network in the orbital right inferior frontal gyrus, left anterior cingulate gyrus, paracingulate gyri, right superior temporal gyrus and bilateral vermic lobule VI of the cerebellum. In contrast, they found higher functional connectivity in the left middle occipital gyrus. Using diffusion-weighted MRI scans, fractional anisotropy (FA) can be used for estimating white matter fiber density, myelination and axonal diameter. FA reductions were found in bilateral frontal and left temporoparietal white matter in 41 ketamine users with a mean use of 2 grams/day for 3.4 years, in comparison with 44 drug-free controls (Liao et al., 2010).

While ketamine isn’t the most fatal of substances when used alone, developing an addiction to this drug can greatly affect quality of life. Fourth, most of the included subjects were of Asian ethnicity, which might have influenced outcomes for instance through genetic differences in drug metabolism. However, it has been shown that frequencies of cytochrome P450 variants responsible for ketamine metabolism do not vary significantly between people with Asian or Caucasian ancestry (Mizutani, 2003; Peltoniemi et al., 2016). Withdrawal symptoms may include chills, sweats, excitation, hallucinations, teary eyes, and drug cravings. The effects of abuse typically last 1 to 2 hours, but the users judgement, senses and coordination may be affected for up to 24 hours or longer. Sensations the user may seek include floating, stimulation and visual effects.

However, at higher doses it may also bind to the opioid mu and sigma receptors. Glutamate is involved with learning, memory, emotion, and pain recognition. It can exhibit sympathomimetic activity which can lead to rapid heart rate and elevated blood pressure. While the drug is largely eliminated from the body within 14 to 18 hours after the last dose, it can also have longer-term effects.

Treatment for Ketamine Addiction

These effects have seen a growing and worrying use of this drug for date rape. While users report feeling complete bliss on ketamine, consuming high amounts of this drug can produce effects similar to a near-death experience. Widely known for its medicinal properties, ketamine’s effects have made it a popular addition to the party scene.

1. The paper’s lead authors are Malika Datta and Yannan Chen, who completed their research in Raju Tomer’s lab at Columbia.
2. The most frequently reported side effects of short term ketamine (hours/days) are related to the nervous system, such as dissociation, sedation, headache, dizziness, blurred vision and memory impairment (Short et al., 2017).
3. High doses may dangerously reduce breathing, lead to muscle spasms or weakness, dizziness, balance difficulty, impaired vision, slurred speech, nausea and vomiting, and severe confusion.
4. The dissociative effect alters the users perception of light and sound and produces feelings of detachment from self and surroundings.

It remains unclear whether the altered connectivity patterns found in this study could be a direct result of ketamine. Being under the influence of ketamine was not an exclusion criterion for participation in this study. Gray matter volumes in rOFC, rMPFC and rNAC were negatively correlated with ketamine dependence severity and gray matter volumes of the rOFC, rmPF, lCN, lGP, lH, and rNAC negatively correlated with cognitive performance (Liu et al., 2016; Tang et al., 2016). Different from other studies, this study also found higher gray matter volume in ketamine users compared to controls, i.e., in the left caudate nucleus.

Brain Changes Associated With Long-Term Ketamine Abuse, A Systematic Review

The findings bolster the case for developing ketamine therapies that target specific areas of the brain, rather than administering doses that wash the entire brain in ketamine. It must be noted that the reported changes were dependent on the dosage and duration of ketamine use which were substantially higher than for clinical use, so our findings cannot be translated to clinical ketamine use. Original studies about recreative ketamine use in which neuroanatomical measurements were performed, either structural or functional, were included. To obtain the articles meeting this inclusion criterion we first excluded all articles that were not about ketamine. Subsequently we excluded articles that were only about brain function and not about neuro-anatomical outcomes (e.g., performance on cognitive tests).

Most illicit use of ketamine appears to be from illegal diversion from legal sources. Central nervous system side effects such as agitation are less intense than those seen with PCP abuse. Rehabilitation centers can help with different treatment options, detox programs, and other necessary assistance for overcoming dependency. Cognitive behavioral therapy can assist with changing the thought patterns that play a role in supporting drug use and addiction. This leaves plenty of room for excessive amounts of ketamine to be taken, amounts which can lead to an overdose.

Binge use, where the user indulges in the drug in excess amounts in a short period of time has been reported, as well. High doses may dangerously reduce breathing, lead to muscle spasms or weakness, dizziness, balance difficulty, impaired vision, slurred speech, nausea and vomiting, and severe confusion. Because ketamine is consumed in liquid and powder form, or mixed in these forms with other stimulants—there is a high chance that a person using this drug has little to no idea of how much is being consumed.

Structural Differences: Gray Matter

Prolonged ketamine may either up- or downregulate important regulatory neuronal proteins, potentially resulting in impaired neuronal functioning and cognitive performance. It needs to be considered however, that there may be a U-shaped dose-effect relation between ketamine and cognitive changes. In rats, different 5–7-days dosing regimens of ketamine yielded opposite effects on cognitive tasks in which the rats had to detect novel objects, or novel placement of objects. Whereas, low ketamine enhanced novelty detection compared to controls, higher doses impaired novelty detection (Schumacher et al., 2016). “This study gives us a deeper brain-wide perspective of how ketamine functions that we hope will contribute to improved uses of this highly promising drug in various clinical settings as well as help minimize its recreational abuse.

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