Is Ketamine Therapy Addictive and How Does It Work? 

Ketamine therapy has gained national attention as a treatment for depression, post-traumatic stress disorder and other mental health conditions that have not responded to traditional medications.

At the same time, ketamine is also known as a recreational drug. This creates understandable confusion.

People often ask two key questions:

• How does ketamine therapy actually work?
• And is ketamine therapy addictive?

The answer requires understanding both the medical process and the risks associated with misuse.

What Is Ketamine Therapy?

Ketamine is a medication originally used as an anesthetic in medical and surgical settings. In lower doses, it is now used in specialized clinics to treat certain mental health conditions, particularly treatment resistant depression.

There are two primary medical forms:

• Intravenous ketamine infusions
• Esketamine nasal spray, which is FDA approved for treatment resistant depression and administered under supervision

Ketamine therapy is not a take home prescription. It is delivered in a controlled clinical setting with monitoring before, during and after each session.

How Ketamine Therapy Works in the Brain

Unlike traditional antidepressants that primarily target serotonin, ketamine affects glutamate, a neurotransmitter involved in mood regulation, learning and memory.

Research suggests ketamine helps:

• Increase neural connectivity
• Stimulate the growth of new synaptic connections
• Reset certain stress related pathways in the brain

Some patients report improvement in mood within hours or days, compared to the several weeks traditional antidepressants may require.

This rapid effect is one reason ketamine therapy has gained attention.

However, the same brain pathways that create rapid mood elevation can also create risk when the drug is misused.

What the Ketamine Therapy Process Looks Like

Ketamine therapy is structured and carefully supervised. While protocols vary slightly by provider, the process often includes:

1. Comprehensive Evaluation

Before beginning treatment, patients undergo a psychiatric and medical assessment. Providers evaluate:

• Diagnosis and symptom history
• Previous treatment attempts
• Current medications
• History of substance use

Individuals with active substance use disorders are typically screened carefully because of the potential for misuse.

2. Treatment Sessions

During a ketamine session:

• The patient sits or reclines in a monitored setting
• Vital signs are tracked
• The medication is administered intravenously or via nasal spray
• The session typically lasts 40 minutes to two hours depending on the method

Patients are monitored throughout the session for safety.

3. What People Experience During a Session

Ketamine produces dissociative effects, meaning people may feel temporarily detached from their body or surroundings.

Common experiences include:

• Altered sense of time
• Dreamlike or floating sensations
• Visual imagery
• Emotional release
• Reduced mental noise

Some people describe it as deeply introspective. Others describe mild disorientation.

These effects are temporary and typically wear off within one to two hours after treatment. Patients are required to have transportation home and are advised not to drive.

4. Treatment Course

Ketamine therapy is usually delivered in a series of sessions over several weeks. For example, some protocols involve six sessions over two to three weeks, followed by maintenance sessions if clinically appropriate.

It is not intended for daily or unsupervised use.

Is Ketamine Therapy Addictive?

Ketamine itself has abuse potential.

It is classified as a Schedule III controlled substance, meaning it has accepted medical uses but also carries risk of dependence when misused.

Recreational ketamine use can lead to:

• Psychological dependence
• Increasing tolerance
• Cravings
• Escalating frequency of use
• Bladder and urinary complications
• Cognitive impairment

However, in structured medical settings, ketamine therapy is:

• Administered in controlled doses
• Given at spaced intervals
• Closely monitored
• Integrated with therapy and psychiatric oversight

Research indicates that when used in a clinical environment with proper screening, the risk of addiction is significantly lower than with recreational misuse.

That said, individuals with a history of substance use disorder may be at higher risk, which is why screening is critical.

What the Data Shows

Recent years have shown increased attention to ketamine in both medical and recreational contexts.

National surveillance data indicates rising emergency department visits involving ketamine misuse, particularly in nightlife and party settings. While ketamine is not as commonly misused as alcohol or opioids, its presence in recreational drug markets has grown.

At the same time, controlled clinical studies show promising results for treatment-resistant depression when ketamine is administered under supervision.

The key distinction is environment and intent.

Who May Not Be a Good Candidate?

Ketamine therapy may not be appropriate for individuals who:

• Have uncontrolled high blood pressure
• Have certain cardiovascular conditions
• Have active psychosis
• Have untreated substance use disorders

Each case must be evaluated individually.

The Difference Between Treatment and Misuse

Medical ketamine therapy is structured and therapeutic. Recreational use is unregulated and often involves higher doses or mixing with other substances.

The therapeutic goal is symptom relief within a treatment framework. Recreational use seeks euphoria or dissociation without medical oversight.

The difference matters.

When to Seek Help

If ketamine is being used outside medical supervision or if there are signs of:

• Cravings
• Increasing use
• Mixing with alcohol or other substances
• Emotional instability between uses

Professional evaluation may be necessary.

At Pyramid Healthcare, we provide comprehensive treatment for substance use disorders and co-occurring mental health conditions. Our programs include medical detox, residential treatment and outpatient services tailored to individual needs.

Understanding the Full Picture

Ketamine therapy can be a valuable tool for certain individuals when delivered responsibly and under medical supervision. It works by targeting different brain pathways than traditional antidepressants and may provide rapid relief for some patients.

However, ketamine itself carries misuse potential when used outside a clinical setting.

The safety of ketamine therapy depends on structured care, screening and ongoing support.

If you have questions about ketamine therapy or concerns about ketamine misuse, speaking with a qualified professional can help you make an informed decision.

Support and evidence-based treatment are available at every stage.