Is Ketamine an Opioid? And Other Common Questions

Ketamine continues to demonstrate efficacy in the treatment of a variety of mental health disorders. However, like many emerging treatments, ketamine's rise in popularity as a medical treatment has also led to questions and concerns about its efficacy, safety, and appropriate use. Is ketamine an opioid, for example? Is it addictive? Let’s take a look at some of the common questions about ketamine to help you make an informed decision about whether or not this treatment is right for you.

Top Questions About Ketamine Therapy

Is Ketamine an Opioid?

No, ketamine is not an opioid. It is in a class of drugs called “dissociatives.” This is actually a subcategory of hallucinogens, which can produce feelings of euphoria, detachment, and distortion of sight and sound. Ketamine acts on the NMDA receptors in the brain, whereas opioids act on opioid receptors. Opioids can produce a feeling of euphoria but rarely sensory distortion and hallucination. 

Is Ketamine a Party Drug?

Ketamine was never intended as a party drug. Its first applications were in surgery, where it was and continues to be used as a dissociative anesthetic. Like other pharmaceuticals, however, it has the potential for off-label abuse. So the answer is, yes, it is illegally used recreationally. Its use in ketamine assisted psychotherapy, however, is perfectly legal.

Is Ketamine a Horse Tranquilizer?

This question comes up a lot, probably due to the numerous times ketamine has been referred to as a “horse tranquilizer” in pop culture headlines.  The short answer is: yes, ketamine is used in certain settings as a horse tranquilizer. It is unique as an anesthetic in that it stimulates the circulatory system (i.e. increases blood pressure) and depresses breathing less than other anesthetics. This means it is often a safer choice for larger animals. But it is also used as a tranquilizer for other animals, along with its original application as an anesthetic and emerging use in treating psychiatric disorders. In other words, ketamine is not just a horse tranquilizer. 

Is Ketamine a Psychedelic?

Technically, no. Ketamine produces psychedelic-like effects, but it acts on a different area of the brain. While ketamine is an NMDA agonist, psychedelics act upon certain serotonin receptors to produce their hallucinogenic effects. 

Does Ketamine Have Severe Side Effects?

Unlike opioids and other analgesics, ketamine does not cause appreciable side effects at the low dose used for ketamine assisted psychotherapy. Most individuals will experience mild side effects, if any. The most common of these include mild nausea, slight itching, and fatigue. 

Is Ketamine Addictive?

When administered at a low dose over a set period in a clinical setting, ketamine has very low risk of physical or emotional dependence. When used recreationally for long periods of time, however, it can be addictive and cause withdrawal symptoms when stopped suddenly. Keep in mind that recreational doses of ketamine typically start at 100 mg and may go as high as 500 mg, taken multiple times in one day.  Ketamine dosing in a clinical setting, on the other hand, averages 0.5 mg per kilogram of weight. For example, a patient weighing 75 kilos (about 165 lbs) would be given 37.5 mg of ketamine over the course of 40 minutes in most cases. This low dose, combined with vigilant monitoring by your healthcare provider, minimizes the likelihood of addiction.  Furthermore, there are studies to support the use of ketamine assisted therapy in treating addiction. A recent review of current literature found that ketamine prolonged abstinence from alcohol and heroin in detoxing users, while also reducing cravings in active cocaine users. 

Can I Take My Antidepressant With Ketamine?

There is technically no reason why you can’t take your antidepressant at the same time you receive ketamine therapy. The most commonly prescribed anti-depressants are in a class called SSRIs. These drugs work on serotonin receptors in the brain, while ketamine is an NMDA agonist. Thus, there is no physiological contraindication.  Furthermore, the only FDA-approved form of ketamine (esketamine) is actually meant to be taken at the same time as an antidepressant. Ultimately, whether or not you continue your SSRI while undergoing ketamine therapy will be up to you and your doctor. 

Is Ketamine Only For Depression?

The FDA has approved intranasal ketamine for two conditions: treatment-resistant depression, and acute suicidal ideation. This does not mean, however, that it can’t be used off-label for other conditions. In fact, ketamine is showing great promise for many mental health concerns, including anxiety, bipolar disorder, PTSD, and more. 

Who Should Not Take Ketamine? 

While generally safe and effective, ketamine is not for everyone. Certain health conditions may mean you are not a good candidate for ketamine therapy. These include certain heart conditions, high blood pressure, hyperthyroidism, and active substance abuse disorder. 

Ketamine Therapy in Destin

The Crane Center in Destin, Florida offers ketamine as one of our many therapies. If you are interested in pursuing ketamine assisted psychotherapy, or you have further questions not answered in this article, please call our office or go online today to schedule a consultation.