Is Ketamine Addictive?
The short answer? It’s complicated.
Ketamine has a relatively low potential for addiction when used in a controlled, therapeutic setting. In clinical contexts, such as for treating depression or PTSD, ketamine is administered in carefully monitored doses under professional supervision, minimizing the risk of dependency.
That said, when used recreationally or outside of therapeutic supervision, ketamine can lead to abuse due to its dissociative and euphoric effects. Regular misuse of ketamine, especially in high doses, can result in psychological dependence. The risk of addiction is higher with frequent use or in environments where the drug is used outside of its therapeutic intent.
During ketamine-assisted therapy (KAT), ketamine is administered sublingually i.e. under the tongue. When administered in a therapeutic session, sublingual use is considered to have a lower potential for addiction compared to other forms of ketamine administration, like nasal or intravenous (IV). There are several reasons for this:
1. Controlled Setting and Supervision
Therapeutic Context: When ketamine is used in a KAT session, you will be guided by a trained professional who is there to monitor the experience and ensure it's being used in a therapeutic manner. This controlled environment minimizes the risk of misuse or recreational use.
Monitoring: Unlike with IV administration, The therapist will be in the room with you for the entire journey, observing your response in real time, ensuring that you are receiving appropriate treatment and not overusing the substance.
2. Lower Potency for Immediate Euphoria
Sublingual Absorption: Sublingual ketamine is absorbed more slowly compared to nasal or IV administration. This slower onset means that the effects are more gradual and less likely to induce a rapid, intense "high" or immediate euphoria, which is often a key factor in the development of addiction. The experience tends to be more therapeutic, focusing on mood enhancement or dissociation for mental health treatment rather than to get “high.”
Less Immediate Reward: The slower onset of effects also means there's a lower potential for the reinforcing "reward" sensation that can contribute to addiction. The brain is less likely to link the experience to a rapid cycle of craving and reinforcement.
3. Lower Risk of Abuse Potential
Dosing Protocols: In therapeutic settings, sublingual ketamine is typically given in doses designed for specific mental health conditions, like depression or PTSD. These doses are calibrated to provide therapeutic effects, not the intense high associated with recreational use. This limits the likelihood of users seeking out the drug for non-medical purposes.
Non-Reinforcing Dosing: Sublingual ketamine is often administered in a series of scheduled sessions, with longer intervals between doses, making frequent use harder to sustain. This structured dosing protocol reduces the opportunity for habitual use, which can lead to dependency.
4. Therapeutic Focus
Healing Focus: The purpose of ketamine therapy is to address underlying psychological issues, like depression, trauma, or anxiety. The experience in these sessions is often dissociative and introspective, rather than pleasurable in the traditional sense. The focus is on emotional healing and cognitive restructuring, rather than creating a "high" that people might chase in the context of addiction.
Therapeutic Framework: During KAT, you will be encouraged to focus on reflection, exploration, and integration of the experience. This reduces the likelihood of seeking to repeat the experience in an uncontrolled manner. In short, you’ll be processing and integrating the effects, rather than using the substance as an escape or crutch.
Conclusion
In summary, sublingual ketamine used in a therapeutic context tends to have a lower potential for addiction because the experience is more gradual, supervised, and focused on mental health treatment rather than recreational use. The therapeutic setting, controlled dosing, and lack of immediate reinforcement all contribute to minimizing the risk of addiction. However, as with any substance, it's crucial that ketamine use remains part of a structured treatment plan, with proper oversight to ensure safety and efficacy.
