Ketamine ranks among the most commonly utilized anesthetic medications worldwide, and when it is administered appropriately in medical settings, it is considered very safe. Although overdose incidents are relatively rare and don’t often lead to permanent harm under clinical supervision, recreational use of ketamine paints a far riskier picture. When misused, this drug can bring about severe toxicity related to cardiovascular, neurological, urogenital, digestive, and psychiatric complications.
Originally created as a variant of phencyclidine (PCP), ketamine is only about one-tenth as strong as PCP, yet consuming it at high doses can still trigger vivid hallucinations, psychosis, and a profound level of sedation. These effects may depress respiration, induce coma, or even prove fatal. In recreational scenarios, ketamine may be snorted, injected (into muscles or veins), smoked, taken in pill form, or dissolved into a liquid and swallowed.
Symptoms of Ketamine Overdose
The degree to which ketamine overdose symptoms appear largely depends on the quantity consumed. Lower doses typically produce sensations of euphoria and dissociation, whereas larger amounts may result in serious symptoms such as sedation, immobility, and hallucinations.
Possible signs of a ketamine overdose include:
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- Nausea and vomiting
- Lethargy
- Excessive salivation
- Trismus (inability to open the mouth fully, often called lockjaw)
- Reduced pain perception
- Nystagmus (unusual eye movements, whether lateral, horizontal or rotary)
- Confusion
- Slurred speech
- Muscular rigidity
- Intense sedation
- Psychosis
- Hallucinations
- Slow or uneven breathing
- Loss of consciousness
- Seizures
- Coma
- Death
Among these indicators, respiratory depression poses one of the most critical threats. When ketamine compromises the area of the brain responsible for controlling breathing, it can cause dangerously slow or irregular respirations, potentially leading to unconsciousness or coma. If breathing becomes severely impaired, irreversible brain damage and death may follow. A ketamine overdose constitutes a medical emergency requiring immediate attention since, without timely intervention, the results can be deadly.
Causes of Ketamine Overdose
Ketamine has surged in popularity as a “club drug,” where users seek out its euphoric and consciousness-altering properties by taking high doses. Disturbingly, ketamine has also been used as a date rape drug due to its ability to induce anesthesia, amnesia, and dissociative states.
In physiological terms, ketamine exerts its effects by dampening the activity of various signaling pathways in the brain responsible for maintaining critical functions, such as normal breathing patterns, heart rhythms, metabolism, and cognition. While it is uncommon for someone to overdose and die from ketamine alone, the dangers rise considerably when it is taken simultaneously with other substances, especially alcohol.
Identifying an exact lethal dose of ketamine for humans is difficult because each individual’s response depends on a wide array of factors, including body weight, genetic makeup, metabolism, overall health, prior ketamine exposure, and the presence of other substances in the person’s system.
A rough approximation of a lethal ketamine dose for a human is about 600 mg/kg of body weight. For instance, in a 155-pound individual, this equates to roughly 4.2 grams of ketamine. In a professional clinical environment, anesthetic doses are generally well under 10 mg. It is important to remember this 600 mg/kg estimate applies to ketamine taken without any other drugs; mixing ketamine with alcohol or other substances raises the danger and likelihood of an overdose.
Ketamine Drug Interactions
Ketamine’s pharmacological profile is complex, exerting multiple actions that can counteract one another. At higher doses, ketamine can slow both breathing and heart rate, yet it also triggers the sympathetic (“fight or flight”) response, promoting an increase in both respiratory and cardiac activity. These competing effects might lessen the risk of a fatal overdose if no other drugs are present.
However, when central nervous system (CNS) depressants are used along with ketamine, the synergistic impact on the body’s respiratory and cardiac functions significantly heightens the likelihood of a dangerous overdose. This synergy means the combined effect is more pronounced than if each substance was taken independently. As a result, life-threatening respiratory depression becomes more probable.
Common CNS depressants often used in conjunction with ketamine include:
Additionally, CNS stimulants like cocaine, ecstasy, and methamphetamine can be taken alongside ketamine. Although precise data on ketamine’s interactions with stimulants is limited, animal studies indicate that co-administration of ketamine with methamphetamine or cocaine can substantially raise the risk of death compared to using any of those drugs individually.
Ketamine Overdose Deaths
In situations where ketamine is used by itself, deaths due to overdose remain relatively rare. However, the likelihood of a fatal outcome spikes considerably when ketamine is mixed with other drugs or alcohol. The interplay of multiple substances amplifies negative physical and psychological effects, leading to a higher risk of fatal respiratory depression or other life-threatening complications.
Ketamine Overdose Treatment
For most individuals who experience an acute ketamine overdose, robust supportive care can be enough to manage immediate symptoms. The duration of these acute effects often depends on the dose and route of administration and can range from about 15 minutes to several hours. It is typically recommended that anyone suspected of a ketamine overdose remain under medical supervision for a minimum of six hours. This observation period allows professionals to respond to any serious complications quickly.
If someone has ingested a large amount of ketamine alongside other substances, a medical team may consider using activated charcoal to decrease absorption within the gastrointestinal tract. However, there are no approved medications from the U.S. Food and Drug Administration (FDA) that can directly counteract a ketamine overdose.
Benzodiazepine-Assisted Treatment
Ketamine-induced agitation or psychosis can sometimes be managed with benzodiazepines, such as lorazepam or diazepam. These medications may alleviate the psychotic-like effects (e.g., delusions or delirium), as well as help reduce high blood pressure, excessive body temperature, and seizures stemming from large ketamine doses.
Although benzodiazepines can be helpful, they must be administered by medical professionals in a controlled environment because they are also CNS depressants and can further suppress breathing. Combining benzodiazepines with high-dose ketamine, therefore, can heighten the risk of respiratory failure and death if not managed carefully.
Ketamine Overdose Prevention
Unquestionably, the most reliable way to avoid a ketamine overdose is to abstain from misusing the drug. Low, infrequent doses of ketamine are typically well-tolerated if there are no other substances involved. Even so, habitual use of minimal amounts can still produce adverse consequences over time, affecting both physical and mental well-being. Meanwhile, combining ketamine with other drugs drastically increases the chance of overdosing.
If you or someone you love is dealing with problematic ketamine use, The Recovery Village Salem is here to offer support. Our specialized team is well-versed in addiction treatment and can guide you or a loved one toward a healthier, substance-free life. Reach out today for more information about our comprehensive rehabilitation programs.
