Is Ketamine Therapy Addictive? What the Evidence Says

Yes, it is possible. When the DEA placed ketamine in Schedule III in 1999, it found that abuse of ketamine may lead to moderate or low physical dependence or high psychological dependence.

The same ruling found that ketamine has an accepted medical use in the United States and a potential for abuse lower than drugs in Schedules I and II. That is a middle position: a medicine with legitimate uses that has to be handled with controls.

Ketamine's current prescribing information tells a consistent story. People with a history of drug abuse or dependence may be at greater risk of misusing it. Withdrawal symptoms, including craving, fatigue, poor appetite, and anxiety, have been reported after people stopped large doses taken more than weekly for long periods, and tolerance has been reported with prolonged use.

Nobody can give a precise answer yet. The patterns most clearly linked with dependence, frequent large doses over long stretches, differ from a supervised course of treatment, but research on ketamine for depression has not followed people long enough to settle the question.

A 2018 systematic review of side effects in depression studies found limited assessment of long-term use and safety, and its authors called for larger trials that test repeated doses with long follow-up.

A 2017 consensus statement from an American Psychiatric Association task force pointed to ketamine's known potential for abuse and to reports of abuse of ketamine prescribed for depression. It advised clinicians to stay alert to the possibility of a ketamine use disorder developing in their own patients.

Because it controls the supply. When every dose is given in the clinic and nothing goes home, there is no stock to take early, take extra, or pass to someone else.

The same consensus statement strongly advised against prescribing ketamine for self-administration at home, and recommended keeping the number and frequency of treatments to the minimum needed for a response. Here is how that looks at Clear Ketamine Therapy:

By asking directly and checking the history. The 2017 consensus statement recommends a full diagnostic assessment that covers past and present substance use, a review of every current medication including any opioid or benzodiazepine use, and, where possible, past records or family input to confirm the history. It also strongly encourages a baseline urine drug screen.

For people who receive repeated doses, the statement suggests checking thinking and memory, urinary symptoms, and substance use along the way, with closer follow-up whenever misuse is suspected.

Answer these questions honestly. A past or current substance use problem is a recognized risk factor, and for some people it means ketamine is not a good option. Either way, a clinician can only weigh it if they know about it.

Wanting more of it, sooner, or outside the plan is the clearest signal. Tell your clinician if you notice any of these in yourself:

Ketamine's label links memory and attention problems mainly with recurrent high-dose misuse, and it links serious bladder, kidney, and liver complications with long-term use or abuse. It also notes liver changes with repeated medically supervised use, and advises baseline liver tests and periodic monitoring for patients on a plan with recurrent dosing. These are reasons to report new symptoms promptly, not reasons to panic about a single session.