Ketamine use: a review
Version of Record online: 22 JUL 2011
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction
Volume 107, Issue 1, pages 27–38, January 2012
How to Cite
Morgan, C. J. A., Curran, H. V. and the Independent Scientific Committee on Drugs (ISCD) (2012), Ketamine use: a review. Addiction, 107: 27–38. doi: 10.1111/j.1360-0443.2011.03576.x
- Issue online: 12 DEC 2011
- Version of Record online: 22 JUL 2011
- Accepted manuscript online: 21 JUL 2011 07:42AM EST
- Submitted 12 October 2010; initial review completed 4 November 2010; final version accepted 4 July 2011
- physical harms;
- social harms;
- ulcerative cystitis.
Aims Ketamine remains an important medicine in both specialist anaesthesia and aspects of pain management. At the same time, its use as a recreational drug has spread in many parts of the world during the past few years. There are now increasing concerns about the harmful physical and psychological consequences of repeated misuse of this drug. The aim of this review was to survey and integrate the research literature on physical, psychological and social harms of both acute and chronic ketamine use.
Method The literature on ketamine was systematically searched and findings were classified into the matrix of Nutt et al.'s (2007) rational scale for assessing the harms of psychoactive substances.
Results A major physical harm is ketamine induced ulcerative cystitis which, although its aetiology is unclear, seems particularly associated with chronic, frequent use of the drug. Frequent, daily use is also associated with neurocognitive impairment and, most robustly, deficits in working and episodic memory. Recent studies suggest certain neurological abnormalities which may underpin these cognitive effects. Many frequent users are concerned about addiction and report trying but failing to stop using ketamine.
Conclusions The implications of these findings are drawn out for treatment of ketamine-induced ulcerative cystitis in which interventions from urologists and from addiction specialists should be coordinated. Neurocognitive impairment in frequent users can impact negatively upon achievement in education and at work, and also compound addiction problems. Prevention and harm minimization campaigns are needed to alert young people to these harmful and potentially chronic effects of ketamine.