Dangers of Mixing Ketamine and Alcohol

It’s Friday, and you’re out with friends at the club. You all order drinks and make your way to the dance floor. Everyone’s having fun, and your friends really want to match the energy of the club. So they ask if you want to take ketamine, a “party drug” that’s popular for its dissociative effects. But you’ve been drinking, so you wonder if mixing alcohol and ketamine is a good idea.

What are the potential ketamine and alcohol interactions? To understand the dangers of mixing ketamine and alcohol, let’s explore the effects of each of these substances on our body.

What Is Ketamine?

Ketamine was first developed to help with surgeries and pain relief. It’s known for its ability to induce dissociative anesthesia, making patients feel detached from their pain and environment. Over time, its use expanded beyond anesthesia to treat various conditions, including depression and chronic pain. At the same time, its recreational use surged and it became associated with club culture for its energy-boosting and mind-altering effects. 

In its pure form, ketamine exists as a white powder or a clear liquid and is often taken by swallowing, snorting, or injecting. It’s popularly known by a variety of street names like "Special K" or "K."

When we take ketamine, it quickly dissolves into our bloodstream and goes to the brain. Despite its hallucinogenic properties, ketamine is different from traditional hallucinogens like LSD or psilocybin. Instead of binding to serotonin receptors, ketamine primarily targets the glutamate system, specifically NMDA receptors in the brain. It acts as an antagonist to NMDA receptors, blocking the transmission of glutamate, a neurotransmitter important for learning, memory, and mood regulation.

This interference is what causes a dissociative state, wherein our perceptions of sight and sound are distorted. It creates a strange feeling in which things don't seem real, and we might see or hear things that aren't there, leading to a sense of detachment from reality. This dissociation, or “out-of-body” feeling, is why ketamine is sometimes referred to as a "dissociative anesthetic."

The Effects of Ketamine 

The effects of ketamine on our body depend on different factors:

• Our size, weight, and health
• Our history with ketamine use
• Our use of other drugs in combination
• The amount taken
• The concentration of the drug

Our ketamine experience can vary drastically depending on how much we take. Lower amounts might induce a “dreaming” feeling, while higher doses could lead to intense hallucinations and a feeling of being completely disconnected from reality. Common symptoms range from physical to psychological:

• A sense of joy and calm
• Dissociation (feeling disconnected from our body)
• Hallucinations (seeing things or hearing sounds that aren't really there)
• A faster heart rate and higher blood pressure
• Confusion and clumsiness 
• Lack of body coordination or immobility 
• Involuntary rapid eye movement
• Trouble speaking 
• Feeling anxious, panicked, or becoming aggressive
• Nausea and/or vomiting 
• Reduced sensitivity to pain 
• In higher doses, a state known as the "K-hole," where the user experiences severe dissociation and immobility

Ketamine may also cause the following unwanted side effects.


• Cognitive difficulties 
• Unconsciousness
• Amnesia

Side effects like unconsciousness, amnesia, or immobility might be signs of ketamine overdose and require urgent medical attention.

Medications (either over-the-counter or prescription) might interact with ketamine with their side effects exacerbated or their efficacy compromised. They can make ketamine use more dangerous. Please exercise caution!

Long-Term Effects of Ketamine

Ketamine's impact extends beyond its immediate, short-term effects. Prolonged use can lead to several long-term health issues. 

• Cognitive impairment. Chronic use of ketamine has been linked to impairments in memory, attention, and executive functioning. These cognitive deficits can affect daily functioning and may persist even after discontinuing use.
• Urinary tract and bladder issues. One of the most significant long-term effects of ketamine use is its impact on the urinary system. Users may experience increased urgency and frequency of urination, pain while urinating, and, in severe cases, bladder inflammation and ulceration.
• Gastrointestinal distress. Regular use of ketamine can lead to chronic abdominal pain and other gastrointestinal issues, a condition sometimes referred to as "K-cramps."
• Mental health problems. Long-term ketamine use has been associated with an increased risk of developing mental health disorders, including depression, anxiety, and, in some cases, symptoms of psychosis. Some people have experienced Hallucinogen Persisting Perception Disorder (HPPD) weeks after taking ketamine; it can have a prolonged effect on our sensory perception. 
• Dependency and tolerance. With regular use, we can develop tolerance to ketamine. When we become tolerant, we require larger doses to achieve the same effects, which may lead to dependence.

Ketamine Abuse and Misuse

According to the 2021 National Survey on Drug Use and Health, approximately 3 million people in the U.S. (aged 12 or older) reported using ketamine at least once in their lifetime. This percentage reflects the growing trend of recreational use. Ketamine abuse is more commonly reported among young adults aged 18 to 25, since they are often exposed to party environments where recreational drug use is prevalent.

Research suggests a correlation between ketamine misuse and mental health disorders: a person with a history of mental health issues is at a higher risk of abusing substances like ketamine. More recently, ketamine has received public attention as a novel treatment for certain psychiatric disorders. While the results are promising, ketamine therapy is still being studied and positive results depend on careful monitoring and guidance from a trained psychiatric professional.  

Recognizing the symptoms of ketamine and alcohol misuse — in ourselves and in friends or loved ones — is important for early intervention:

• Increased tolerance. Needing more of the substances to achieve the same effects.
• Withdrawal symptoms. Experiencing physical or psychological symptoms when not using.
• Neglect of responsibilities. Failing to meet professional, academic, or personal obligations.
• Risky behavior. Engaging in dangerous activities while under the influence.
• Social and relationship problems. Strained relationships and social isolation due to substance use.
• Physical health issues. Experiencing health problems related to substance use, such as weight loss, gastrointestinal issues, or urinary tract problems.
• Mental health deterioration. Worsening of mental health symptoms, including depression, anxiety, or hallucinations.

Mixing Ketamine and Alcohol

When ketamine is mixed with alcohol, the risks of danger escalate dramatically. Alcohol, a depressant, can amplify ketamine's sedative effects, leading to dangerous levels of respiratory depression. Using both in combination can have many harmful effects.

• Exacerbated sedation and respiratory depression. Both alcohol and ketamine have sedative effects. Combining ketamine with alcohol amplifies the sedation and can dangerously slow down breathing and heart rate, increasing our risk for respiratory depression, which can be life threatening.
• Impaired cognitive and motor functions. The combination of alcohol and ketamine severely impairs cognitive and motor functions. This impairment can result in poor judgment, difficulty in making decisions, and a decrease in motor coordination. We are then at risk of accidents and injuries as we become less capable of assessing risks and responding to our environment.
• Increased risk of blackouts and memory loss. Both substances can disrupt our memory formation process. This can lead to blackouts, in which we cannot recall events that occurred while under the influence. These memory lapses can be distressing and may lead to dangerous situations where we may fail to have awareness or consent.
• Heightened psychological distress. Ketamine can cause dissociative effects, including hallucinations and detachment from reality. When mixed with alcohol, these effects can become more intense and disorienting, potentially leading to anxiety, panic attacks, or exacerbation of preexisting mental health conditions.
• Risk of gastrointestinal distress. Alcohol is known to irritate the gastrointestinal tract, and ketamine can cause nausea and vomiting. The combination of these substances can increase the likelihood of gastrointestinal distress, which can lead to dehydration and electrolyte imbalance.
• Potential for developing substance use disorders. Using multiple substances in combination increases the risk of developing substance use disorders. If you have Alcohol Use Disorder, ketamine may add to the addictive potential. The interplay between the two can create a cycle of dependence and abuse, leading to long-term health and social consequences.
• Dangerous interactions with other medications. When mixed with other medications, especially those that affect the central nervous system (such as antidepressants, anxiety medications, or other sedatives), the combination of alcohol and ketamine can lead to unpredictable and potentially harmful impairments.

Ketamine and Alcohol Overdose

Recognizing the symptoms of ketamine and alcohol abuse is important for early intervention. 

• Increased tolerance. Needing more of the substances to achieve the same effects.
• Withdrawal symptoms. Experiencing physical or psychological symptoms when not using.
• Neglect of responsibilities. Failing to meet professional, academic, or personal obligations.
• Risky behavior. Engaging in dangerous activities while under the influence.
• Social and relationship problems. Strained relationships and social isolation due to substance use.
• Physical health issues. Experiencing health problems related to substance use, such as weight loss, gastrointestinal issues, or urinary tract problems.
• Mental health deterioration. Worsening of mental health symptoms, including depression, anxiety, or hallucinations.

Alcohol with ketamine also increases the risk of overdose due to alcohol’s sedative effects on the body. Look for these signs of potential ketamine/alcohol overdose.

• Seizures
• Chest pains or trouble breathing
• Unconsciousness
• Impaired motor function
• Confusion
• Nausea or vomiting
• High blood pressure
• Slowed heart rate
• Clammy skin
• Low body temperature

If you or your loved ones are experiencing any of these symptoms, call 911 or reach out to your healthcare professional right away. Polysubstance abuse makes these effects more dangerous, leading to potential death. The probability of surviving an overdose involving both ketamine and alcohol is influenced by how much you took, your age, your health, and other factors. 

Substance abuse is a serious problem, but there are other ways you can work on reclaiming your well-being and live a substance-free life. Read on to find out more!

Treatment for Ketamine and Alcohol Abuse

Effective treatment for ketamine and alcohol abuse requires a comprehensive approach that factors in both parts of the equation. Let’s look at some treatment tools. 

• Detoxification and withdrawal management. The first step in treatment is often detoxification, which should be medically supervised to monitor for potentially dangerous withdrawal symptoms.
• Behavioral therapies. Cognitive behavioral therapy (CBT) and other psychotherapies can help us understand our substance-use triggers and develop healthier coping mechanisms.
• Medication-assisted treatment (MAT). While there are no specific medications for ketamine abuse, MAT can help treat co-occurring disorders or symptoms and relieve any underlying chemical imbalances that are triggering substance use.
• Support groups and peer support. Groups like Narcotics Anonymous (NA) or other peer support groups can provide valuable social support and a sense of community.
• Treatment of co-occurring disorders. Addressing any co-occurring mental health disorders is crucial for successful recovery.
• Lifestyle changes. Encouraging healthy lifestyle choices — such as exercising regularly, eating a balanced diet, and engaging in hobbies and interests — can support recovery.
• Family therapy and support. Involving family members in the treatment process can improve outcomes and provide additional support.

Treatment should be tailored to each individual’s specific needs, the severity of their substance use disorder, the presence of co-occurring conditions, and their personal circumstances. Professional help is critical in overcoming ketamine abuse and reclaiming a healthy, substance-free life.

Tips for Safety and Awareness

• Educate yourself. Research the effects of ketamine and alcohol when combined. Understand the risks and consequences to make informed decisions. Join a supportive community like Reframe for science-backed advice on alcohol and alcohol related concerns to learn more about ways to improve your health.
• Create boundaries. Set clear personal limits regarding substance use. Establishing boundaries helps in avoiding situations where mixing ketamine and alcohol might occur.
• Seek support. Foster a supportive network of friends and family who are aware of your goals to decrease substance intake. A positive, understanding environment helps in making healthier choices.
• Explore alternatives. Engage in activities and hobbies that provide fulfillment and joy without relying on substances. Discovering new passions can divert attention from potentially harmful behaviors.
• Practice mindfulness. Incorporate mindfulness techniques such as meditation or deep-breathing exercises to manage stress and cravings effectively.
• Professional guidance. Consider seeking professional help or counseling to address underlying issues contributing to substance abuse.
• Develop healthy coping mechanisms. Identify and adopt healthy coping strategies like regular exercise, journaling, or creative outlets to navigate challenging emotions without resorting to substance use.

Summing Up

Now that we understand the risks associated with mixing ketamine and alcohol, we can make informed, responsible choices to ensure our safety and the well-being of those around us. Remember: a night of fun should never compromise our health or future. Stay informed, stay safe, and let’s help create a culture of awareness and responsibility!