Emmalynn Pepper Clemmensen, M.S., LPCC, CRC
Emmalynn Pepper Clemmensen is a Licensed Professional Clinical Counselor who has experience providing both individual and group therapy in an outpatient setting. She has experience working with individuals who have disabilities, those who are experiencing depression, anxiety, bipolar disorder, PTSD, and other mental health concerns. She also has experience working with those who are struggling with both a mental health disorder and substance use disorder.
Recent contributions of Emmalynn Pepper Clemmensen, M.S., LPCC, CRC
Understanding Ketamine and How to QuitPublished on February 11, 2019 Updated on May 25, 2022
Ketamine is a dissociative drug, which means it can cause the user to feel disconnected from himself and reality.1,2 Ketamine can have a very significant impact on the body and mind and is especially dangerous when taken with other drugs that cause respiratory depression, such as alcohol.1 Are you regularly using ketamine and interested in quitting? If so, you might be concerned about the possible risks of withdrawal. Understanding what to expect during detox from this dissociative drug and how to mitigate the risks can boost your confidence in quitting for good. What Does Ketamine Do to the Body? Ketamine can cause the following short-term side effects:1 Increased blood pressure Abnormally slow breathing Sedation Loss of consciousness Problems paying attention, learning, and retaining information* Amnesia Confusion Hallucinations Feeling as though you are in a dream Some issues that may arise with consistent ketamine use include:1 Kidney problems. Abdominal pain. Bladder problems, including pain and ulcers. Depression. *Research has found that dissociative drugs, such as ketamine, alter the activity of the brain chemical glutamate at certain sites known as NMDA receptors.2 As a neurotransmitter, glutamate is involved in a wide range of physiological functions, and this disruption can significantly impact a person's perception of pain, their emotions, their ability to learn, and their memory.2 Tolerance and Dependence to Ketamine Studies show that tolerance to ketamine can develop rapidly, which means that in order to continue experiencing the desired effects of the drug, the user must continually increase the dose and/or regularity with which they consume ketamine.3 Case report evidence supports the phenomenon of physical dependence development in association with ketamine use, though the extent to which users become dependent on ketamine is not well studied.3 With many drugs, a substance-dependent person will depend on the drug to feel normal and avoid withdrawal. Withdrawal symptoms, such as anxiety and shaking, have been noted in regular ketamine users who begin a period of abstinence, indicating the drug may be associated with some degree of physical dependence.3 Many frequent users are concerned about addiction and report trying but failing to stop using ketamine. While there are many diagnostic criteria for addiction, the hallmark of this disease is the compulsive use of a substance despite all of the current or probable negative consequences.4 For example, if ketamine use is negatively impacting someone’s school performance, leads to job loss, creates tension within the person’s important relationships, causes significant financial stress, or creates legal issues, but the person continues to use in light of these problems, it is likely that they are struggling with addiction.4 Addiction to any substance is a challenging condition to overcome, but with treatment it can be managed. What Are the Withdrawal Symptoms of Ketamine? Users who abruptly discontinue their ketamine use may experience symptoms such as:3 Cravings. Shakiness. Excessive sweating. Irregular heartbeat. Some users going through ketamine withdrawal may also show signs of anxiety. While the existence of a concrete withdrawal syndrome for ketamine is debated, one study showed that 28 of 30 daily ketamine users reported failed attempts to stop using ketamine. Every one of these 28 users blamed cravings for their inability to quit ketamine.3 Cravings combined with anxiety and the physical symptoms above can harm even the strongest-willed person in their attempts to get clean. However, professionals in detox and addiction treatment programs can provide emotional support and sometimes medication to manage these symptoms and help the individual begin a meaningful period of recovery. How Is Ketamine Treated? Numerous treatment options exist for those addicted to ketamine. For many, the first step is a detoxification program. During detoxification, support and sometimes medications are offered to increase the comfort and safety of the individual going through withdrawal.5 Withdrawal can put the detoxing individual under a lot of physical and psychological stress. For some drugs, it can be a dangerous process, while for others it will mainly be uncomfortable. For withdrawal syndromes where the symptoms are not medically severe, such as ketamine, a non-medical detox is an option. Often called "social" detox, this approach relies on emotional support and a non-stimulating environment rather than medications. Medical detox options that utilize medications to alleviate symptoms, provide continuous monitoring, and prevent any potential complications include:5 Hospital settings. Stand-alone detox facilities. Inpatient rehab programs that incorporate this kind of detox. A great benefit of detoxing in an inpatient rehab that offers care during acute withdrawal is that you won't have to transfer from one facility to another; you'll instead experience a smooth transition to ongoing treatment, which may lower the risk of relapse during this period. Detox may also take place on an outpatient basis. This may involve regular visits to a hospital or treatment center for sessions usually lasting under an hour, with the exception of the initial assessment that may take longer.9 Though it is certainly possible to overcome ketamine dependence on your own, having outside help can make the withdrawal process much easier to manage. Sometimes, the cravings and other uncomfortable symptoms of withdrawal will lead to relapse, which is why it is so important to receive help during detox. Despite the clear benefits in promoting early sobriety, it's important to realize that detox is not the only step to getting and staying clean; it is the first.5 Once this process is complete, the real work of recovery can begin. Does your insurance cover rehab for Ketamine use? We can help - check your coverage instantly or text us your questions to find out more. [vob-aktify-cta] After Detox: What Happens? At the end of the detoxification process, the physical dependence to ketamine is no longer be an issue; however, cravings for ketamine can persist. Attending further treatment can help a newly sober person understand their addiction and address any behavioral and psychological issues that fuel their urges to use ketamine. Like detox, substance abuse treatment programs may take place in inpatient/residential or outpatient settings: Inpatient rehab programs offer intensive treatment in a live-in facility. Recovering individuals attending inpatient rehab will participate in many types of treatment. For example, they might participate in group therapy sessions, individual therapy sessions, addiction education classes, and life skills training. Outpatient rehab, like outpatient detox, offers the individual recurring treatment sessions, but the crux of treatment will be therapy as opposed to the management of substance withdrawal. This is a good option for people who can't afford the time and/or money required to attend an inpatient program, though people with very debilitating addictions may need the structure and intensive treatment of a live-in rehab program. Attending a support group may also be extremely beneficial to someone who is in recovery and, often, these are incorporated into other forms of treatment. Those who attend such groups are encouraged to share their experiences regarding substance use with other group members, listen to others while they share, and give back by supporting others new to recovery. Ketamine Information at a Glance Medication Name, Costs Class of Medicine Generic Name: Ketamine6 Brand Name: Ketalar6 NMDA receptor antagonist6 Form, Intake and Dosage Interactions and Complications Illicit Drug Forms: powder, liquid1 Administration Routes: ingested orally, injected, snorted, or smoked1 Dosage: Varies, no more than 60 mg/day Alcohol: Should not be used with alcohol; risk of respiratory depression 2 Prescription Drugs: Benzodiazepines, barbiturates, and opioids may increase respiratory depression.7 Effects and Adverse Reactions Substance Abuse Short-Term: Increased heart rate, disorientation, sedation, nausea, euphoria, numbness, double vision1,2 Long-Term: Loss of memory, depression, anxiety, aggression, ulcers, pain in the bladder, kidney issues, stomach problems, and breathing problems1,2 Risk of Substance Abuse: Moderate8 Signs of Abuse: Depression, change in behavior4 Physiological Problem Signs and Symptoms Dependence and Addiction Issues Withdrawal Syndrome Onset: Cravings, anxiety, feeling shaky, unusual sweating, and irregular heartbeat.3 Tolerance: Builds quickly3 Dependence: Moderate potential for dependence 1,8 Addiction: Abuse may result in addiction1 Legal Schedules and Ratings Controlled Substances Act Rating: Schedule III8 [accordion title="Rehab at American Addiction Centers"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Rehab insurance coverage"] Ambetter American Family Beacon BHO Blue Cross Blue Shield Cigna Connecticare Geisinger HCSC Harvard Pilgrim Highmark Kaiser Permanente Magellan Magnacare Meritain Health Medicare and Medicaid Optum Oxford Health Providence Qualcare Sierra Health Tricare Triwest Tufts United Healthcare UPMC Zelis [/accordion][accordion title="Rehab near me"] Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming [/accordion][accordion title="Rehab"] Choosing a rehab center Couples rehab Court ordered rehab COVID-19 and rehab Dual-diagnosis rehab Deciding you need rehab Helping a loved one go to rehab Medication asssisted rehab Preparing for rehab State-funded rehab Teen rehab Veterans rehab [/accordion][accordion title="Detox"] 24/7 detox hotlines Medical detox Dangers of detoxing at home The cost of detox [/accordion] [sources] National Institute on Drug Abuse. (2018). Commonly Abused Drug Charts: Ketamine. National Institute on Drug Abuse. (2015). Hallucinogens and Dissociative Drugs: What Are the Effects of Common Dissociative Drugs on the Brain and Body? Morgan, C.J.A., & Curran, H.V. (2011). Ketamine Use: A Review. Addiction, 107, 27-38. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington, VA: American Psychiatric Association Publishing. Substance Abuse and Mental Health Services Administration. (2006). Detoxification and Substance Abuse Treatment: A Treatment Improvement Protocol. U.S. National Library of Medicine. (2017). Ketalar-Ketamine Hydrochloride Injection. National Institute on Drug Abuse. (2014). Drug Facts: Club Drugs (GHB, Ketamine, and Rohypnol). U.S. Drug Enforcement Administration. Drug Scheduling. Hayashida, Motoi, M.D. (n.d.). An Overview of Outpatient and Inpatient Detoxification. Alcohol Health & Research World, 44-46. [/sources] ...Read more