News related to ketamine was largely unnoticed until ‘Friends’ actor Matthew Perry died from a suspected ketamine overdose.[1] This tragic event brought ketamine into the spotlight, sparking a surge of interest and concern. Suddenly, Google was flooded with queries like “what is ketamine” and “how much ketamine does it take to overdose“. Interestingly, despite its effects, which are similar to phencyclidine (PCP), overdose deaths are relatively rare.[2]

In this blog, you’ll learn what ketamine is, how much ketamine it takes to overdose, and treatment methods for suspected ketamine toxicity.

What is Ketamine?

Ketamine is an anesthetic used to induce a state of sedation.[3] This drug belongs to the dissociative anesthetics class of medications since it has hallucinogenic effects.[4] Ketamine works by distorting the user’s perception of pain, as well as sight and sound. It instantly produces a state of calm and relaxation in the user; however, it does come with a list of troubling side effects. These include immobility and amnesia, which is why it has become a popular drug of choice in cases of sexual assault.[5]

Ketamine nasal spray—esketamine (Spravato)—is currently available in a medical setting as a short-term and aesthetic treatment in humans and animals.[6] It is also used to treat treatment-resistant depression.[7]

Can You Overdose on Ketamine?

Yes, it is possible to overdose on ketamine nasal spray. However, the Centers for Disease Control and Prevention state that ketamine, as a standalone cause of an overdose death, was only detected in less than one percent of overdose cases.[8] However, ketamine was found on toxicology reports in 82% of overdose deaths involving polysubstance use. Namely, fentanyl, methamphetamine, and cocaine.[8]

Ketamine toxicity usually results from recreational use. However, it is possible to be given a toxic amount by a medical professional. Individuals who use ketamine intravenously, intramuscularly, or by sniffing or smoking it are more likely to suffer an overdose.[3]

How Much Ketamine Does it Take to Overdose?

The amount of ketamine it takes to initiate toxicity differs, depending on the patient’s weight, age, and method of administration. It is also possible to overdose on a prescribed amount of ketamine if it is combined with other central nervous system depressants such as alcohol or opioids. To avoid ingesting a toxic amount, it is best to use ketamine only as prescribed, being careful to avoid the use of medications that enhance its effects or worsen them.

What Are the Signs of Ketamine Overdose?

The signs of ketamine overdose include:[2]

• Severe confusion
• Disorientation
• Profound sedation
• Respiratory depression
• Muscle rigidity
• Depression
• Dangerously high blood pressure (hypertension)
• Rapid heart rate
• Seizures
• Coma
• Loss of consciousness

Symptoms may differ if another substance is used alongside ketamine.

Who is At Risk of a Ketamine Overdose?

Individuals at risk of ketamine overdose include, but are not limited to:[9]

• Individuals with a previous history of addiction
• Individuals with untreated mental health conditions, such as depression or anxiety
• Anyone who uses ketamine recreationally
• Anyone who uses ketamine in a method other than prescribed
• Individuals who use ketamine alongside other controlled substances
• Individuals who use more ketamine than prescribed

Is Ketamine Overdose Life-Threatening?

While ketamine toxicity can be life-threatening, especially when combined with other substances, the effects of ketamine overdose are typically short-lived. However, the person suffering an overdose must receive supportive care in a medical setting to avoid complications.

What is the Treatment for Ketamine Overdose?

Individuals presenting with ketamine toxicity, who may be unresponsive or in and out of consciousness, require immediate professional medical care in a hospital emergency room setting.

They will receive supportive care here while being monitored for signs of complications, such as suppressed breathing or an irregular heart rate. Although the effects of a ketamine overdose typically last only 15 minutes to a few hours, the emergency room physician may initiate intravenous fluids during this time to support hydration or to administer intravenous medications.

If ketamine is ingested, the patient will be provided with a 1g/kg dose of activated charcoal.[2] This is a common method of gastrointestinal decontamination. Activated charcoal works by binding to the drug in the stomach, preventing it from being absorbed into the bloodstream. In some cases, the patient will need their stomach pumped to remove ketamine.[2]

There are currently no FDA-approved medications to counter the effects of ketamine toxicity.

What to do if Someone Overdoses on Ketamine?

The best way to help someone who has taken a toxic amount of ketamine is to call 911 right away. Arriving EMTs can help stabilize the patient until they arrive for further support and evaluation.

Once discharged, your loved one might feel hesitant to discuss the reasons behind their overdose. It’s important to offer support during this period. Disparaging them could cause them to use again or withdraw from speaking about it entirely.

Instead, follow these best practices for bringing up your concerns to your loved one:[10]

• Learn more about the substance they used, in this case, ketamine
• Be sure you are in a private location away from other people
• Tell them that you are concerned about their well-being because you love them
• Express your exact concerns
• Allow them to speak and give them room by actively listening without judgment.
• Listen for the reasons why they overdose, such as having an underlying mental health condition or struggling with depression or anxiety
• Offer resources and support without pushing them into accepting them
• Create a list of the good things they have going on in their life, and remind them of these things during your discussion
• Express how strong you believe they are, and the fact that they can overcome this
• Remind them that you are there for them anytime they want to talk
• Use person-first language with a focus on health and recovery

If you or someone you know has misused ketamine and experienced an overdose, you may be facing an addiction. Treating an addiction on your own can be challenging, but with the right support, you can recover and achieve lasting sobriety.

For information about recovery from ketamine addiction or polysubstance abuse, contact Engage Wellness Missouri. We have helped thousands of individuals overcome addiction and transition to healthier, happier lives.

You’ve already taken the first step; let us help you the rest of the way.

Frequently Asked Questions