Is Ketamine Addictive?
While ketamine can be addictive, it's safest under clinical supervision.
Updated December 5, 2025 | Reviewed by Lybi Ma
Ketamine Has a Low Addiction Potential in a Clinical Setting
Ketamine is an anesthetic agent, used off-label as a novel, rapid-acting antidepressant . For many people with treatment-resistant depression , ketamine and Spravato (an FDA-approved version of ketamine) are life-changing. But isn't ketamine that drug people take at raves? Isn't it addictive?
When ketamine is delivered in a controlled clinical environment, the risk of addiction is extremely low. However, ketamine does have abuse potential, with misuse occurring primarily outside medical settings—recreationally, at high frequency, and at doses far above antidepressant doses. Fortunately, there have been no cases of ketamine addiction developing within clinical trials for depression. Furthermore, long-term follow-ups show no development of physiologic dependence, even after months to years. Studies have also shown that ketamine's addiction potential is markedly lower than benzodiazepines, stimulants, cocaine, and opioids.
Patients with Active Addictions Are More at Risk
However, the risk of ketamine addiction is not zero. The tragedy surrounding Matthew Perry’s death is a grave reminder. Perry had a long history of polysubstance dependence, and sadly began using more and more ketamine outside the clinical setting, resulting in addiction and death. Given the potential for ketamine addiction, the rise of ketamine telehealth companies, driven by profit, is worrisome. Low barriers to receiving large supplies of at-home ketamine may foster addiction in this vulnerable patient population.
Evidence Shows Ketamine May Help Treat Addiction
Ironically, this addictive molecule is also capable of treating addictions in some patients. Small studies have demonstrated that ketamine helps to decrease cravings and maintain sobriety for those struggling with substances, including alcohol , cocaine, opioids, and stimulants. In addition, there is some evidence that ketamine may help ease withdrawal for opioid dependence and alcohol.
How Might Ketamine Work to Treat Addiction?
Perhaps most importantly, ketamine helps to treat the underlying depression, anxiety , and trauma fueling one's addictive behaviors. There is less need to escape life when suffering is decreased. Secondly, ketamine appears to lessen cravings for substances, which may be related to its physiological effect on the opioid receptor. There is also speculation that the potential for a mystical experience during a ketamine experience may be correlated with quitting an addiction. In addition, there is an intriguing study about ketamine playing a role in disrupting memories involved in addiction and cravings, creating a window to rewrite these memories and alter maladaptive associations.
Psychedelic Medicine for Opioid Addiction?
Evidence is mounting that many psychedelics may play a powerful role in treating addiction in the future. For example, Ibogaine, a psychedelic extracted from the bark of a West African shrub, has shown promising results in treating opioid addiction. Small psilocybin studies have demonstrated success in treating tobacco and alcohol dependence. We clearly need more research with these powerful medicines in the area of addiction to unlock their potential to heal.
In summary, ketamine is less addictive than many substances, but the risk is not zero. Taking ketamine in a clinic setting will lessen the risk of abuse and diversion, and may be the safest way to prevent ketamine addiction. In the future, ketamine may have a role to play in treating addictions. But first, we need more research to help determine who ketamine may help and who it may hurt.
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Gail Serruya, M.D., is a psychiatrist with years of training in psychotherapy, who recently founded Voyage Healing PC, a ketamine-assisted psychotherapy clinic in Philadelphia.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.