Ketamine Tolerance: Are There Risks?

Medically Reviewed by Johnelle Smith, M.D. on September 2, 2022

Ketamine is a medical anesthetic that is also used and abused as a recreational drug. It is known for producing powerful hallucinations and dissociative effects, and it is not difficult for people to build up a tolerance to it.

Ketamine Tolerance: Are There Risks?

Ketamine is a medication that is used during surgery to sedate a person and make them lose consciousness. It is also known to reduce pain.

Because of its sedative qualities, ketamine is sometimes used as a date rape drug. On the street ketamine is known as Special K, Ket, or K.More recently, ketamine has also been used as an antidepressant.

Regardless of how ketamine is used or what it’s called, people who abuse the drug can develop a tolerance to its effects.

Is It Possible To Develop A Tolerance To Ketamine?

As a dissociative anesthetic like PCP, ketamine can lead to a high that is described as euphoric and strong, usually accompanied by vivid hallucinations.

Dependence and addiction to ketamine are both very rare. Any addiction for ketamine is purely psychological and will cause no physical withdrawal symptoms. A person may experience strong cravings, though.

However, it is still highly possible to develop a tolerance to ketamine after repeatedly taking high doses of the drug.

When this happens, a person will start to require higher and higher doses of ketamine in order to reach their baseline.

When taken legally, ketamine comes in either pill form or can be taken through intravenous methods and ketamine infusions.

The preferred method of ketamine administration when used recreationally, however, is to crush it and snort it. A drug tolerance can occur through either method.


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Factors That Influence Ketamine Tolerance

The rate at which development of tolerance happens will be different for everyone and depend on a few factors. For instance, tolerance to almost any substance is usually affected by a person’s size and weight.

The biggest influence will undoubtedly be how much ketamine a person takes and in how little time. The more frequently ketamine is used and the higher the doses, the faster a person will build up a tolerance.

It is also possible for someone’s tolerance to ketamine to be affected by their use of other drugs with similar attributes, called cross-tolerance.

In addition to cross-tolerance, it is risky to take ketamine doses with other drugs, such as alcohol, prescription opioids, and opiates as this can increase a person’s risk of overdose and death.

Risks Of Ketamine Tolerance: The K-Hole

While ketamine addiction is not necessarily a risk, there are still many adverse effects and uncomfortable side effects that can be experienced with this drug.

When large doses of ketamine are taken, a person can have what is called a “K-Hole”. This is typically thought of as one of the more unpleasant effects of ketamine.

During a K-Hole, a person may be unable to move or speak and experience a slowed heart rate and slow breathing.

The risk of experiencing a K-Hole becomes stronger the more ketamine a person takes. As a person builds up a tolerance and consistently takes more, they are putting themselves at risk for a K-Hole.


When the use of ketamine is enough to cause a K-Hole, a person may experience regular and scary flashbacks of the event later, even when they are not high.


Ketamine use can produce powerful hallucinations during which the person may either see or hear things that are not happening.

Its hallucinogenic properties have been compared to those of LCD and other psychoactive drugs.

Aggressive Behavior

During a K-Hole, a person may have very little or no control of what they are doing and may behave in ways that are uncharacteristic of them, including acting aggressively.

Memory Loss

After a K-Hole experience, a person may have little recollection of what happened during it. When ketamine is abused repeatedly, it can cause permanent memory impairment.

Is Ketamine Tolerance Reversible?

It is possible to reverse a ketamine tolerance but it can take some time, such as the tolerance took time to build up in the first place.

Just as a person becomes more tolerant to ketamine as they use more of it more frequently, they can reverse this by using less of the drug less frequently.

The best way to reduce a person’s tolerance to ketamine is to stop using it completely for an extended period of time.

Treatment Programs For Ketamine Abuse

While ketamine is not known to be particularly addictive, it can still be dangerous when regularly abused.

Treatment programs are widely available for treating a variety of drug and alcohol use disorders, including ketamine abuse.

Treatment programs for ketamine and other types of drug abuse include:

  • outpatient programs
  • inpatient programs
  • day treatment
  • medical detox
  • medication management
  • case management
  • peer support
  • aftercare support

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This page does not provide medical advice. See more

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Medically Reviewed by
Johnelle Smith, M.D. on September 2, 2022


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