Is Ketamine an Opioid?

The Home Office has said that it is seeking expert advice on changing ketamine classification from Class B to Class A, which is generally seen  as the most harmful and potentially harmful substances. This follows a surge in use, with an estimated 269,000 people aged 16-59 reported ketamine use in the year to 2024.

Even as use of ketamine increases, however, there remains some confusion about what the drug actually is, how it works and what the potential risks are. Here we’ll take a look at some of the issues surrounding this drug and answer the question, ‘Is ketamine an opioid?’

What Is Ketamine?

Ketamine is a type of drug known as a dissociative anaesthetic. It was first developed in the early 1960s and used as a battlefield anaesthetic and later as a veterinary drug – you may have heard of ketamine being referred to as a ‘horse tranquiliser’.

It is also used as an anaesthetic for human patients, but this is not common and it is typically only used where other drugs have not been effective. The use of ketamine to treat mental health conditions including depression is also being explored, but the drug is not currently licenced for such use in the UK.

Ketamine is increasingly being used as a recreational drug, due largely to its ability to produce dissociative sensations and hallucinations.

Is Ketamine an Opioid?

The short answer is no, ketamine is not an opioid. Opioids are a specific class of drug that are either derived from, or mimic the effects of, parts of the opium poppy plant. These can include natural opioids like opium and morphine, semi-synthetic opioids such as heroin and entirely synthetic opioids such as fentanyl.

Opioids can come in different strengths and have different effects but they all work in broadly the same way, by affecting molecules known as opioid receptors on nerve cells in the brain, the spinal cord and elsewhere in the body.

Ketamine might also interact with opioid receptors but that is not the main mechanism for the drugs effects. It primarily acts on NMDA receptors and the ketamine drug type is generally regarded to be that of dissociative anaesthetics. These are characterised by distorted sensory perceptions and feelings of detachment from the environment and oneself.

Why the Confusion?

There are a number of reasons why some people may believe that ketamine is an opioid.

Both may be used as painkillers and ketamine may sometimes be used alongside opioids – either legitimately in a medical setting or misused recreationally.

When considering ketamine vs opioids, there are also some similar effects that people might intentionally seek out, including sedation and a sense of euphoria.

As mentioned, there is some evidence that ketamine may have an effect on opioid receptors. A drug called naltrexone, which is used to reverse accidental opioid overdoses, works by binding to opioid receptors on the surface of brain cells, preventing opioids like heroin or opium from working on them. Researchers observed that naltrexone also blocks the antidepressant effects of ketamine but this does not necessarily mean that the mechanism is the same in both cases. NDMA receptors, which are involved with learning and memory, are located alongside opioid receptors and some researchers believe ketamine affects these receptors instead.

Is Ketamine Addictive?

Opioids like heroin and synthetic opioids like fentanyl can be highly addictive, with effects including both psychological and physical dependency. This physical dependency can lead to severe withdrawal symptoms that can be very unpleasant and potentially life-threatening. Official government guidance warns that opioid medications can lead to addiction even when it is used as prescribed – especially with long-term use.

Ketamine is not generally considered to be as physically addictive as opioids but there is a potential for psychological dependency. This can lead to compulsive and increasing use of the drug and can be very difficult to break free from without expert help and drug addiction treatment.

The largest study to date to explore the experience of people living with ketamine addiction found commonly occurring psychological symptoms including cravings, low mood, anxiety and irritability. It also found that some people continued to use ketamine to help deal with physical problems such as bladder damage that had already been caused by the drug – leading to a vicious cycle of more misuse and worsening symptoms.

Health Risks of Ketamine Abuse

Even when used in a controlled environment, the NHS lists a number of potential ketamine side effects including:

• Nausea/vomiting
• Anxiety
• Headache
• Tinnitus (a ringing in the ears)
• Increased blood pressure and heart rate
• Hallucinations
• Mania

Long-term potentially serious side effects include damage to the liver and bladder. Ketamine bladder syndrome is a very painful condition that can cause long-term issues including incontinence and ulcers in the bladder.

Ketamine use is also linked to psychological and neurological issues such as cognitive impairment, mood disorders, psychotic and dissociative symptoms. The drug can produce a severe dissociative state commonly known as a ‘K-hole’, which can cause lasting psychological damage to some people.

Dual diagnosis or mental health treatment options may be required to help some individuals to deal with the psychological impact of ketamine use.

There may also be increased risks when mixing ketamine with other substances, especially depressants or alcohol.

Getting Help for Ketamine Misuse

If you recognise ketamine abuse signs in yourself or a loved one, it may be time to seek professional help. Ketamine addiction UK specialists like Asana Lodge can offer evidence-backed treatment and rehab programmes to address every aspect of the addiction.

This may include elements such as supervised and medically assisted detox and a range of psychological therapies such as cognitive behavioural therapy (CBT), group therapy and one-to-one counselling.

Know the Facts, Seek Support

Ketamine misuse can be very harmful and ketamine addiction can be extremely difficult to break free from. It can be overcome with the right support and ketamine treatment options, however.

If you want to move on from this damaging drug, or help a loved one to do so, contact Asana Lodge today for confidential advice or assessment.