Ketamine is a drug used in medical and veterinary practice, it is primarily used as a dissociative anaesthetic drug used to sedate people and animals before medical operations.
It is a dissociative drug ketamine users will experience a sense of “separation” from themselves and the environment they are situated in as the chemicals in ketamine affect aspects of our perception. (4)
Scientific research has also revealed that ketamine also has medical uses for:
Recreational ketamine use has become much more common in the UK over the last 10-15 years during which time it has grown into a regularly used recreational drug throughout the world. (2,5)
Like most drugs used for medical purposes, there are several positive effects generated by taking ketamine. Psychoactive drugs like ketamine can affect our perception, emotions, mood and behaviour causing effects such as:
Ketamine takes effect in minutes which makes it ideal for recreational users as there is very little delay in them experiencing its positive effects when taken on a night out, whether this is to escape their ordinary lives or gain a positive high. (2,4)
Ketamine first became popular as a recreational drug during the evolution of the club scene in London and New York in the 1980s and then the rave culture during the 1990s.
The practice of combining ketamine with other substances such as alcohol increased in popularity in the club scene throughout the world since the turn of the 21st century.
As a result of this, there are increasing worries in the USA and UK about the significant rise in the number of recreational users mixing these two substances. (8)
This is the label given to a common practice amongst recreational users who regularly take more than one substance. This can include taking two substances within a short period in one evening or mixing them and consuming them both together as well as taking both substances regularly over the longer term. (8)
Research into polydrug (polysubstance) use has revealed that after marijuana alcohol is the next most common substance combined with ketamine by recreational users.
The reason polydrug users combine substances is to experience an even greater or more intense high and sense of euphoria than they have experienced previously. This could be because they have built up a tolerance to one substance (usually alcohol) and are seeking new ways of experiencing a greater high. (7,8)
Combing drugs with alcohol can produce very toxic effects throughout the body which can affect our internal biology causing negative consequences for the heart, our digestion and the urinary, and central nervous systems. (7,8)
It has been well established over the last 20 years, mainly thanks to the increased sophistication of medical technology that alcohol has a highly toxic effect on the human body.
The World Health Organisation states that alcohol misuse contributes to around 200 illnesses and diseases worldwide and leads to 3 million deaths per year throughout the world.
Alcohol is the primary reason for early deaths in the 16-50-year-old age range accounting for 10% of all deaths in that range. (13)
Alcohol’s harmful properties can cause internal damage throughout the body, affecting various organs (especially the liver) and biological systems including the cardiovascular system.
This is because the body is very efficient at absorbing and processing alcohol.
Even though the liver is the primary organ responsible for metabolising alcohol and eliminating it from our bodies all the tissues in the body are capable of processing alcohol.
This explains why it can cause a range of health issues both directly and indirectly, including: (5,6)
Alcohol is a central nervous system depressant as its chemicals activate the GABA neurotransmitter in the brain.
Chemicals present in alcohol slow down the activity of the central nervous system making us feel calm and relaxed and possibly lethargic with no enthusiasm or inclination to participate in any physical or mental activities.
Consuming alcohol at lower levels can make us feel good and relax us during social occasions, however, if alcohol consumption continues it will slowly begin to have a depressive effect on our central nervous system and our breathing. (5,6,11)
Alcohol and ketamine are both powerful drugs that contain harmful chemicals and whenever two such substances are mixed together there is always an interaction effect which is difficult to accurately predict.
This is mainly due to the chemical structure of each substance and how much of each substance has been taken.
Both substances are capable of producing a significant effect on our brain chemistry changing our perception, thought patterns, mood and emotions, consciousness and behaviour.
There has not been a lot of research on the specific consequences of combining ketamine and alcohol but plenty of research strongly suggests it is not a good idea at all.
This is because combing alcohol with any drug always leads to negative consequences, whether the drug in question is used for medical purposes or recreational use. (5,6)
Medications can be controlled as the dose strengths and chemical contents are clearly stated which is never the case with recreational drugs like ketamine when they are obtained on the illegal drug market.
This makes it highly unpredictable to establish exactly how it will interact with alcohol, but the strong probability is that anyone mixing the two substances will come to harm, with the end result potentially life-threatening. (11)
The full effects of ketamine are still being examined in ongoing scientific research studies so many of ketamine’s effects are not yet fully understood by scientists.
However, the fact that ketamine has so many medical benefits proves what a powerful and complex drug it is.
Combining ketamine with alcohol can lead to many aspects of our brain chemistry and functioning being affected, including our heart rate and breathing patterns. (4,14)
Mixing alcohol with ketamine is potentially a very dangerous combination and the greater the amount of each substance consumed the greater the danger.
Although even consuming a small amount of ketamine whilst drinking a lot of alcohol in the space of a few hours can lead to serious physical consequences, including:
Anyone consuming higher doses of ketamine or alcohol when mixing the two is at serious risk of having a stroke or suffering a cardiac arrest.
Research has found that combing ketamine and alcohol can lead to mental deterioration signified by confusion, memory difficulties and poor decision-making.
High levels of alcohol will have a depressive effect on the respiratory system and when an anaesthetic-based drug is mixed in this can lead to our breathing suddenly becoming slower and more laboured. (3,7)
When people mix alcohol and ketamine within one or two hours of each other they may experience several of the following symptoms:
They may also display the following severe symptoms, some of which can be life-threatening:
Scientific research has shown that there are also serious long-term implications for individuals who mix alcohol and ketamine, such as:
Unfortunately, there are from time to time media reports of young people dying from the effects of experimenting with substance combinations. For example taking ketamine and alcohol together, either at the same time or within a couple of hours of each other.
Young people or recreational users experimenting with mixing substances are very vulnerable to succumbing to the dangerous effects of mixing alcohol with ketamine if their body has not built up any tolerance to either substance. (3,7,8)
Individuals who are addicted or dependent on alcohol are more likely to become addicted to another substance because they are vulnerable to chasing a more intense high by mixing alcohol with other recreational drugs such as ketamine.
People who also need to be cautious include:
The effects of ketamine can differ depending on how much of the drug a person has taken. When taken at higher doses ketamine has a depressive effect on the central nervous system.
When ketamine is combined with other depressants such as alcohol this combination can lead to serious medical consequences possibly resulting in overdose, severe breathing difficulties, cardiac problems and seizures.
Consuming high doses of alcohol with ketamine can cause a build-up of toxic chemicals in the body because alcohol is metabolised by the liver quite slowly which can lead to a harmful accumulation in the bloodstream which causes many physical and life-threatening consequences.
Mixing ketamine and alcohol can lead to an overdose as the body is overloaded with toxic substances that can’t be processed by the liver and kidneys quickly enough.
As a result, the bloodstream and the body become poisoned as the body needs time to metabolise the two substances. (9,10)
Doctors acknowledge that it is very difficult and time-consuming to measure a precise dose of ketamine. A suitable dose of ketamine that causes the desired effect only differs slightly from an amount that could cause an overdose.
Inexperienced individuals with no poor scientific knowledge are likely to measure inaccurate doses of ketamine that could have severe consequences for themselves and/or other people if this is mixed in with alcohol as well.
Overloading the body with too many depressant substances can also lead to several psychiatric and psychological problems such as delirium (confusion), memory difficulties such as amnesia, poor coordination and motor control and mental health problems. (3,7,8)
As well as ketamine there are many other hallucinogenic drugs, these include; LSD, PCP and Dextromethorphan to name but a few.
Scientific analysis has shown that combing alcohol with any hallucinogenic drug tends to lead to the following physical and psychological consequences, which can often be severe:
Anyone who is taking ketamine is increasing the chances of them having a bad trip if they have been drinking alcohol as well.
A bad trip includes a range of intense and distressing symptoms, including visual and auditory hallucinations and other perceptual disturbances and delusions that can be quite frightening and leave the person in a vulnerable position.
Consuming high levels of ketamine and alcohol together is likely to lead to more unpleasant trips which can be exacerbated further by the current mood of the person mixing the substances and the situation they find themselves. Trips can last from half an hour up to several hours.
Other symptoms of a bad trip include:
Many recreational substance users do become dependent on more than one substance and health statistics indicate that individuals who are addicted to one substance are highly likely to become addicted to another substance.
Heavy drinkers who have developed a high tolerance to alcohol may be vulnerable to taking ketamine as well to gain a more intense high than they can obtain from drinking alcohol alone.
Because of the nature of the brain’s reward system which allows us to feel pleasure, a person who achieves a high will be highly motivated to repeat the experience which will make them very vulnerable to becoming addicted to both ketamine and alcohol. (3,7)
The increase in the number of people requiring treatment for polysubstance misuse is a worry for the UK government and healthcare providers. Patients who engage in polydrug use are less likely to have their physical and psychiatric treatment needs taken care of.
Polysubstance users are also more at risk of being violent and aggressive and have an increased risk of overdose and dying prematurely compared to patients addicted to one substance. (3,7,8)
Addiction treatment statistics reveal that clients receiving treatment for polysubstance use are less likely to achieve a successful recovery than clients who have been diagnosed with being addicted to one substance.
Because clients who are addicted to more than one substance are highly vulnerable to relapsing their treatment usually takes place in a residential setting for a minimum 28-day period to treat both their substance dependencies together.
This ensures that they are protected from any negative influences that might tempt them back into using ketamine or alcohol again.
They will also receive around-the-clock care from medical professionals who can monitor their physical and psychological health during the early stages of treatment. (5,6)
Treatment specialists will be required to organise detox treatments for both alcohol and ketamine dependence as part of the client’s treatment plan as well as a range of psychological therapies and treatments, including:
It is likely that many clients with polysubstance use may well be in treatment for 2-3 months due to the complexity of their condition.
However, this does not necessarily mean that they will spend all of that time in residential care as they may join an outpatient service for treatment after spending 4-6 weeks receiving inpatient care in a residential setting. (5,11)
(1) Black, D., Grant, J. (2013) DSM5 Guidebook: The Essential Companion to Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. APP. London.
(2) Brown University, USA, (2023) What are the short-term effects or risks of using ketamine?available@What are the short-term effects or risks of using ketamine? | Health Promotion | Brown University
(3) Crummy, E., O’Neal, J. & Ferguson, S. (2020) One is not enough: Understanding and modelling polysubstance use. Frontiers in Neuroscience. available@ One Is Not Enough: Understanding and Modeling Polysubstance Use – PMC (nih.gov)
(4) Department of Justice / Drug Enforcement Agency (2022) Ketamine Fact Sheet. available@Drug Fact Sheet: Ketamine (dea.gov)
(5) Ghodse, H. (2002) Drugs and Addictive Behaviour: A guide to treatment Cambridge University Press.
(6) Herie, A. & Skinner, W. (ed) (2014) Fundamentals of Addiction: A Practical Guide for Counsellors. CAMH. Canada.
(7) Kobayashi, N. et al (2022) Ketamine plus Alcohol: What We Know and What We Can Expect about This. International Journal of Molecular sciences. Jul 23(14). available@ Ketamine plus Alcohol: What We Know and What We Can Expect about This – PMC (nih.gov)
(8) Lankeneau, S., Clatts, M. (2005) Patterns of Polydrug Use Among Ketamine Injectors in New York City. Substance Use Misuse. 40 (9-10). available@ Patterns of Polydrug Use Among Ketamine Injectors in New York City – PMC (nih.gov)
(9) NI Direct (2022) Mixing alcohol with other drugs. available@Mixing alcohol with other drugs | nidirect
(10) Public Health Agency (2022) Mixing: Reduce your risk of harm. available@ Mixing_leaflet_05_2019.pdf (hscni.net)
(11) Rassool, G.H. (2011) Understanding Addictive Behaviours. Palgrave MacMillan. New York.
(12) University of Michigan (2022). The Effects of combining alcohol with other drugs. available@The Effects of Combining Alcohol with Other Drugs | University Health Service (umich.edu)
(13) World Health Organisation (2022) Alcohol. available@Harmful use of alcohol (who.int)
(14) Yin, H, (2021) What ketamine actually does to the brain. New Frontiers: Psychiatric and TMS.available@What ketamine actually does to the brain – New Frontiers Psychiatry & TMS | Milwaukee Psychiatrist
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
