Beyond the High: A Narrative Review of the Chronic Complications of Recreational Ketamine Use.

Chronic, high-dose recreational ketamine use is associated with dependence and long-term complications affecting the urinary tract, nervous system, mental health, and liver. This narrative review describes these complications and emphasizes the need for clinicians to recognize them early for proper investigation and management.

Study at a glance

Abstract

Ketamine, initially developed as a dissociative anaesthetic, has seen expanding therapeutic applications, in managing treatment-resistant depression and chronic pain. However, its psychoactive properties have also been associated with a significant rise in recreational use globally. Chronic, high-dose recreational ketamine use is associated with dependence potential and a spectrum of long-term complications affecting multiple organ systems. This narrative review details the major chronic urological, neurological, neuropsychiatric and hepatobiliary complications that clinicians may encounter in individuals with long-term ketamine use, along with an overview of the potential risk of dependence. This review highlights the importance of heightened awareness among clinicians of the issues related to long-term ketamine use, enabling early identification and prompt, appropriate investigation and management.