Ketamine Use Disorder Treatment
As ketamine use has expanded, both therapeutically and recreationally, we're seeing more patients with problematic patterns and medical complications. We have specific expertise in treating ketamine use disorder and its unique medical sequelae.
Specialized Expertise
A Growing Concern
Ketamine occupies a unique space: it's a legitimate anesthetic, an FDA-approved treatment for treatment-resistant depression (as esketamine/Spravato), widely used in off-label ketamine clinics, and also a common recreational drug.
This means people develop problematic ketamine use through multiple pathways, some from recreational use, others from therapeutic use that evolved into daily self-medication. Regardless of how it started, stopping turns out to be harder than people expect.
Unlike opioids or alcohol, in our experience most people can stop ketamine without physical withdrawal. That fact is usually the problem rather than the reassurance it looks like. It becomes the reason to conclude this is not really an addiction, and it sits alongside something patients describe with real bewilderment: they know they want to stop, and they do not stop.
Withdrawal symptoms do happen for some people, and when they do, stopping gets harder still. But the pull we hear about most often is stranger than withdrawal. The experience itself carries an intense salience. Its content matters to people in a way ordinary life does not, and many describe returning to the same places each time they use, where the role they occupy is larger and more important than the one waiting for them here.
Why Treatment Matters
Heavy ketamine use carries serious medical risks that many users are unaware of:
- Ketamine cystitis: Bladder damage causing urinary frequency, urgency and pain. In severe cases the bladder can require removal
- Nasal damage: Persistent congestion, crusting and damage to the septum, common with the intranasal route
- Cognitive effects: Memory impairment and difficulty with concentration that may persist
- Gastrointestinal issues: Chronic abdominal pain, known as K-cramps. Because ketamine is also an analgesic, the pain often sends people back to it for relief
- Liver and bile ducts: Chronic use can injure the bile ducts and cause cholestasis. It presents as abdominal pain, so it is easily mistaken for K-cramps, and it is worth checking rather than assuming
- Psychological dependence: Compulsive use despite mounting consequences
Our Approach
Comprehensive Assessment
We evaluate your pattern of use, any medical complications, co-occurring mental health conditions (depression, anxiety, trauma), and what role ketamine has been serving in your life. This informs a personalized treatment plan.
Medical Management
While there are no FDA-approved medications for ketamine use disorder, we can address underlying conditions (depression, anxiety, ADHD) that may be driving use, and manage medical complications like cystitis. Referral to urology when needed.
Psychotherapy
Therapy is essential, and on its own it is often not enough. Ketamine is a dissociative, and the self who wants to stop has limited access to the self who uses. That is why talking about the problem, by itself, so often fails to shift it. Our psychotherapists work with you to understand the function ketamine has served, develop alternative coping strategies, and address any underlying trauma or psychiatric conditions. We pair that work with external structure.
Structure and Separation
For most people the first real stretch of abstinence comes from distance rather than insight. That may mean drug testing, bringing in the people who already have a stake in your life, or arranging a period of residential care when outpatient structure is not enough. We treat these as scaffolding rather than consequences. With a dissociative, they are often what makes the therapy reachable at all.
Who We See
Recreational Users
Patients who started using ketamine at parties or for "self-exploration" and found it has become a daily or near-daily habit that's affecting their health, relationships, or work.
Therapeutic Ketamine Escalation
Patients who began with supervised ketamine therapy for depression and ended up at higher doses, taken more often, increasingly alone at home. Compounded ketamine shipped for unsupervised use has made this route common, and the FDA has warned that no safe dose of compounded ketamine has been established for any psychiatric indication, and that taking it at home leaves nobody present to monitor sedation or dissociation. We treat the problems created by inappropriate ketamine prescribing. The escalation is usually gradual, and it rarely feels like a decision.
Dual Diagnosis
Patients with treatment-resistant depression, PTSD, or anxiety who have been self-medicating with ketamine. We can address both the ketamine use and the underlying condition.
Medical Complications
Patients presenting with ketamine cystitis or other medical complications who need both addiction treatment and medical management of the physical sequelae.
Your Treatment Team
Paul Abramson, MD
Medical Director & Founder
Dr. Abramson comes from a multi-generational lineage of physicians.
Kelly Yi, PhD
Psychotherapist
Dr. Kelly Yi completed his doctoral training from the clinical psychology program at Sofia University in Palo Alto, CA.
Orion Harris, LMFT
Psychotherapist
Orion Harris completed his masters degree in Counseling Psychology at California Institute of Integral Studies.
The Pull Is Real
You do not need withdrawal symptoms for this to be real. Whether you're worried about your health, can't seem to stop, or are dealing with medical complications, contact us for a confidential consultation.